Oncology nurses are frontrunners in identifying and managing symptoms experienced by people with cancer. From communication approaches and apps to integrative interventions, today’s tools can help nurses more efficiently assess and address side effects, thereby improving patient care.

Inspired by cultures around the Mediterranean Sea, the Mediterranean diet emphasizes whole, minimally processed, seasonal foods. It is rich in fruits, vegetables, grains, nuts, legumes, and olive oil with moderate amounts of red wine and smaller portions of dairy, poultry, and seafood. Considered more of a lifestyle than a diet, a key element is sharing and enjoying food with family and friends, encouraging social exchange and communication.

Dance/movement therapy (DMT) is an integrative symptom management modality that uses the elements of dance and movement along with other body-focused activities, including guided imagery, mindfulness, breath awareness, and therapeutic play to support self-expression and promote well-being. Defined by the American Dance Therapy Association as “the psychotherapeutic use of movement to promote emotional, social, cognitive and physical integration of the individual,” DMT has been used in pediatric cancer settings. However, data on its delivery and outcomes are limited.

Patients with cancer who participate in virtual mind-body classes are less likely to be hospitalized and are hospitalized for shorter durations, researchers reported at the 2023 American Society of Clinical Oncology Quality Care Symposium. Their findings highlight the benefits of mind-body practices in reducing symptoms and improving mental health in patients with cancer.

One in five patients experiences anxiety or depression at some point during their cancer journey, and those with a concurrent mental health condition have an increased risk of death and shorter life span compared to the general population. Despite that stark reality, mental health conditions have been frequently undertreated in patients with cancer.  

Many patients with cancer experience sleep disturbances, including insomnia, that can persist for years if not appropriately managed. The resulting increased risk for infections, anxiety, and depression can take a toll on patients’ quality of life.

Pharmacologic treatments for insomnia may contribute to adverse effects such as performance problems, memory disturbance, falls, and driving accidents, leading many patients to seek alternative or complementary therapies.

A reported 22%–58% of patients with cancer experience distress that can occur at any point along the clinical course, and it can interfere with their ability to cope well with cancer, its physical symptoms, and treatment. Oncology nurses can teach patients about mind-body approaches such as deep breathing, progressive muscle relaxation (PMR), and mindfulness to help self-manage distress and guide them to resources for mind-body practices. 

Despite pain’s prevalence as a debilitating symptom correlated with poor outcomes among patients with cancer, it is often inadequately treated. Racial disparities further contribute to the challenges of assessing and managing cancer pain, with health systems reporting markedly lower doses of opioid prescriptions for Black patients compared to White patients. The inequities stem from provider biases, patient belief systems, and systemic racism.

A form of mind-body therapy, tai chi has been practiced in China for centuries and progressed around the world today. The practice combines a sequence of gentle body movements with meditation and coordinated breathing. Under traditional Chinese medicine theory and philosophy, tai chi harmonizes the vital forces of yin and yang and promotes the flow of qi (internal energy).

Regular, light-intensity exercise and activity has been shown to reduce the risks of fractures, heart disease, and death. Substantial evidence also indicated benefits for cancer-related outcomes, including fatigue, depression, and quality of life. Additional observational data suggested that sustained physical activity may help reduce cancer recurrence and improve overall survival.

An estimated 16% of patients with cancer experience depressive spectrum disorders in oncologic, hematologic, and palliative care settings, seriously affecting their quality of life. Although conventional antidepressants can be effective in many situations, they are associated with adverse effects, such as fatigue, drowsiness, sleep difficulties, nausea, weight gain, nervousness, dry mouth, blurred vision and sexual dysfunction.

A common and distressing symptom among patients with a variety of health diagnoses as well as the general population, constipation is characterized by reduced stool frequency, incomplete evacuation, straining, and a sense of anorectal blockage. Nearly 43%–58% of patients with cancer report constipation caused by a variety of factors, including organic, functional, or drug associated. Standard treatment options such as fiber supplements, laxatives, and stool softeners are not entirely effective and can cause adverse effects.

Dance/movement therapy is a complementary modality that may help patients manage cancer and its treatment-associated symptoms. Based on the concept that mind, body, and spirit are interconnected, it combines the communicative elements of dance and movement with other body-focused activities—such as guided imagery, mindfulness, breath awareness, and play—to create an emotionally inviting environment where participants can share feelings and experiences. 

