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DEFINITIONS

Traditional medicine
It is the sum total of the knowledge, skills and practices based on the theories, beliefs and experiences
indigenous to different cultures, whether explicable or not, used in the maintenance of health, as well as in the
prevention, diagnosis, improvement or treatment of physical and mental illnesses. The terms
complementary/alternative/non-conventional medicine are used interchangeably with traditional medicine in
some countries. (WHO)

CAM
“Complementary and alternative medicine, as defined by NCCAM, is a group of diverse medical and health
care systems, practices, and products that are not presently considered to be part of conventional medicine.

“Complementary medicine”
refers to use of CAM together with conventional medicine, such as using acupuncture in addition to usual
care to help lessen pain.

“Alternative medicine”
refers to use of CAM in place of conventional medicine.

“Integrative medicine” (also called integrated medicine)

refers to a practice that combines both conventional and CAM treatments for which there is evidence of safety
and effectiveness.

Differences Between Conventional and Alternative Medicine

Factor Conventional Medicine Alternative Medicine
Definition of health Normal function (ie, absence of Optimal balance, resilience, and integrity
specific disease or dysfunction) of the body, mind, and spirit, and their
interrelationships
Definition of illness Disease based: Dysfunction of Symptom and individual based:
organs or biochemical processes Imbalance of body, mind, and spirit
Concept of life force Life processes that involve A nonphysical life force that unites mind
physical and biochemical events and body, interconnects all living beings,
and not a nonphysical life force and is the underpinning of health
Understanding of Results only from physical Not localized to the brain; can exert
consciousness processes in the brain healing effects on the body
Method of treatment External interventions (eg, drugs, Support and strengthening of patients'
surgery, radiation therapy) inherent capacity for self-healing

GOAL of CAM
The goal of complementary medicine is to balance the whole person — physically, mentally, and emotionally
— while conventional medicine does its work. For many people, complementary medicine has helped to:
 relieve symptoms
 ease treatment side effects
 improve quality of life

Types of CAM
CAM practices are often grouped into broad categories, such as natural products, mind-body medicine, and
manipulative and body-based practices. Although these categories are not formally defined, they are useful for
discussing CAM practices. Some CAM practices may fit into more than one category.
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The National Center for Complementary and Alternative Medicine Classifies Alternative Therapies Into Five
Categories:

1. Whole/Alternative Medical Systems

Alternative medical systems are built upon complete systems of theory and practice. Often, these systems
have evolved apart from and earlier than the conventional medical approach used in the U.S. Examples of
alternative medical systems that have developed in Western cultures include homeopathic medicine and
naturopathic medicine. Examples of systems that have developed in non-Western cultures include traditional
Chinese medicine and Ayurveda.

2. Mind-Body Interventions
Mind-body medicine uses a variety of techniques designed to enhance the mind's capacity to affect bodily
function and symptoms. Some techniques that were considered complementary and alternative medicine
(CAM) in the past have become mainstream (for example, patient support groups and cognitive-behavioral
therapy). Other mind-body techniques are still considered CAM, including meditation, prayer, mental healing,
and therapies that use creative outlets such as art, music, or dance.

3. Biologically Based Therapies

Biologically based therapies in CAM use substances found in nature, such as herbs, foods, and vitamins.
Some examples include dietary supplements, herbal products, and the use of other so-called natural but as yet
scientifically unproven therapies (for example, using shark cartilage to treat cancer).

4. Manipulative and Body-Based Methods

Manipulative and body-based methods in CAM are based on manipulation and/or movement of one or more
parts of the body. Some examples include chiropractic manipulation and massage therapy.

5. Energy Therapies
Energy therapies involve the use of energy fields. They are of two types:
 Biofield therapies are intended to affect energy fields that purportedly surround and penetrate the
human body. The existence of such fields has not yet been scientifically proven. Some forms of energy
therapy manipulate biofields by applying pressure and/or manipulating the body by placing the hands
in, or through, these fields. Examples include qi gong, Reiki, and therapeutic touch.
 Bioelectromagnetic-based therapies involve the unconventional use of electromagnetic fields, such as
pulsed fields, magnetic fields, or alternating-current or direct-current field
Types of Alternative Medicine
Overview Examples Description Clinical Significance
Whole medical systems
All-encompassing Ayurveda Aims to restore balance Use in treatment of different
approaches, within the body diseases of nervous system,
including theory and Uses diet, massage, eyes, ears skin and hair
practice (eg, herbs, meditation, problems, cardiovascular
explanation of therapeutic elimination, system, lymphatic and
disease, and yoga respiratory system, digestive
diagnostics, therapy) and urinary system. Cure for
  fever and infection. Increased
  breast milk production.
  Specific diseases like
Alzheimer’s and anemia
Homeopathy Based on the law of People use homeopathy for a
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similars: A substance range of health concerns, from

that causes certain wellness and prevention, to the
symptoms when given in treatment of diseases and
large doses is used in conditions such as allergies,
minute doses to cure the asthma, chronic fatigue
same symptoms syndrome, depression,
digestive disorders, ear
infections, headaches, and skin
rashes.
Naturopathy Aims to prevent and treat For pain management
disease by promoting a Helps improve quality of life in
healthy lifestyle, treating multiple sclerosis patients.
the whole person, and
using the body's natural A study of treatment
healing abilities alternatives for patients with
temporomandibular (jaw)
Uses a combination of disorders found that two whole
therapies, including medical system approaches—
acupuncture, counseling, naturopathic medicine and
exercise therapy, guided traditional Chinese medicine—
imagery, homeopathy, both resulted in greater pain
hydrotherapy, medicinal reduction than state-of-the-art
herbs, natural childbirth, conventional care.
nutrition, physical
therapies, and stress
management
Traditional Chinese Aims to restore proper Both acupuncture and Chinese
medicine flow of life force (qi) in herbal medicine have been
the body by balancing used and studied for a wide
the opposing forces of range of conditions. A few
yin and yang within the examples are
body Acupuncture
Uses acupuncture,  Back pain
massage, medicinal  Chemotherapy-induced
herbs, and meditative nausea
exercise (qi gong)  Depression
 Osteoarthritis
Chinese herbal medicine
 Cancer
 Heart disease
 Diabetes
 HIV/AIDS
Based around the Clinical trials are being
Unani Medicine concepts of four conducted in vitiligo, eczema,
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humours: Phlegm, blood, psoriosis, infective hepatitis,

yellow bile and black bile. urolithiasis, peptic ulcer,
As long as these chronic diarrhea, infantile
humours are in balance, diarrhea, helminthiasis, malaria,
the human system is amoebic dysentery, kala azar,
healthy. filariasis. Diabetes mellitus,
rheumatoid arthrms, sin usitis,
Similar to ayurveda bronchial asthma, leucorrhoea,
and hyperlipidemia. The council
has developed potential drugs
for the treatment of some
diseases such as malaria,
filariasis, infective hepatitis and
infantile diarrhoeas.

