Article: FDA busts myths of preventing and treating cancer by eating apricot kernels, herbs, and other ingredients

Dietary Supplements

National Comprehensive Cancer Network (NCCN) guidelines on survivorship include the following recommendations on dietary supplement use:

• Taking dietary supplements is not recommended for most cancer survivors unless a patient has a known nutritional deficit, an inadequate diet or other indication (for example, osteoporosis).
• Little data exist to support the use of vitamins or other dietary supplements for cancer prevention, control or recurrence.
• Taking vitamin supplements does not replace the need for a healthy diet. Patients should try to get nutrients from the foods they eat and the beverages they drink.
• Providers should ask about supplement use at regular intervals, about a patient’s reasons for using supplements and the ingredients in those supplements.
• Survivors of certain cancers are at risk of vitamin deficiencies based on cancer treatment (e.g., gastric cancer patients who have had a gastrectomy may be at risk of vitamin B12 and iron deficiencies).
• NCCN recommends calcium and vitamin D supplements for people who have been prescribed denosumab or a bisphosphonate to treat bone metastasis or osteoporosis.
• Patients taking multiple supplements and those in need of nutritional support should be referred to a registered dietitian or nutritionist, preferably one who is trained in supporting oncology patients. 

Updated: 05/20/2022

The American Society of Clinical Oncology (ASCO) endorses the Society for Integrative Oncology (SIO) guidelines recommending the following evidence-based integrative therapies for reducing fatigue, pain, anxiety and depression.

Fatigue

To reduce fatigue during cancer treatment, the SIO recommends:

• Exercise
• Cognitive behavioral therapy (CBT) uses exercises and skills to reduce symptoms
• Mindfulness-based programs
• Tai chi, a Chinese martial art, is composed of gentle, low-impact exercises while focusing on deep, slow breathing
• Qigong is a Chinese practice using movement, body posture, breathing and meditation to optimize energy within the body, mind and spirit.
• American ginseng, an herb 
• Psychoeducation, an intervention for patients and their loved ones provides information and support to better understand and cope with illness

To reduce fatigue after cancer treatment the SIO recommends:

• Exercise
• CBT
• Mindfulness-based programs
• Yoga
• Acupressure
• Moxibustion (a type of therapy that involves burning the leaves of mugwort—a small spongy herb—close to the skin)
  
  CBT and mindfulness-based programs are particularly effective for managing moderate to severe fatigue after treatment.

Pain

To reduce pain, the SIO recommends:

• Acupuncture for aromatase inhibitor-related joint pain
• Acupuncture, reflexology or acupressure for general cancer pain or musculoskeletal pain
• Hypnosis for patients who experience pain after a procedure
• Massage for patients experiencing pain during palliative care

ASCO provides guidelines on the use of opioids to reduce pain in cancer patients:

• Should be offered to patients experiencing moderate-to-severe pain from cancer or cancer treatment
• Starting dose should be the lowest possible
• For patients with substance use issues, clinicians should collaborate with a palliative care, pain and/or substance use disorder specialist(s)
• Patients should be monitored for adverse effects

Anxiety

To reduce anxiety during cancer treatment, the SIO recommends:

• Mindfulness-based programs, yoga, relaxation, music therapy, reflexology and aromatherapy (using inhalation)

To reduce anxiety after cancer treatment, the SIO recommends:

• Mindfulness-based programs, yoga, acupuncture, tai chi or qigong and reflexology

Depression

To reduce depression during treatment, the SIO recommends:

• Mindfulness-based programs, yoga, music therapy, relaxation and reflexology.

To reduce depression after treatment, the SIO recommends:

• Mindfulness-based programs, yoga, tai chi or qigong.

Updated: 07/02/2024

The following resources can help you locate a nutritionist near you or via telehealth

Finding nutritionists

• You can find a registered dietician in your area through Eatright.org, the website for the Academy of Nutrition and Dietetics. Search for nutritionists by specialty, including "cancer," "weight management" and "heart health."

Related experts

• The Livestrong at the YMCA program includes a free 12-week membership and fitness training with certified exercise experts. You can search by zip code for a program near you.  

Other ways to find experts

• Register for the FORCE Message Boards and post on the Find a Specialist board to connect with other people who share your situation. 
• The National Cancer Institute (NCI)-Designated Comprehensive Cancer Centers have specialists to manage the symptoms and side effects of cancer prevention or treatment. 
• FORCE partners with Savor Health® to provide free, personalized, evidence-based nutrition support 24/7 and “on-demand" through their text-based Intelligent Nutrition Assistant (Ina®). You can subscribe here.

Updated: 11/20/2023