complementary

Stimulating the P6 point on the inner wrist, with needles, electrical stimulation or a pressure band, adds a small further reduction in chemotherapy vomiting on top of modern anti-sickness drugs. It is safe and cheap, and guidelines say it can be offered.

Joint pain and stiffness are the main reason women stop aromatase-inhibitor tablets early. In a large randomised trial, twelve weeks of acupuncture reduced that pain more than sham needling or no treatment, and the benefit lasted after the sessions ended.

Numb, tingling or painful hands and feet after taxanes, platinum or bortezomib have no proven preventive treatment. Small trials suggest acupuncture may ease the symptoms, but they are too small and inconsistent to be sure, so it is an option to try inside a trial or with careful tracking rather than an established treatment.

Radiotherapy to the head and neck can permanently dry the mouth. A randomised trial in the United States and China found that acupuncture given during radiotherapy reduced dry mouth a year later compared with standard care, an effect that needs confirming.

Hot flushes on tamoxifen or aromatase inhibitors are common and hormone replacement is off the table. Acupuncture reduced flushes in several randomised trials, in one about as well as the drug gabapentin and with fewer side effects, though sham-controlled results are mixed.

Complementary approaches used alongside treatment can help with symptoms. Choosing an alternative therapy instead of surgery, chemotherapy, radiotherapy or hormone therapy is a different decision: in a national US database, people who did so were two and a half times as likely to die within the study period, and more than five times as likely with breast cancer.

In a randomised placebo-controlled trial of 364 people, eight weeks of Wisconsin American ginseng modestly improved cancer-related fatigue, mainly in those still on treatment. The 2024 fatigue guideline says it may be offered during treatment; quality of the product matters.

Antineoplastons are peptide fractions first isolated from urine and given at one private clinic in Texas for nearly fifty years, mostly to children with brain tumours. Despite dozens of registered trials, none has been published in full, no independent group has confirmed benefit, and the treatment is expensive and causes serious salt imbalance.

Scented essential oils, alone or with massage, are pleasant and may briefly ease anxiety or nausea, but the trials are small and a Cochrane review found no reliable evidence that adding aromatherapy to massage does anything more than massage alone.

Ayurveda, the traditional medicine of India, offers diet, yoga, herbs and mineral preparations. Yoga has good evidence in its own right; the herbal and mineral remedies have not been shown to treat cancer, and a fifth of products sold online contained lead, mercury or arsenic in one study.

Eyelashes and eyebrows often fall out with chemotherapy and can be slow to return. Bimatoprost, a glaucoma eye drop approved for thin lashes, applied along the lash line each night increased lash length and thickness in a randomised trial that included people after chemotherapy.

Black salve is a corrosive paste containing bloodroot and zinc chloride sold online to 'draw out' skin cancers. It burns whatever it touches, leaves disfiguring scars, does not reliably remove the cancer, and has let melanomas spread while people believed they were cured.

Two synthetic cannabinoid tablets, dronabinol and nabilone, have been approved for chemotherapy nausea since 1985 and can help when standard anti-sickness drugs fail. Modern antiemetics work better for most people, and evidence for herbal cannabis or vaped products is thin.

Cannabis and cannabinoids are used by patients for pain, appetite and sleep. Three phase 3 trials of a THC:CBD mouth spray added to opioids did not beat placebo for cancer pain, dronabinol failed for appetite, and no human trial shows tumour control, so ASCO's 2024 guideline advises against them as cancer treatment outside a trial.

A brief hypnosis session before breast surgery or a biopsy reduces pain, nausea and anxiety afterwards, and a course of hypnosis roughly halved hot flushes in one randomised trial. It is a skill some psychologists offer, not a stage act.

Cancer-related fatigue and anxiety respond to structured talking therapy that targets the thoughts and habits that keep them going. Randomised trials show benefits during treatment and, for persistent fatigue, years afterwards; guidelines recommend it.

Insomnia is one of the most persistent problems after cancer treatment. A short structured talking therapy that retrains sleep habits works better and for longer than sleeping tablets, and digital versions bring it to people who cannot reach a therapist.

Arm or leg swelling after lymph node surgery or radiotherapy is managed with compression garments, specialised massage, skin care and exercise. Weight lifting, once forbidden, was shown in a randomised trial to reduce flare-ups rather than cause them.

Curcumin, the yellow pigment in turmeric, kills cancer cells in a dish and is one of the most studied supplements, but it is barely absorbed from the gut and no randomised trial has shown it treats cancer in people. Cooking with turmeric is fine; high-dose capsules can interact with chemotherapy and blood thinners.

Dance and movement therapy is enjoyable and a form of exercise, and small trials hint at better quality of life and mood in women with breast cancer, but a Cochrane review found too little evidence to judge whether it helps beyond that.