Chronic pain is a common but debilitating late effect for many patients with cancer. When undertreated, patients may experience negative functional, mental, and cancer-related outcomes. Although opioids are often effective for managing cancer pain, they may not be appropriate for some patients and others may struggle to access them because of the opioid crisis. The need for nonpharmacologic pain management options is critical. 

Cancer-related fatigue is a serious, debilitating symptom that affects nearly 90% of patients following treatment, with the majority reporting the adverse event at moderate to severe levels. It can prolong hospital stays and limit patients’ ability to complete their treatments and resume daily activities, ultimately affecting quality of life and survival. Despite high prevalence rates, cancer-related fatigue was reported as “inadequately addressed” in findings from a large multisite study.

Imagery is a mind-body practice with deep historical roots. It uses imagination to recreate mental images, sounds, smells and even tastes to help achieve relaxation and to promote healing. Guided imagery can be learned in an interactive manner from a licensed practitioner or from books and self-help tapes. Repeating the practice results in a conditioning effect that can empower the individual to use it whenever needed.

An annual flowering herb native to East Asia, Cannabis sativa is cultivated around the world. It is used in traditional medicine as an analgesic, hypnotic, hallucinogenic, sedative, and anti-inflammatory. Preparations derived from its flowers, leaves, and hashish made from its resinous extract are taken orally, by smoking, or by vaporizing. Cannabis teas, tinctures, ointments, and oil-based extracts that can be mixed into food products are also popular.

Qigong is a mind-body practice that originated in China nearly five millennia ago. It integrates movement, meditation, and breath regulation to improve physical and emotional health. The actions are slow, gentle, flowing, repetitious, and weight-bearing and can be adapted or practiced while sitting, standing, or walking. Qigong styles and forms vary widely, depending on the school of thought and philosophy.

The COVID-19 coronavirus is causing dramatic increases in anxiety and stress around the world, disrupting daily life. Healthcare professionals, including oncology nurses, are confronting enormous challenges as they struggle to deliver optimal patient care.

Sleep disturbances such as insomnia are prevalent and persistent among cancer survivors and diminish quality of life. Because of adverse effects such as continued sleep difficulty, memory disturbances, and falls associated with associated with conventional medications, many patients prefer nonpharmaceutical options to address their insomnia.

Kratom is a Southeast Asian tropical tree, the leaves of which have been chewed, smoked, or made as tea for their stimulant and euphoric effects. They have also been employed in traditional medicine to reduce pain and fever, to relieve diarrhea, for wound healing, and as a substitute for opium. Recently, kratom supplements have become popular in the United States for alleviating pain, improving mood, lowering anxiety, and alternative opioid withdrawal treatment.

Reiki is a complementary health approach in which practitioners place their hands lightly on or just above a person to promote a sense of well-being. It was founded by the Japanese Buddhist and spiritual teacher Mikao Usui in the early 20th century and brought to the United States in the 1930s, where it has become increasingly popular.

Nearly 60% of people with cancer experience insomnia; it can persist for years if not appropriately managed. Furthermore, patients with cancer who have insomnia are at increased risk for infections, anxiety, and depression, which can negatively affect quality of life.

Fatigue is one of the most prevalent and challenging side effects that people with cancer experience. Commonly known as cancer-related fatigue (CRF), the National Comprehensive Cancer Network  defines it as “a distressing, persistent, subjective sense of physical, emotional, and/or cognitive tiredness or exhaustion related to cancer or cancer treatment that is not proportional to recent activity and interferes with usual functioning.” CRF affects 50%–90% of patients and can diminish quality of life, lead to functional impairment, and is associated with significant morbidity. Although it improves in many patients the year following treatment, CRF may persist over a much longer period in some.

Reactive oxygen species (ROS), such as hydroxyl and superoxide radicals, singlet oxygen, and hydrogen peroxide, are byproducts of metabolic processes in the body and play an important role in regulating cell physiology and function. But uncontrolled ROS formation (oxidative stress) can result in DNA, protein, and lipid damage, which has been implicated in several diseases, including cancer. Antioxidants, produced endogenously or in supplemental form, function as ROS scavengers and inhibit oxidative stress. Popular antioxidants include vitamins C and E, selenium, beta carotene, lycopene, resveratrol, flavonoids, anthocyanins, and catechins. They are widely used to prevent cancer and its recurrence.