Osteopathy emphasizes the role of treatment of and rehabilitation

the musculoskeletal associated with,
system in health and musculoskeletal injuries and
disease. disorders
musculoskeletal system
(bones, muscles and
joints) aids the
recuperative powers of
the body
Mind-body medicine
Use of behavioral, Biofeedback Uses electronic devices Beneficial to immune system
psychologic, social, to provide patients with Can lead to substantial
and spiritual information about improvements among select
techniques to biologic functions (eg, chronic stroke patients and can
enhance the mind's BP, muscle activity) and be of considerable functional
capacity to affect the to teach patients to benefit to others
body and thus to control these functions
preserve health and Biofeedback seems to be a
prevent or cure particularly useful technique in
disease relieving eczema.

  Guided imagery Uses mental images to In studies of breast cancer

  help patients relax or to patients, guided imagery has
  promote wellness or been shown to help the
  healing of a particular immune system and relieve
condition (eg, cancer, anxiety, depression, and
psychologic trauma) moodiness.
Hypnotherapy Puts patients into a state In research studies, hypnosis
of relaxation with has been shown to help
attentive and focused reduce:
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concentration to help pain

them change their nausea
behavior and thus vomiting
improve their health stress
anxiety
Meditation Involves intentional self- In studies, meditation has been
regulation of attention or shown to help:
a systematic mental  reduce stress
focus on particular  improve moods
aspects of inner or outer  improve quality of sleep
experience.  reduce fatigue
Relaxation techniques Aim to elicit a Several clinical studies have
psychophysiologic state shown that relaxation
of hypoarousal by techniques can reduce the
reducing sympathetic number of flares and relieve
nervous system activity symptoms of eczema.
and BP, easing muscle Treating phobias and treating
tension, slowing emotional problems
metabolic processes, or
altering brain wave Have been used to treat stress
activity related disorder including
hypertension and asthma.
Aromatherapy Uses scented oils during Research in cancer patients
a massage has shown that aromatherapy
The use of essential oil may help relieve:
has health benefit 
anxiety

depression

nausea

high blood pressure
Pilates Uses the mind to control It can be beneficial for those
the muscles and seeks to with Chronic Pain syndromes
increase the strength, & people with hypermobilty
flexibility and control of
the body.
Journaling Creating a written Research has shown that
account of events and journaling may be able to:
emotions that a person
experienced and helping  help people experience
people experience a a greater sense of
greater sense of emotional well-being
emotional well-being and  help people feel better
feel better physically physically
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Light therapy consists of exposure to Treatment with light may help

daylight or to specific mild-to-moderate cases of
wavelengths of light eczema in children over age 12
using lasers, light- and adults. Phototherapy or
emitting diodes, light therapy may be combined
fluorescent lamps, with a type of drug called
dichroic lamps or very psoralen. It is then called
bright, full-spectrum light, photochemotherapy.
usually controlled with Use to treat acne vulgaris and
various devices. neonatal jaundice, circadian
rhythm disorders such as
delayed sleep phase syndrome
and can also be used to treat
seasonal affective disorder,
with some support for its use
also with non-seasonal
psychiatric disorders.
CAM applications of light
therapy also include pain
management, accelerated
wound healing, hair growth,
acupuncture, improvement in
blood properties and blood
circulation, and sinus-related
diseases and disorders.
Music Therapy Use of live or recorded Studies have shown that music
music to help provide therapy can help to:
distraction from  increase feelings of
symptoms and side well-being
effects and to promote
 reduce anxiety
relaxation. Using music
in a therapeutic way can  reduce physical
also ease communication symptoms such as pain
for people who don't and nausea
always feel comfortable
expressing feelings.
Spirituality Described as an The benefits of praying may
awareness of something include:
greater than the  reducing stress and
individual self and is anxiety
expressed through  promoting a more
religion and prayer, positive outlook and a
although there are many stronger will to live
other ways to express
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and pursue spirituality.

The benefits of praying
may include reducing
stress and anxiety and
promoting a more
positive outlook and a
stronger will to live
Support Groups Groups of people in Studies have shown, however,
similar life situations who that support groups can provide
meet on a regular basis an increased quality of life for
to share their concern people with breast cancer.
and a safe place to
exchange ideas about
how to handle difficult
issues. They can meet
regularly in person, by
telephone, or online.
Yoga Incorporates nutrition Research in breast cancer
guidelines, ethics, patients has shown that yoga
exercise, and meditation may be able to help:
with the intention of
bringing together the  improve physical
mind, body, and spirit. functioning
 reduce fatigue
 reduce stress 
 improve sleep
 improve quality of life
Biologically based practices
Use of naturally Biologic therapies Uses substances eg, shark cartilage [to treat
occurring naturally occurring in cancer]
substances (eg, animals to treat disease S-adenosyl-L-methionine
particular foods, [SAMe], glucosamine [to treat
micronutrients) to osteoarthritis]
affect health
Chelation therapy Uses a drug to bind with approved by the U.S. Food and
  and remove a Drug Administration (FDA) for
  hypothesized excess or use in treating lead poisoning
  toxic amount of a metal and toxicity from other heavy
  or mineral in the body metals
some patients with CAD seek
out EDTA chelation therapy as
a treatment option.
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Diet therapies Use specialized dietary to treat or prevent a specific

regimens (eg, Gerson disease like cancer,
therapy, macrobiotic diet, cardiovascular disorders, skin
Ornish diet, Pritikin diet) diseases like atopic dermatitis
to restoreand maintain
god nutritional status or
to generally promote
wellness
Herbalism Uses plants and plant Lagundi for cough remedy
extracts to treat disease Sambong is used as diuretic
and promote wellness
Guava is used as antiseptic
Orthomolecular Uses substances that Use in cancer treatment and
medicine occur naturally in the down’s syndrome, use of
body (eg, hormones, Vitamin C
vitamins), often in doses
higher than the RDA, to
treat disease and
promote wellness
Apitherapy medical use of honey The bee-venom therapy is
bee products. This can helpful in curing autoimmune
include the use of honey, diseases that arise from
pollen, bee bread, overactive immune response
propolis, royal jelly and and multiple sclerosis. It is
bee venom. useful for patients suffering
from arthritis, some forms of
herpes and tendonitis. It is also
said to dissolve scar tissues
and permanently cure one from
scars
Fasting primarily the act of Conditions that respond to
willingly abstaining from fasting, including:
some or all food, drink, or  Cardiovascular
both, for a period of time diseases such as
hypertension
 Gastrointestinal
diseases such colitis or
irritable bowel syndrome
 Diabetes
 Uterine Fibroid Tumors
 Back and neck pain
 Addictions
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Urine Therapy various applications of Human urine has strengthening

