Breast Cancer, Complementary, and Alternative Therapies
What new research tells us about complementary medicine, alternative treatments, and outcomes in breast cancer.
As an oncologist, I’m often asked about complementary and alternative medicine (CAM), both online and in the clinic. The term covers a wide range of practices. Sometimes it refers to approaches like acupuncture, meditation, massage, supplements, or dietary changes used alongside standard cancer treatment. Other times, it refers to choosing alternative therapies instead of proven treatments such as surgery, chemotherapy, radiation, endocrine therapy, or immunotherapy. These therapies can be harmful (think: coffee enemas, castor oil and metabolic therapies like “Gerson therapy”). If you haven’t seen the Netflix show, Apple Cider Vinegar, that is a deep dive into the dangers of alternative therapies, I highly recommend it.
One of the challenges is that we often have limited (if any) data on the safety or effectiveness of many alternative therapies, and patients are frequently navigating a landscape filled with misinformation. The National Cancer Institute has excellent information here on complementary and alternative medicine.
I spoke with the American Cancer Society on ways to find cancer information you can trust. If you see something online, ask yourself:
Who is sharing the information and what are their credentials?
What research support the claims? Does the claim reference a peer-reviewed study, an ongoing clinical trial, or guidelines from a respected organization? Is there a link to the research? Was the research conducted in humans?
Does the information encourage you to stop or avoid standard treatment or try to sell you something? That is always a red flag for me.
Photo by Markus Winkler on Unsplash
Linking here to an interview I did with PopSugar last year called “Beware of the Cancer Scammers” all about this topic!
Misinformation can have real consequences for health. It may lead patients to delay or decline treatments that are proven to be effective. In some cases, patients may pursue therapies that have not been properly studied, which can result in harmful side effects or dangerous interactions with medications they are already taking. Given these concerns, it is important to better understand how the use of complementary and alternative therapies may affect cancer outcomes.
A recent study published in JAMA Network Open examined the relationship between complementary and alternative medicine and survival among women with breast cancer, using data from more than 2.15 million patients in the National Cancer Database diagnosed with breast cancer between 2011 and 2021.1 Here are the treatments received:
97.6% of patients (2,106,665) received traditional therapy
<0.1% of patients (273) received CAM alone
<0.1% of patients (568) received a combination of CAM and traditional therapies
2.3% of patients (49,713) received no treatment
Researchers found that compared with patients who received traditional therapies, those treated with CAM alone had a 3.67-fold higher risk of death, and those who received no treatment had a 3.53-fold higher risk of death. Patients who received a combination of CAM and traditional therapy were also less likely to receive endocrine therapy and radiation compared with those treated exclusively with traditional therapies. This group had a 1.45-fold higher risk of death compared with patients receiving traditional therapy alone.
What this study tells us: Patients who did not receive standard breast cancer treatment (whether because they chose complementary and alternative medicine alone or no treatment at all) had worse outcomes. That said, there are many limitations in this study and we have to be careful about how we interpret the conclusions.
In this study, CAM treatments were defined as therapies administered by non-medical personnel. Importantly, we do not actually know which specific CAM treatments patients received, and to me this is a significant limitation. There is a wide variety of therapies that fall under the CAM umbrella. There is a huge difference between therapies like acupuncture or massage and an untested supplement that could potentially cause liver damage or interact with medications. Complementary therapies and alternative therapies are not the same.
Another important point is that the risk of death was very similar for patients who used CAM alone and those who received no treatment at all. This raises an important question: are the worse outcomes due to the CAM therapies themselves, or simply because patients did not receive standard cancer treatment? The findings suggest that the biggest issue may be the absence of proven therapy.
Patients often reach for CAM treatments when they are experiencing side effects from standard therapies. In the group that used both CAM and traditional therapy, we do not know whether patients were able to remain on treatments such as endocrine therapy, which can significantly influence recurrence risk and outcomes. I do not think we can draw any conclusions from this study about the combination of CAM and traditional treatments.
Another limitation of this study is the relatively low reported rate of CAM use. Other research suggests that CAM use among cancer patients is much higher. This likely reflects the fact that patients may not always disclose the complementary or alternative therapies they are using, or that these therapies are not consistently documented in the medical record. This study could only abstract what was documented in the health record, so if not documented, it was not captured. This study likely missed many patients who were utilizing complementary and alternative medicines, which has the potential to skew the results.