Essiac tea, Hoxsey tonic and similar herbal mixtures have been sold as cancer cures for a century. Laboratory tests and reviews by the NCI and Canadian regulators found no anticancer effect, and the clinics that sell them have never produced a controlled trial.

Dog dewormers and anti-parasite drugs are promoted on social media as hidden cancer cures on the strength of cell-culture experiments and anecdotes. No clinical trial shows benefit in people, liver damage has been reported, and drug repurposing is real but works through trials, not forums.

Fish oil rich in EPA was expected to slow cancer-related muscle wasting by damping inflammation. Randomised trials and a Cochrane review found no convincing effect on weight or survival, though fish oil is safe and sits comfortably inside general nutritional support.

Wearing frozen gloves and socks, or tight surgical gloves, during taxane infusions reduces nail damage and may reduce numbness in the hands and feet, by narrowing the blood vessels while the drug is at its peak. Trials are small but consistent, and it is cheap.

The Gerson regimen prescribes hourly juices, a strict low-salt vegetarian diet, supplements and several coffee enemas a day, and is sold at clinics in Mexico. It has never shown benefit in any controlled study, and coffee enemas have caused fatal electrolyte disturbances and infections.

Ginger capsules taken alongside standard anti-sickness drugs reduced nausea in the largest randomised trial, but other trials found no effect and the doses and products vary. It is safe for most people, with a caution about bleeding for anyone on anticoagulants.

Oral glutamine, an amino acid that gut and mouth lining cells use for fuel, may reduce the severity of mouth ulcers during head and neck chemoradiation; mucositis guidelines suggest it for that use. Intravenous glutamine in transplant patients is not recommended, and evidence for preventing nerve damage is thin.

Drinking green tea is safe and pleasant, but a Cochrane review found no consistent evidence that it prevents cancer, and concentrated green tea extract capsules have caused liver injury and can interfere with some drugs.

Vitamin C tablets do not treat cancer: two randomised trials at the Mayo Clinic settled that in the 1980s. Intravenous doses reach blood levels high enough to generate hydrogen peroxide in tumours, and small trials alongside chemotherapy are under way, but no adequately sized trial has yet shown benefit.

Homeopathic remedies are diluted until no molecules of the starting substance remain, so any effect would need new physics. A Cochrane review of trials for chemotherapy and radiotherapy side effects found no convincing evidence that they work; they are harmless as long as they do not replace real treatment.

Swallowing honey before and after head and neck radiotherapy sessions reduced mouth ulcers in several small trials, mostly from single centres, but the studies are of low quality and mucositis guidelines could not make a recommendation either way.

Hydrazine sulfate was promoted in the 1970s and 80s to reverse cancer weight loss and prolong life. Three large randomised trials sponsored by the National Cancer Institute found no benefit and more side effects, and the compound is a suspected carcinogen.

Breathing pure oxygen in a pressurised chamber, over 30 to 40 sessions, helps heal radiation damage to the jaw, bladder and bowel that appears years after treatment. A Cochrane review found moderate-quality evidence of benefit for these sites, and little for others.

Laetrile, sold as vitamin B17 or apricot kernel extract, was tested in a large National Cancer Institute study in the 1980s and did nothing against cancer. It releases cyanide in the gut, and people have been poisoned by it.

Gentle massage by a trained oncology massage therapist gives short-term relief of pain, anxiety and mood in people with advanced cancer, shown in a randomised trial of 380 patients. It is safe when pressure is adapted around tumours, bone metastases, ports and low platelet counts.

Reishi, turkey tail, shiitake, maitake and cordyceps extracts are rich in beta-glucans that stimulate natural killer cells in the laboratory and are sold as supplements to people with cancer. A 2016 Cochrane review found five small, poor-quality reishi trials and no evidence it treats cancer; the other species lack randomised efficacy trials, and rare liver toxicity is reported.

Melatonin helps some people sleep and is safe at usual doses, but the claim that high-dose melatonin improves survival rests on a series of small unblinded trials from one group that has never been reproduced elsewhere. It is not a cancer treatment.

Structured eight-week mindfulness courses reduce anxiety and low mood during and after cancer treatment, with dozens of randomised trials behind them. Guidelines from ASCO and the Society for Integrative Oncology recommend them as a first option alongside, not instead of, psychological care.

Most hair grows back after chemotherapy, but a minority, especially after docetaxel, are left with thin hair, and tamoxifen and aromatase inhibitors cause gradual thinning. Minoxidil lotion or low-dose tablets, the same treatment used for pattern hair loss, improved regrowth in most patients in dermatology series and shortened regrowth time in an early randomised trial.