human urine for and curative characteristics
medicinal or cosmetic concerning many deficiencies.
purposes, including  hair loss
drinking of one's own  all kinds of throat
urine and massaging inflammation,
one's skin with one's own  trembling hands and
urine knees,
 a universal and
excellent remedy for all
distempers inward and
outward,
 cures the scurvy, makes
the body lightsome and
cheerful,
 good for jaundice,
against deafness other
ailments in the ears,
 cures sore eyes and
clears and strengthens
the sight,
 takes away numbness,
chaps and sores and
makes the joints limber
 takes the itch away.
 sustains health when
taken as a preventative.
 best medicine for the
kidneys
 disinfectant for surgery
instruments.
A Russia doctor treated many
people from far and wide, and
was able to alleviate or
completely cure illnesses with
nothing else than urine therapy,
while other methods up until
then had failed.
Manipulative and body-based practices
Focused primarily Chiropractic Involves manipulating the Studies have shown that
on the body's spine, other joints, and chiropractic therapy can help
structures and soft tissue to restore relieve headaches and back
systems (eg, bones, normal spinal and joint pain in women who
joints, soft tissues) have had breast cancer
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Based on the belief neuromuscular function treatment. Other studies have

that the body can Also involves prescribing looked at using chiropractic
regulate and heal exercises and ergonomic therapy to relieve menopausal
itself and that its measures symptoms in breast cancer
parts are survivors, but the results were
interdependent mixed.
  Massage Involves manipulating Studies have demonstrated that
  tissues to promote massage can offer some health
  wellness and to reduce benefits for people with cancer.
  pain and stress Massage has been found to be
helpful for:
 anxiety
 pain
 fatigue
 immune function

Postural reeducation Uses movement and useful to treat musculoskeletal

touch to help patients imbalances and/or aches and
become more aware of pains
their body, relearn
healthy posture, and
move more easily
Reflexology Involves applying manual Some of the many uses that
pressure to specific reflexology has shown to be
areas of the foot that effective for are:
theoretically correspond  Used in hospitals and
to different organs or Hospices
systems of the body  Stress related Illnesses
 Arthritis
 Osteoarthritis and
Osteoporosis
 Sleep disorders
 water retention
 reduction of
inflammation
 Hormone Balance
 Mentruation
 Menopause
 Fertility
 Maternity
 ME
 Depression
 Back Pain and skeletal
problems
 Muscular problems
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
Migraine

Digestive disorders

Cancer Care

Asthma

Post and Pre op
patients
 Irritable Bowel
 Strokes
 MS
Rolfing Involves manipulating Use with patients with
and stretching the fascia musculoskeletal-based pain.
to reestablish healthy
bone and muscle
alignment
Iridology The eye is perceived as Mainly a preventive medicine
the gateway to the body because it can warn a doctor of
whereby its condition a person's apparent tendency
reflects the overall toward disease. If a person is
condition of the patient. potentially approaching an
The scientific practice illness, this will show up in an
which involves examination of his or her iris. A
correlating the markings person's progress can also be
and patterns of the iris to expressed by the iris.
reflex manifestations and Cleansing and healing of the
bodily malfunctions body can be verified from
among the many organs changes in the iris. A patient
of the body. who undergoes iridology should
have irides that look
significantly different after
analysis and treatment.
Energy medicine
Manipulation of the Acupuncture Stimulates specific points Studies show that acupuncture
body's energy fields on the body, usually by may:
(biofields) with the inserting thin needles  help relieve fatigue
intent to affect health into the skin and  control hot flashes

Based on the belief underlying tissues to  help decrease nausea

that a universal life unblock the flow of qi
 reduce vomiting
force or subtle along energy pathways
and thus restore balance  lessen pain
energy resides in and
around the body in the body

  External qi gong Involves master healers For the treatment of major

  using the energy of their Depression, Dysthymia or
  own biofield to bring the Bipolar Disorder
patient's energy into
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  balance
  Magnets Placing magnets on the For of chronic pain
body to reduce pain management, orthodontic
treatment, fatigue and
insomnia, reduce depression
Magnets reduce reduced fluid
buildup, acted as a pain
reliever, and had anti-
inflammatory effects (Man et
al., 1997)
Pulsed electrical field Placing injured body To resolve bacteria, virus, yeast
parts in an induced and parasite infections in
electrical field to facilitate human body like Lyme disease.
healing and chronic infections
It has potential to become
effective therapy for MS,
fibromyalgia, chronic fatigue,
arthritis and many other chronic
conditions.
Reiki Involves practitioners Although there are no scientific
channeling energy studies showing that Reiki is
through their body and effective in treating any
into a patient's body to disease, a Reiki treatment may
promote healing be able to bring about feelings
of:
 deep relaxation
 warmth or sleepiness
 increased well-being
Therapeutic touch Uses the therapist's Clinical effectiveness of HT in
healing energy, usually health enhancement,
without touching patients, specifically for raising sIgA
to identify and repair concentrations, lowering stress
imbalances in a patient's perceptions and relieving pain.
biofield

Reasons to use CAM (Accdg to survey)

• CAM would improve health when used in combination with conventional medical treatments: 55%
• CAM would be interesting to try: 50%
• Conventional medical treatments would not help: 28%
• A conventional medical professional suggested trying CAM: 26%
• Conventional medical treatments are too expensive: 13%

Sources:
National Center for Complementary and Alternative Medicine (NCCAM) nccam.nih.gov
Merck Online
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What is acupuncture?
In acupuncture, sterile, hair-thin needles are inserted into specific points on the skin, called "acupuncture
points," and then gently moved. Researchers propose that acupuncture stimulates the nervous system to
release natural painkillers and immune system cells. They then travel to weakened areas of the body and
relieve symptoms.
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Studies show that acupuncture may:

 help relieve fatigue

 control hot flashes
 help decrease nausea
 reduce vomiting
 lessen pain
Along with practices such as tai chi, acupuncture is a central part of traditional Chinese medicine (TCM), an
ancient system of medicine. In Chinese medicine, it is believed that vital energy, called "qi" (pronounced
"chee"), flows through 20 pathways, or "meridians," which are connected by acupuncture points. According to
TCM, if qi is blocked, the body can't function at its peak. The goal of acupuncture is to open certain points on
these pathways and release blocked qi.

What to expect in a typical acupuncture session

At an acupuncture session, you can expect the following:

 The practitioner will ask you questions about your health and lifestyle. At your first acupuncture
session, you'll answer questions to let the practitioner know about any medications you're taking, including
herbal supplements, and any symptoms you have. Your treatment will be tailored to your individual lifestyle
and health issues.

 The practitioner will insert needles into acupuncture points on your skin. Your practitioner will
insert needles into the most appropriate acupuncture points for your condition. Acupuncturists use very
thin, solid, stainless steel needles, and most people feel slight or no pain as needles are inserted. Needles
are only inserted into the top layer of skin and are never inserted directly into any organs. Once the needles
are in place, there is no pain.

The effects of acupuncture can feel different from person to person — you may feel relaxed, or you may feel
energized. Directly after the first treatment, some people feel slightly disoriented, but this is usually brief. After
treatment, avoid activities that require you to be extra alert, such as driving, mowing the lawn, or cooking.