When patients or loved ones receive a cancer diagnosis, they often experience fear, worry, and a desire to do everything possible to increase the chance of survival. It is also a pivotal time for patients to assess their well-being and lifestyle and make positive changes. For many, complementary therapies become part of their cancer care journey. Internationally, 40% of patients with cancer have reported using complementary therapies to address cancer-related symptoms, improve the effectiveness of conventional treatments, and provide hope.

Pain is the most common and debilitating side effect that patients with cancer experience. Contributing factors include the disease itself via tumor invasion on surrounding tissue and bone; nerve compression; treatments including chemotherapy, radiotherapy and surgery, especially chemo-induced peripheral neuropathy (CIPN), which can be disabling; and aromatase inhibitors that can cause persistent diffuse joint pain. In addition, pain that “breaks through” continuous pain medicine can be difficult to predict and control.

As more U.S. states approve the use of medical cannabis, oncology advanced practice RNs (APRNs) may see increasing inquiries from patients who are interested in using it to manage cancer-related symptoms. However, the drug remains illegal under federal law, confounding research efforts for its use in cancer care and limiting the generation of supportive evidence.

Probiotics are live microorganisms that can offer health benefits following consumption, by reversing dysbiosis: changes in the composition or function of gut microbes associated with the development of many chronic and degenerative diseases. The majority of probiotics contain nonvirulent, lactic acid-producing bacteria, including Lactobacillus, Streptococcus, Bifidobacterium, Propionibacterium, and Enterococcus, or yeasts such as Saccharomyces boulardii. They are available as dietary supplements or can be obtained from yogurt and other fermented foods. Probiotics have grown in popularity over the past few decades because of perceived benefits such as improved digestion, immune function, and nutrient absorption.  

Aromatherapy has grown in popularity over the past few decades for improving sleep and mood and for reducing anxiety, but its first use dates back more than 5,000 years. The practice involves using essential (aromatic) oils, derived typically from steam distillation of plants, through application to the skin as a component of therapeutic massage or inhalation with vaporizers, inhalers, or hot water baths.

Lymphedema, the chronic swelling of a limb resulting from fluid accumulation, is a common sequela of surgery or radiation treatment for breast cancer. Nearly 90% of women who develop lymphedema do so within three years of treatment. Survivors commonly report physical and emotional distress, limitations to daily activities in fear of exacerbating lymphedema, and body image issues because of an abnormally enlarged limb.

Music has historically been associated with health and healing in cultures around the world. As a therapeutic intervention in patients with cancer, it is used to address physical and psychological symptoms. The sessions are tailored to meet patients’ individual needs and abilities and can involve listening to, writing, performing, or discussing music and lyrics, guided by a trained therapist. Although music does not affect the disease itself, it produces more immediate effects compared to pharmacologic agents, has a positive impact on mood, and strengthens patients’ ability to cope.

As medicinal cannabis continues to make its way into practice in states in which it has been legalized for medical use, oncology nurses, nurse practitioners, physicians, and all members of the cancer care team must be aware of the ways in which cannabis can be administered to patients. Although medicinal cannabis is still being studied, patients have several ways to use it to combat side effects like pain, nausea, and vomiting associated with cancer and its treatments. Knowing the routes of administration and the potential for drug interactions can help all oncology professionals approach medicinal cannabis in the safest possible ways for their patients.

Medicinal cannabis, a topic that remains largely unstudied in human trials in the United States, is slowly becoming introduced in areas of health care and oncology in states that have legalized it for medical and adult recreational use.

In clinics across the country, oncology nurses are moving the needle when it comes to patient-centered care. They innovate, create practice change, and are the lifelines for many of their patients. One oncology nurse and ONS member has combined her unique background in software development and health care to form a new business that aims to provide real-time practice resources to oncology nurses. In recognition of her achievements, ONS member and chief executive officer of Helpsy Health, Sangeeta Agarawal, RN, has been selected to attend the 8th annual Global Entrepreneur Summit (GES) in Hyderabad, India.

A large study published in the Journal of the National Cancer Institute found that patients with nonmetastatic breast, lung, or colorectal cancer who chose to use only alternative medicine had substantially worse survival than patients who received conventional cancer treatment.

Mushrooms have been valued for their health-promoting and medicinal effects for thousands of years. Research over the past few decades has focused on maitake (Grifola frondosa), reishi (Ganoderma lucidum), coriolus (Coriolus versicolor), shiitake (Lentinula edodes), and agaricus (Agaricus blazei), which are predominantly used in Asia.