Injectable mistletoe extracts are the most prescribed complementary cancer treatment in German-speaking Europe. Decades of studies have not shown that they lengthen life; some suggest better quality of life during chemotherapy, but the trials are weak and the largest well-run ones were negative.

Listening to music, or working with a trained music therapist, reduces anxiety, pain and fatigue during cancer treatment in a Cochrane review of more than 80 trials. The effects are real but modest, and the evidence is of low to moderate certainty because blinding is impossible.

Sucking ice chips for half an hour around a bolus dose of fluorouracil or high-dose melphalan roughly halves the risk of painful mouth ulcers. It costs nothing and is recommended in international mucositis guidelines.

Meeting others in the same situation reduces distress and isolation, and randomised trials of supportive-expressive groups show better mood and pain coping. The once-famous claim that support groups lengthen survival did not hold up in a larger trial.

Shining low-power red or near-infrared light on the inside of the mouth before and during treatment prevents severe mouth ulcers in people having head and neck radiotherapy or high-dose chemotherapy for transplant. Mucositis guidelines recommend it, though few centres yet have the equipment.

Probiotic supplements (Lactobacillus, Bifidobacterium) may reduce diarrhoea during pelvic radiotherapy for cervical, rectal and prostate cancer and some chemotherapy, but a 2018 Cochrane review rated the evidence low certainty and strains differ between trials. Patients in profound neutropenia or with a central line should not take them without advice, because bloodstream infections have occurred.

PSK, a protein-bound polysaccharide from the turkey tail mushroom, has been an approved adjuvant cancer drug in Japan since 1977. Meta-analyses of Japanese randomised trials in stomach and bowel cancer found a modest survival benefit added to chemotherapy, but these results have never been tested outside Japan.

Reflexology is foot massage guided by a map of the body that has no anatomical basis. Small trials report short-lived relaxation and pain relief similar to any gentle foot massage; guidelines list it as an option for pain only with low confidence.

Reiki and similar practices involve a practitioner holding hands on or near the body to channel an 'energy' that has never been detected. Trials show relaxation similar to sham sessions; they are harmless as rest, but they treat nothing.

Progressive muscle relaxation, breathing exercises and guided imagery are simple techniques that reduce anxiety and treatment-related distress during chemotherapy and radiotherapy. Guidelines say they may be offered, and audio versions cost nothing.

A tightly fitted cap chilled to a few degrees above freezing, worn before, during and after each chemotherapy infusion, narrows the blood vessels of the scalp so less drug reaches the hair roots. In a randomised trial about half of women on taxane-based chemotherapy kept most of their hair, compared with none who went without.

In the first randomised trial of a modern scalp cooling system, half the women who used the Paxman device during taxane or anthracycline chemotherapy for early breast cancer kept most of their hair, compared with none of those who did not.

The idea that sharks do not get cancer (they do) launched a supplement industry. Two randomised trials, including a large phase 3 in lung cancer, found that shark cartilage extract does nothing for survival, and the trade contributed to shark population declines.

St John's wort is a herbal antidepressant whose active ingredient hyperforin switches on the liver enzyme CYP3A4 and the P-glycoprotein pump, cutting blood levels of irinotecan's active metabolite by 42% and imatinib by about a third. It is contraindicated with most tyrosine kinase, CDK4/6 and PARP inhibitors, and its effect lasts two weeks after stopping.

Slow, low-impact movement practices from Chinese tradition improve fatigue, sleep and balance in people with cancer. Randomised trials are moderately sized and positive, and the 2024 fatigue guideline recommends them during treatment.

Traditional Chinese herbal medicine prescribes individualised multi-herb decoctions, taken by most cancer patients in China to reduce chemotherapy side effects. Cochrane reviews found the hundreds of trials small, unblinded and poorly reported, so whether they help is unknown, and some herbs damage the liver or interact with tyrosine kinase inhibitors through CYP3A4.

People with curable breast, lung or bowel cancer who chose alternative medicine instead of conventional treatment were two and a half times as likely to die during follow-up as matched patients who had standard treatment.

A wig, scarf or cap restores privacy and confidence during hair loss. In the UK wigs come on NHS prescription, free in Scotland, Wales and Northern Ireland and in England for children, students under 19 and people on qualifying benefits; in the US a prescription for a 'cranial prosthesis' lets some insurers reimburse one, and charities give wigs free.

Yoga combining postures, breathing and relaxation reduces fatigue, anxiety and low mood and improves sleep and quality of life, on the evidence of a Cochrane review of 24 randomised trials in women with breast cancer. SIO-ASCO guidelines recommend it for fatigue and anxiety during treatment; it does not replace aerobic and resistance exercise.