In the days following treatment, symptoms may worsen for a day or two, or you may notice changes in your
appetite, sleep, or mood before you begin to feel improvement. If this happens, it lasts only a short while and
passes with rest.

Important things to consider before trying acupuncture

Millions of people are treated with acupuncture every year. Still, as with all therapies, acupuncture carries
certain risks.
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 Risk of lymphedema: Anyone who has had lymph nodes removed from under the arm should not
have needles inserted into that arm. If acupuncture is used on an arm, there is a risk of lymphedema, or
swelling caused by an excess of fluid in the arm. Talk to the acupuncturist about other treatments that could
be used on that arm, such asaromatherapy.

 Risk of infection: It is standard practice to use disposable, single-use, sterile needles and to swab
acupuncture areas with alcohol or a similar disinfectant before using needles. Infection is always a risk, but
the risk is higher if the acupuncturist does not follow this process. People who have low white blood cell
counts are at an increased risk of infection during acupuncture. This is because the low white blood cell
count weakens their immune systems.

 Risk of bleeding for certain people: Because of the risk of bleeding, acupuncture should not be
received by people who:

o have bleeding disorders

o have low white blood cell counts
o take blood thinners
 Risk of reducing chemotherapy effectiveness because of using herbal supplements: Although
acupuncture sometimes incorporates the use of herbal supplements, you should NOT take herbal
supplements during a course of chemotherapy. Herbal supplements can reduce the effectiveness of
chemotherapy

What is aromatherapy?
Aromatherapy is a practice in which scented oils are inhaled through the nose or rubbed on the body during a
massage.

Research in cancer patients has shown that aromatherapy may help relieve:

 anxiety
 depression
 nausea
 high blood pressure
The oils used in aromatherapy, called "essential oils," are the highly concentrated extracts of flowers, leaves,
stems, roots, seeds, bark, resin, or fruit rinds. Essential oils can be purchased in most health food stores.

Because of their high concentration level, essential oils must be diluted before they are rubbed onto the skin.
Oils are usually diluted with a "base" or "carrier" oil, which is a vegetable oil processed from nuts, seeds, or
trees that helps spread the essential oil over a larger area and protects the skin from a reaction.

What to expect in a typical aromatherapy session

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 An aromatherapy session often begins with an interview during which you will be asked questions
about your personality, your interests, your general health, and your particular symptoms. Your responses
will help the therapist decide what type of fragrance would best suit your needs.

 After this discussion, the aromatherapist selects a blend of oils that he or she feels is suitable for you.

 The aromatherapist will then apply the oils to your body, usually by massaging them into your skin.

 Appointments may last up to 90 minutes.

 You will probably be told not to shower for several hours afterwards, to allow more time for the oils to
sink into your skin.

The National Association for Holistic Aromatherapy reports that commonly used oils can have the following
benefits:

 Headache relief: Peppermint

 Immune system stimulation: Eucalyptus, rosemary, tea tree

 Muscle tension relief: Chamomile, clary sage, eucalyptus, peppermint, ylang ylang

 Indigestion relief: Peppermint

 Relaxation: Ylang ylang, geranium, lavender, lemon, clary sage, and chamomile

 Respiratory problem relief: Eucalyptus

Other ways to use aromatherapy:

 Place a few drops of essential oil in a small oil burner to allow a soothing fragrance to fill the room.

 Sprinkle 5-10 drops of oil in your bath.

 Sprinkle 2-4 drops of oil on a tissue or a handkerchief, and hold it up to your nose. Keeping your eyes
closed to avoid irritation, take 2-3 deep breaths through the nose.

 Place 10-15 drops of oil in a 4-ounce spray-bottle of water. Shake the bottle and then spray fragrance
around a room.

Important things to consider before trying aromatherapy:

 Make sure you're using essential oil. The label should say "pure essential oil," not "blend" or
"massage" oil. If the label isn't clear, don't purchase the oil.
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 Some essential oils are poisonous. You should NEVER TASTE OR SWALLOW any essential oil.

 Pregnant women and children should not inhale essential oils or rub them on their skin.

 Always do a skin test with new oils. When using an oil for the first time, it's important to do a skin test
on a small area of skin.

o Spread a little bit on your arm and put a bandage over it.
o Wait 24 hours to make sure there is no skin reaction before trying it on a larger area.
o If the area becomes red, swollen, or sore, do NOT use the oil again.
o It's important to use oils that have been produced without chemicals, or "organic" oils. Oils made
with chemicals can irritate the skin.
 If you find that you are sensitive to different aromas, avoid essential oils.

Always check with your doctor before using aromatherapy.

What is chiropractic therapy?

Chiropractic therapy focuses on the relationship between the body's structure — mainly the spine — and the
body's function. Doctors of chiropractic, who are also called chiropractors or chiropractic physicians, mostly
use a type of hands-on therapy called manipulation (or adjustment). Chiropractic therapy is used most often to
treat musculoskeletal conditions — problems with the muscles, joints, bones, and connective tissue such as
cartilage, ligaments, and tendons.

The basic concepts of chiropractic therapy can be described as follows:

 The body has a powerful ability to heal itself.

 The body's structure (mainly the spine) and its function are closely related, and this relationship affects
health.

 Chiropractic therapy is given with the goal of normalizing the relationship between structure and
function and helping the body as it heals.

What to expect in a typical chiropractic session

During your first visit, the chiropractor will take your health history. You will be given a physical exam, with
special emphasis on the spine. You might also be given other exams or tests, such as X-rays. If the
chiropractor determines that you are an appropriate candidate for chiropractic therapy, a treatment plan will be
developed for you.

During treatment, the chiropractor may do one or more adjustments. An adjustment (also known as a
manipulation treatment) is manual therapy, which means it's done with the hands. Given mainly to the spine,
chiropractic adjustments usually apply controlled force to a joint. The adjustments are done to increase the
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range and quality of motion in the area being treated. Other health care professionals — including physical
therapists, sports medicine doctors, and orthopedists — perform types of manipulation. In the United States,
research shows that chiropractors perform more than 90% of manipulative treatments.

Most chiropractors use other treatments in addition to adjustment, such as:

 mobilization (moving a joint through its range of motion)

 massage
 nonmanual treatments such as applying heat or ice, ultrasound, or electrical stimulation
Some side effects may include temporary discomfort in the parts of the body that were treated, headache, or
tiredness. These side effects tend to be minor and go away after 1 or 2 days.

The rate of serious complications from chiropractic therapy has been debated. There have been no organized
clinical studies on the number of serious complications. But based on what is known now, the risk appears to
be very low.

Important things to consider before trying chiropractic therapy

It's important to talk to your doctor if you're thinking about trying chiropractic therapy.

 Anyone with bleeding problems or those on anticoagulants (blood thinners) may have a higher risk of
stroke caused by manipulation of the spine.

 Women with weakened bones or osteoporosis from breast cancer treatment may be at risk for broken
bones from chiropractic therapy.