Because the groups receiving CAM were very small compared with the traditional-therapy group, we should also be careful not to overgeneralize.
It is a cohort study, not a randomized controlled trial (which is considered the gold standard in research). That means the study can show associations but cannot prove direct causation. However, it would be unethical to conduct a randomized trial in which one group of patients is assigned to receive no proven cancer treatment.
The overall message is consistent and important: patients who did not receive standard breast cancer treatment had worse survival.
I am a strong proponent of complementary therapies that support patients during and after treatment, such as acupuncture, mindfulness, and massage, among others. There are supplements that can be beneficial in certain situations such as Vitamin D, tart cherry for joint pain, and creatine (among others)— always talk to your doctor before taking any supplements to make sure it is right for you. One resource I frequently recommend is the Memorial Sloan Kettering Cancer Center About Herbs database which provides excellent evidence-based information on supplements, herbs, botanicals, and integrative medicine therapies.
If you are interested in supplements, mind-body therapies, integrative oncology, or symptom-management strategies, please bring them up with your oncology team. That conversation is important. Some approaches are helpful. Some may be neutral and some can interfere with treatment and cause harmful side effects.
The best version of cancer care is not one in which patients feel they have to choose between “traditional medicine” and “whole-person care.” The best version is one in which we combine evidence-based treatment with thoughtful, safe, supportive strategies that help people get through treatment and beyond it.
I would love to know your thoughts on this topic and your experiences with complementary and alternative medicine? What have you tried? Did you talk to your team about it?
Pre-order my book, Beyond The Pink: Navigating Life, Health, and Breast Cancer - out 9/29/2026!
Ayoade OF, Caturegli G, Canavan ME, Resio BJ, Berger ER, Boffa DJ. Use of Complementary and Alternative Medicine in the Management of Breast Cancer. JAMA Netw Open. 2026;9(3):e260337. doi:10.1001/jamanetworkopen.2026.0337.
First of all thank you for writing this. It’s very well done and respectful. As someone doing both traditional and CAM and who has done a clinical trial I would like to share. You may be in agreement to some of this from what I read.
I think the medical system is missing something big: quality of life.
Many patients don’t refuse therapies because they’re anti-science — they refuse them because the side effects can be devastating. Endocrine therapy in particular has huge dropout rates. People literally risk their lives because living on the medication can feel unbearable.
I’m a single mom. I don’t want to die. But I also can’t become someone in constant pain and misery who can’t show up for my child.
So we try to support ourselves: acupuncture, lymphatic massage, organic food, exercise. But none of that is covered. Lymph massage is $150–$200. Healthy food costs more. All of it takes time and energy on top of standard treatments. I’m always looking for who is thinking about how patients actually live through this?
I’m grateful for my oncologist and team at UCSF and for the clinical trial I participated in. I’m not anti-medicine. But even the best system focuses almost entirely on the tumor, not the whole body — not the gut, nervous system, or long-term resilience. They offer pills to combat side effects but the main treatment is harmful to the whole body. The tech is here.And we can be more holistic and personalized.
Patients are trying to bridge that gap themselves. The future has to merge East and West: rigorous science with whole-body health. We now have enough data and tools to study why some people heal exceptionally well without traditional therapies. Study those humans if they consent. Study them more deeply than some blood work and scans. Do a deeper more integrated dive and lifestyle and location and dna stress tests and all that. I am sure there are things I am missing.
If patients are choosing death over treatment, that’s the signal the system needs to pay attention to.
As a breast cancer survivor, I went through surgery, chemotherapy, and radiation, and I have now been taking Letrozole for five years. Throughout each stage of my conventional treatment, I also received complementary support from Dr. Neil McKinney, ND (now retired), author of Naturopathic Oncology.
My healthcare team was fully aware of my complementary program and trusted Dr. McKinney’s recommendations and the supplements he added to my treatment plan.
Now in my fifth year of Letrozole, I continue to take several supplements, including Vitamins K and D, Quercetin, and low-dose Naltrexone. I had an Oncotype score of 45, and at present my health is good.
My belief is that a patient’s healthcare team—including both conventional and complementary practitioners—should work collaboratively to meet the individual needs of each patient.