Research on complementary/alternative medicine for patients with breast cancer: A review of the biomedical literature

Purpose: This article reviews English-language articles published in the bi omedical literature from 1980 to 1997 that reported results of clinical res earch on complementary and alternative medical treatments (CAM) of interest to patients with breast cancer. Methods: We searched 12 electronic databases and the bibliographies of the retrieved papers, review articles, and books on CAM and breast cancer. The retrieved articles were grouped by end point: breast cancer (eg, tumor size , survival), disease-related symptoms, side effects of treatment, and immun e function. Within each end point, we organized the articles by modality an d assessed study design, findings, and qualitative aspects. Results: Of the more than 1,000 citations retrieved, 51 fit our criteria fo r review. Of the articles reviewed, 17 were randomized clinical trials; thr ee of these were trials of cancer-directed interventions, two of which invo lved the same treatment (melatonin). Seven articles described observational studies, and the remainder were reports of phase I or II trials. Relativel y few CAM modalities reportedly used by many breast cancer patients were me ntioned in articles retrieved by this process. Most articles had shortcomin gs. Conclusion: Although many studies had encouraging results, none showed defi nitively that a CAM treatment altered disease progression in patients with breast cancer. Several modalities seemed to improve other outcomes (eg, acu puncture for nausea, pressure treatments for lymphedema). If CAM studies ar e well-founded, well-designed, and meticulously conducted, and their hypoth eses, methods, and results are reported clearly and candidly, research in t his controversial area should acquire credibility both in the scientific co mmunity and among advocates of unconventional medicine. J Clin Oncol 18:668 -683. (C) 2000 by American Society of Clinical Oncology.