If your doctor says chiropractic therapy is OK for you, it's also important to tell your chiropractor about any
cancer treatments you have had. The chiropractor will need to take extra care with any adjustments near the
area that had surgery. In some people, the surgical area may not be able to receive adjustment.

What is guided imagery?

Guided imagery, sometimes known as "visualization," is a technique in which a person imagines pictures,
sounds, smells, and other sensations associated with reaching a goal. Imagining being in a certain
environment or situation can activate the senses, producing a physical or psychological effect.

Studies have shown that practicing guided imagery may be able to:

 temporarily increase numbers of immune system cells to keep the rest of your body healthy

 help reduce feelings of depression

 increase feelings of well-being

 19

What to expect in a typical guided imagery session

Guided imagery can be practiced at home with a book or audio recording or with a trained therapist. Guided
imagery can be done in group or one-to-one sessions and can last an average of 20 to 30 minutes. In a typical
guided imagery session:

 The therapist will use one of a variety of guided imagery techniques that will lead you through imagined
experiences in your mind.

 Usually, the therapist will guide your imagination to places or situations that will make you feel peaceful,
safe, relaxed, and secure.

 The therapist may use gentle background music to create a relaxed atmosphere and help you avoid
distractions.

 You'll be asked to imagine something, such as a warm healing light on the area where the cancer was
or images of your immune system attacking cancer cells. One popular exercise involves picturing tiny Pac-
Man characters chasing and eating cancer cells.

 The therapist will describe sounds, smells, tastes, or other sensations that might accompany what
you're imagining.

 While you focus on the imagined situation, you might start to experience sensations and feelings, such
as warmth, lightness, contentment, or strength.

Important things to consider before trying guided imagery

Guided imagery is considered to be safe. It's best to practice guided imagery when you can devote your full
concentration to it. For instance, don't try to practice guided imagery while driving or cooking.

What is hypnosis?
Hypnosis is a method that helps a person enter into a state of calm, alert awareness so he or she can more
easily work on making personal changes. People often use hypnosis to overcome fears or habits.

 Under hypnosis, a person is more focused. Hypnosis helps a person block out distractions and
focus on a specific idea, sensation, or memory.

 Hypnosis brings a state of deep relaxation. The relaxation during hypnosis makes it easier to
observe anxieties, fears, pain, and other difficulties from a new perspective.

 Hypnosis can help a person be more open to suggestion. Hypnosis enables openness, because
the conscious mind — which can be more closed and critical — is quiet, while the unconscious mind has
center stage.

In research studies, hypnosis has been shown to help reduce:

 20

 pain
 nausea
 vomiting
 stress
 anxiety
There are many kinds of hypnotic techniques. After you're under hypnosis, a hypnotherapist may:

 talk to you in a soothing way to help you feel relaxed and secure

 make suggestions about positive behaviors

 encourage you to clearly imagine yourself acting differently, a powerful practice called "mental imagery"

A hypnotherapist can work with you to find the technique that can work best for what you're trying to
accomplish. Although it's important to begin by working with a hypnotherapist, the hypnotherapist can then
teach you self-hypnosis so you can practice at home. Once you have a firm grip on an issue like pain or fatigue
with the therapist, you can continue on your own with self-hypnosis.

What to expect in a typical hypnosis session

At your first hypnosis session, the hypnotherapist will probably ask you questions about your medical and
emotional history. He or she will ask you to talk about any problems you're having, such as pain, anxiety, or
tiredness. Once the hypnotherapist knows more about what you're going through, he or she will choose an
appropriate hypnotic technique.

 The hypnotherapist may begin by asking you to close your eyes and then may talk to you in soothing
tones and describe vivid imagery to help you relax.

 Once you are under hypnosis, the hypnotherapist may propose ways of reaching certain goals, such as
pain reduction or increased feelings of serenity.

 A typical session can last from half an hour to an hour.

 You may have one session or a series of sessions.

 At the end of a session, you are capable of bringing yourself out of hypnosis.

 After your session, you can resume your normal activities.

What hypnosis is not:

 When you're under hypnosis, the hypnotherapist cannot control you. It is not possible for a
hypnotherapist to force you to do anything that you don't want to do.
 21

 You cannot be hypnotized against your will. You must be open and receptive to the idea of hypnosis for
it to work.

Important things to consider before trying hypnosis

While hypnosis has shown benefits in cancer patients, hypnosis can occasionally trigger deep and sometimes
upsetting emotions. Always check with your doctor before starting hypnotherapy, particularly if you have a
history of mental illness.

What is journaling?
Journaling is creating a written account of events and emotions that you experience. A journal can be as rough
or complete as you choose. Some people find that they can't end the day without putting an entry into their
journal.

Research has shown that journaling may be able to:

 help people experience a greater sense of emotional well-being

 help people feel better physically

What to expect with journaling

People approach journaling in a variety of ways. If you're interested in journaling, don't set any rules — express
yourself in any way that feels comfortable.

 Some people use a journal to write about their emotions during a tough time such as an illness, divorce,
or death of a loved one.

 People also use journals as a way to relieve the minor stresses of day-to-day living.

 A journal can also be used to set personal goals and provide self-encouragement.

 Journaling doesn't always have to mean writing. Some people find that sketching and drawing in their
journals can help to express emotions.

Keeping a journal can also help a person to gain perspective. Journaling can allow you to compare how you
felt months ago to how you feel now.

Important things to consider before you try journaling

Journaling is generally viewed as a safe practice. However, journaling is not for everyone.

 People who don't really enjoy writing may not benefit from journaling. If it feels like a chore, you may
want to consider a different way to reduce stress.
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 If you're the kind of person who worries about the quality of your writing, penmanship, and readability, it
might be difficult to let go and focus on your thoughts and feelings. If this is true for you, you may benefit
from a more body-based therapy, such as yoga or tai chi.

 Studies have shown that journaling only about negative feelings without including thoughts or goals
may actually increase stress.

What is massage?
Massage is a hands-on method of manipulating the soft tissues of the body using the hands, fingertips, and
fists. Massage can include a variety of types of pressure and touch. A massage can be light, concentrating on
the skin, or deep, focusing on the underlying layers of muscle tissue.

Studies have demonstrated that massage can offer some health benefits for people with cancer. Massage has
been found to be helpful for:

 anxiety
 pain
 fatigue
 immune function
What to expect in a typical massage session
Here is what you can usually expect at a massage session:

 When you arrive for your massage appointment, the massage therapist will ask if you have any injuries
or health conditions. Make sure to tell your therapist about your breast cancer treatment. This helps him or
her to determine the type of massage that's right for you, as well as any areas to avoid.

 Depending on the setting, you may have the option to either lie on a table or sit in a chair for your
massage.

o If you choose a table massage, you'll be taken to a private room and asked to remove some or
all of your clothing and to cover yourself with a blanket.
o If you choose a chair massage, you will probably not be taken to a private room, and you won't
need to remove your clothing.
 Most massage techniques involve lying on a cushioned table. Your massage therapist may use pillows
to support different areas of your body.

 Your massage therapist may use oils or lotions on your skin. If you are allergic to any common
ingredients of body oils or lotions, let the therapist know.

 Don't hesitate to let your massage therapist know if the level of pressure is too hard. If you feel any
discomfort, ask him or her to use lighter strokes.
 23

 A typical massage lasts about an hour, although sessions can range from 30 to 90 minutes.

 After a massage, the massage therapist will step out of the room and allow you to relax alone for a few
minutes and then get dressed.

Important things to consider before trying massage therapy

If you have breast cancer and are interested in finding a massage therapist, ask your surgeon or oncologist for
recommendations. It's important to let your massage therapist know about your diagnosis, treatment, and any
symptoms you may have. Massage can be very helpful. But it has the potential to cause harm. Keep these
things in mind:

 If you've just had breast surgery, you should lie on your back for a massage until your doctor
decides it is safe for you to lie on your stomach.

 Deep massage, or any type of massage that involves strong pressure, should NOT be used if
you are undergoing chemotherapy and radiation. People undergoing chemotherapy may have a
decrease in red and white blood cells, so with deep massage, there is a risk of bruising. Since deep
massage can be taxing to a system already vulnerable from chemotherapy and radiation, it is not
recommended for people currently in treatment. Light massage can be used instead.

 If you're currently undergoing radiation, your massage therapist should avoid touching any
sensitive skin in the treatment area. Massage and massage oils can make already-irritated skin feel
much worse. Your therapist should also avoid touching any temporary markings in the corners of the
radiation treatment field. If you don't have skin irritation in the treatment area, any massage to this area
should be done very lightly through a soft towel or cloth.

 If you have had lymph nodes removed, the massage therapist should only use very light touch
on your affected arm and the area around the underarm.

 If you have arm lymphedema, the massage therapist should avoid the affected arm and
underarm areas completely. Traditional massage therapy can worsen lymphedema. A massage therapist
who has experience with breast cancer patients may already know this, but it's important to make sure he
or she understands.

 If you have arm lymphedema, your arm and underarm area should be treated by a different kind
of massage especially for lymphedema, called manual lymphatic drainage. Look for a physical,
occupational, or massage therapist trained and certified in manual lymph drainage to treat your
lymphedema. Get more information about finding a therapist.

What is meditation?
Meditation is a focusing practice that suspends the normal stream of thoughts occupying the mind. Usually, the
attention is focused on a specific thing, such as the breath or a phrase. Practicing meditation regularly is
 24

believed to calm the mind, increase alertness, and bring a person into a state of physical and psychological
balance.

Some people choose to learn meditation at home using an instructional book or audio CD. Others choose to
learn from a teacher.

In studies, meditation has been shown to help:

 reduce stress
 improve moods
 improve quality of sleep
 reduce fatigue
There are many approaches to meditation. Here are some of the more common ways people meditate:

 Focus on the breath: Keeping the attention on the sensation of the breath as it passes in and out of
the nostrils. Sometimes called "mindfulness meditation," it tries to teach the meditator to be "mindful," or
aware, of the present moment without judging or reacting.

 Focus on the body: Feeling the sensations throughout the body, such as pain, warmth, or tension

 Focus on a word or phrase: Repeating a word or phrase, sometimes called a "mantra," to keep the
mind free of distracting thoughts

While many people sit still to meditate, it's possible to use the above techniques while lying down, standing, or
walking. Meditation can also be combined with other practices such as yoga or tai chi if sitting still is difficult for
you.

What to expect during meditation

Meditation usually begins with finding a position that's comfortable for you. Most people choose to close their
eyes to reduce any visual distractions. Once you're in position, you'll focus your attention on the area of your
choosing — the breath, a mantra, or another area of focus. During your session, you will be working to bring
your awareness back to your area of focus whenever you find your mind wandering.

Tips for beginning meditation:

 Look for a quiet location. If you're beginning a meditation practice, a quiet place with minimal
distractions is ideal.

 Make sure your posture is comfortable. If you are sitting or standing, make sure you are in a
comfortable position.
 25

 Keep an open attitude. It is very common to become distracted while meditating, so try not to judge
yourself when your mind wanders — just gently return your attention to the focus. Observe and accept the
thoughts that come and go.

 Try to avoid positions that make you sleepy. When meditating in a sitting position, some people feel
as though they are falling asleep. If this is a problem for you, try to meditate while standing or walking.

 Allow yourself the time you need. It takes time and dedication to develop a meditation routine. It's
best to begin with small, manageable time increments, such as 5 minutes once or twice a day, and then
work up to longer blocks of time. With regular practice, meditation becomes easier and more automatic.

Important things to consider before trying meditation

Meditation is generally thought to be a safe practice. However, in people with psychiatric problems, there have
been a small number of reports in which intense meditation has worsened symptoms. If you have been treated
for a psychiatric issue, talk to your mental health professional before starting a meditation practice.

What is music therapy?

Music therapy is the use of live or recorded music to help provide distraction from symptoms and side effects
and to promote relaxation. Using music in a therapeutic way can also ease communication for people who
don't always feel comfortable expressing feelings.

Studies have shown that music therapy can help to:

 increase feelings of well-being

 reduce anxiety
 reduce physical symptoms such as pain and nausea
What to expect in a typical music therapy session
A music therapy session can happen in a variety of settings, including hospitals, clinics, cancer centers, and in
a person's home. No musical ability is required in order to experience a benefit.

A music therapist will ask questions about your unique situation and tailor the therapy to your emotional and
physical needs. Sessions might involve:

 playing music
 listening to music
 performing movements to music
 writing songs
 discussing what lyrics mean to you
Important things to consider before trying music therapy
 26

Music therapy is thought to be a generally safe practice. However, music therapy given by an untrained person
may not be effective, and it can even be a source of increased stress and anxiety. If you're interested in music
therapy, make sure your therapist:

 is board-certified
 has experience with people who have had cancer
What is progressive muscle relaxation?
Progressive muscle relaxation, or PMR, involves tensing and releasing the muscles, one body part at a time, to
bring about a feeling of physical relaxation.

Some studies of cancer patients have shown that PMR can help to reduce:

 nausea
 vomiting
 anxiety
 depression
What to expect with progressive muscle relaxation
Researchers report that relaxation training methods, including PMR, work best if a person is trained before
cancer treatment starts. The researchers also said that after 2 hours of training from an expert, patients are
usually experienced enough to successfully practice the techniques on their own.

Important things to consider before trying progressive muscle relaxation

Progressive muscle relaxation is generally thought to be a safe practice, but as with all relaxation techniques,
there are some risks:

 Rare increases in anxiety. In rare cases, the increased body awareness that comes with relaxation
training has led to more anxiety instead of a reduction in anxiety.

 Very rare physical symptoms. In some people who use relaxation techniques, there have been
extremely rare instances of pain, heart palpitations, and muscle twitching.

People with schizophrenia and other mental disorders should avoid PMR and other forms of relaxation training.

What is Reiki?
Reiki is a Japanese form of therapy that is delivered through the hands. Reiki means "universal life energy."
Reiki practitioners believe that energy surrounds and moves through the human body. Reiki attempts to
balance the flow of this energy and stimulate the body's healing abilities.
 27

Although there are no scientific studies showing that Reiki is effective in treating any disease, a Reiki treatment
may be able to bring about feelings of:

 deep relaxation
 warmth or sleepiness
 increased well-being
What to expect in a typical Reiki session
Reiki can be performed in a variety of settings — offices, clinics, hospitals, and homes. During a Reiki session:

 You'll sit or lie down, fully clothed.

 The Reiki practitioner will place his or her hands on or above your body, using 12 to 15 different hand
positions.

 The practitioner will hold each hand position for about 2 to 5 minutes as he or she tries to direct your
energy to clear any blockages in your body's energy patterns. Hand positions are held until the practitioner
feels that energy patterns are resolved.

 Sessions can last from 30 to 90 minutes.

 Afterwards, you may feel deeply relaxed.

Important things to consider before trying Reiki

In general, Reiki is considered to be a safe practice. However, after a Reiki treatment, some people may
experience symptoms such as:

 headache
 stomach upset
 tiredness
 weakness
Reiki practitioners believe that these types of symptoms indicate that the body is releasing toxins. If you
experience these symptoms, your practitioner may tell you to rest, drink plenty of water, or eat lighter meals.

What is Shiatsu?
Shiatsu (which means "finger pressure" in Japanese) is a Japanese massage practice that uses acupressure.
Acupressure is based on the Chinese principles of acupuncture. In Shiatsu massage, the therapist applies
varying, rhythmic pressure using the fingers on particular parts of the body. The goal is to improve the body's
ability to heal itself and to promote overall health.
 28

Though Shiatsu seems like traditional massage in some ways, it is based on the internal flow of a vital energy
called "qi" (pronounced "chee"). As described in Chinese medicine, it is believed that qi flows through 20
pathways, or "meridians," which are connected by points (sometimes known as "acupoints" or "acupuncture
points"). If qi is blocked, the body can't function at its peak. Shiatsu uses pressure and other techniques to
stimulate the acupoints and energy meridians to increase and balance energy flow in the body. Some people
consider acupressure to be a form of acupuncture without needles.

While no scientific studies have been done on Shiatsu in women with breast cancer, people using Shiatsu
have reported that it helped them with relief of:

 neck, shoulder, and back pain

 stiffness
 muscle tension
 headaches
What to expect in a typical Shiatsu session
A Shiatsu practitioner will press with his or her fingers, thumbs, and palms on the acupuncture points and
energy pathways or meridians on your body. Pressure on these vital points is intended to stretch and open
pathways for the body's flow of qi. There are a number of types of Shiatsu, some of which use stretching,
special breathing techniques, and meditation.

Shiatsu may be performed on a thick floor mat or on a low massage table. No oils or lotions are used, and both
the practitioner and client wear loose comfortable clothing.

What is spirituality?
Spirituality is described as an awareness of something greater than the individual self. It is often expressed
through religion and prayer, although there are many other ways to express and pursue spirituality.

Studies have found that spirituality, religion, and prayer are very important to quality of life for some people
who have been diagnosed with cancer. Research has not shown that spirituality and prayer can cure cancer or
any other disease, but they may be a helpful addition to conventional medical care.

The benefits of praying may include:

 reducing stress and anxiety

 promoting a more positive outlook and a stronger will to live
What to expect when you pray
Prayer may be silent or spoken out loud and can be done alone in any setting or in groups (as in a church,
temple, or mosque). Regular attendance at a church, temple, or mosque may involve prayer that focuses on
you or on others. Sometimes, the entire congregation of a church may be asked to pray for a sick person or the
person's family.
 29

Some religions set aside certain times of the day and special days of the week for praying. Standard prayers
are often memorized and repeated during private sessions and in groups.

Prayer can also be done individually and in informal groups, without a specific religion or denomination, with no
particular schedule. Prayers often ask a higher power for help, understanding, wisdom, or strength in dealing
with life's problems.

Spirituality and prayer can take many forms. Meditation, 12-step work (as practiced in Alcoholics Anonymous
and similar groups), and seeking meaning in life all involve spirituality. Simple practices such as silent
observation, listening, or gratitude can become part of everyday spirituality. Some people choose to express
their spirituality by spending time in nature, doing creative work, or serving others.

Important things to consider before trying prayer therapy

If spirituality and prayer are important to you, talk to your doctor about the role they play in your life. Knowing
what's important to you can help your doctor know how best to take care of you.

Many people believe spirituality is important when a person is coping with serious illness. The ability to find
meaning in life can be helpful when dealing with cancer, even though it cannot cure the disease.

What are support groups?

Support groups are groups of people in similar life situations who meet on a regular basis to share their
concerns. A support group is a safe place to exchange ideas about how to handle difficult issues. Support
groups can meet regularly in person, by telephone, or online.

Support groups can be organized in different ways:

 Open membership: Open membership means that members can come and go freely, and long-term
commitment is not required. If you're going through treatment and your schedule isn't consistent, this may
be the type of group for you.

 Closed membership: Closed membership means that registration and commitment to a certain

number of sessions is required. Once a specific number of people have signed up, the group is closed to
new members. This helps members to establish consistency and to get to know each other better.

Some of the benefits of cancer support groups include:

 connection during an experience that can sometimes feel isolating

 tips and information from those who've been through the same thing
 opportunities to use your knowledge to help others
What to expect with support groups
 30

Although there are no standards for how support groups are conducted, they are often moderated by a group
leader. Some breast cancer support groups are led by professionals, such as psychologists, psychiatrists,
oncology social workers, oncology nurses, or pastors. Other groups are led by breast cancer survivors. Both
types of groups have advantages and disadvantages:

 Groups organized by professionals: Trained professionals have their experience in setting up

groups, helping members get what they need, and responding to people who are upset or angry. However,
many times, trained professionals are not breast cancer survivors themselves and cannot offer advice from
their own experience.

 Groups organized by breast cancer survivors: Breast cancer survivors bring personal experience to

support groups they organize. For example, a cancer survivor can help those who are newly diagnosed
know what to expect. But because many breast cancer survivors have not had support group skill training,
they may not always know how to respond to difficult group situations. At the same time, even without
official training, people who've had breast cancer often have enough life experience to be comfortable when
group dynamics get challenging.

Once you've chosen a support group, you may need to allow yourself time to adjust to the group setting. Some
people have an easier time sharing feelings than others. It's okay if you feel more comfortable just listening.

Important things to consider before trying support groups

 You may find that a support group is helpful during one phase of your treatment, but not so helpful in
another phase. For example, if you've just been diagnosed, it may feel overwhelming if some people in the
group are going through the stress of a recurrence.

 Ongoing issues such as marital problems or depression are better managed one-on-one with an
individual counselor than in a support group.

Check with the support group leader before going to a session to make sure your needs are similar to those of
the group.

What is tai chi?

Tai chi is an exercise that combines slow, graceful movements with meditation and breathing techniques.
Because the body is constantly in motion, tai chi is sometimes called "moving meditation." Although tai chi has
developed into an exercise for health purposes, it originated as a martial art in 12th-century China. Many
practitioners believe that there is a vital energy flowing throughout the body, called qi (pronounced "chee") and
that tai chi helps prevent the flow of qi from being blocked.

Research in cancer patients has shown that tai chi may help to increase:

 strength
 balance
 31

 flexibility
 heart and lung function
 feelings of well-being
What to expect in a typical tai chi session
During a tai chi session, your instructor will help you learn and practice a series of relaxed yet deliberate
movements. Here's what you can expect:

 Movements: You'll learn a series of tai chi movements, which are practiced in pairs of opposites: a
twist to the right is followed by a twist to the left. A series of movements is called a "form," or routine. You
and your instructor should decide what movements and forms are appropriate for you.

 Forms: A form can include between 20 and 100 movements, which may take up to 20 minutes to
perform.

 Breathing: As you perform the movements, you'll be asked to pay attention to your breathing, which
originates in the diaphragm.

 Meditative concentration: At the same time, you will focus a relaxed concentration, called "meditative
concentration," on the area just below the navel. It is believed that qi begins below the navel and travels
through the body.

Once you've practiced a form on a regular basis with a teacher, you can begin practicing at home.

Important things to consider before trying tai chi

Tai chi is a low-impact exercise and is considered to be relatively safe. However, as with any practice, there
are precautions you should take if you've had breast cancer. If you're considering tai chi, here are a few things
to keep in mind:

 Tell your doctor. Before starting tai chi, tell your doctor. It's particularly important to talk to your doctor
if you've recently had surgery, if you haven't exercised in a while, or if you have osteoporosis or joint
problems.

 Start slow. Gradually build up your tai chi experience. Learn how to position your body properly, and
take your time. Overdoing it during practice can result in muscle strains or sprains.

 Know when not to practice. Don't practice tai chi immediately after a meal, if you have any type of
infection, or if you're tired.

 Know your limits. If you're unable to stand for long periods of time, modified versions of tai chi can be
done in a chair or bed. Talk to your instructor about other ways you can do tai chi.

What is yoga?
 32

Yoga, which means "union," is a 5,000-year-old system of principles and practices originating in India. Yoga
incorporates nutrition guidelines, ethics, exercise, and meditation with the intention of bringing together the
mind, body, and spirit.

Most types of yoga practiced in the United States focus on movement and breathing, and do not require a total
lifestyle change. More than a hundred variations of yoga are practiced in the United States — some slow and
gentle and others active and fast-moving.

One of the most frequently practiced types of yoga is called hatha yoga, which uses physical poses and
breathing techniques to increase strength, flexibility, and well-being.

Research in cancer patients has shown that yoga may be able to help:

 improve physical functioning

 reduce fatigue
 reduce stress 
 improve sleep
 improve quality of life
What to expect in a typical yoga session
A yoga session can last from 20 minutes to an hour and can be done alone at home or in a class setting with
an instructor. During your yoga session you will:

 Learn and practice a series of poses: A typical hatha yoga session consists of a wide range of
poses. If you're taking a class, the instructor will have students practice a list of poses in a specific order.
Poses are designed in a variety of ways: lying down, sitting, or standing.

 Breathe: Another aspect of a typical yoga session is learning and practicing breathing techniques for
better mind and body control. Techniques include breathing through one nostril at a time and focusing on
your breath as it enters your nose and fills your lungs.

 Learn what your limits are: Some yoga poses may be too challenging. Start out with the basics and
push yourself a little, but not too hard. The idea is not to force the body into any position but to ease and
breathe into it. The longer you breathe in a posture, the more your muscles tend to give.

o If you're practicing at home and have trouble with a pose, use pillows to ease into a more
comfortable position or move on to another pose.
o If you're taking a class and have difficulty with a pose, an experienced instructor will design
an easier posture for you. Many teachers use props such as blocks or cushions to make the practice
more comfortable.
 33

o If you find even basic classes to be too difficult, ask your teacher if there is a "restorative"
yoga class you could try. These gentle classes are beneficial when recovering from illness or surgery
and involve a minimum of physical work, concentrating on breathing while being supported by pillows
and other props.

Important things to consider before trying yoga

Like all practices, yoga comes with some risks:

 Risk of inexperienced instructors: Because of the variation in certification requirements for yoga

teachers, it's possible to take a class with a yoga teacher who has very little experience. This is not always
safe and can result in injuries. Ask your oncologist or cancer center staff to recommend highly experienced
yoga instructors who regularly work with cancer patients.

 Risk of lymphedema: In people who have had lymph nodes removed, some of the more strenuous
yoga types and poses may present a risk for lymphedema. A yoga instructor who has experience with
breast cancer patients will know which yoga types and poses are safe.

 Risk of fracture in people with bone metastasis: In people with breast cancer that has metastasized
to the bone, some types of yoga may carry a risk of fractures. If you have bone metastasis, ask your doctor
whether yoga is right for you, or if there is a gentle form of yoga or another practice that might work better,
such as meditation or guided imagery. Always check with your doctor before you begin a yoga practice.

Traditional Chinese Medicine (TCM)

• 200 B.C.
• Disease is due to an internal imbalance of yin and yang. This imbalance leads to blockage in the flow of qiIn
traditional Chinese medicine, the vital energy or life force proposed to regulate a person's spiritual, emotional,
mental, and physical health and to be influenced by the opposing forces of yin and yang. (or vital energy) and
of blood along pathways known as meridians.
• TCM practitioners typically use herbs, acupuncture and to help unblock qi.

Ayurvedic Medicine
• Ayurveda, which literally means "the science of life," is a natural healing system developed in India.
• It is a comprehensive system of medicine that places equal emphasis on the body, mind, and spirit, and
strives to restore the innate harmony of the individual.
• It includes diet, exercise, meditation, herbs, massage, exposure to sunlight, and controlled breathing.

Naturopathy
• Naturopathy is a system of healing, originating from Europe, that views disease as a manifestation of
alterations in the processes by which the body naturally heals itself.
• The core modalities supporting these principles include diet modification and nutritional supplements, herbal
medicine, acupuncture and Chinese medicine, hydrotherapy, massage and joint manipulation and lifestyle
counseling.

Homeopathy
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• Hahnemann, its founder, proceeded to give repeated doses of many common remedies to healthy volunteers
and carefully record the symptoms they produced. He developed his treatments for sick patients by matching
the symptoms produced by a drug to symptoms in sick patients.
• Examine all aspects of a person's health status, including emotional and mental states.

Source: National Center for Complementary and

Alternative Medicine (NCCAM)
nccam.nih.gov