Table 4.
Non-pharmacological interventions and therapies recommended by the included clinical practice guidelines.
| Clinical Outcomes | Recommended Non-pharmacological Interventions/Therapies | Guidelines | Grading System Used |
|---|---|---|---|
| Anxiety/depression/distress |
Meditation
Form: MBSR Duration/Frequency: NR LoE/GoR: I/B (generally recommended) SoE: NR |
ESO-ESMO (ABC5) 2020 | Infectious Diseases Society of America–United States Public Health Service Grading System |
|
Hypnosis
Form: NR Duration/Frequency: NR LoE/GoR: I/B (generally recommended) SoE: NR |
ESO-ESMO (ABC5) 2020 | Infectious Diseases Society of America–United States Public Health Service Grading System | |
|
Yoga
Form: NR Duration/Frequency: NR LoE/GoR: I/B (generally recommended) SoE: NR |
ESO-ESMO (ABC5) 2020 | Infectious Diseases Society of America–United States Public Health Service Grading System | |
|
Meditation
Form: “MBSR Program/Mindful Movement Program/brain wave vibration meditation/Tibetan sound meditation/cognitively based compassion training/Transcendental Meditation” (Greenlee et al., 2017, p. 205) Duration/Frequency: NR LoE/GoR: A/recommended SoE: 10 RCTs and several systematic reviews and meta-analyses |
SIO 2017 | Modified version of the US Preventive Services Task Force Grading System | |
|
Music therapy
Form: Passive or active music therapy Duration/Frequency: NR LoE/GoR: B/recommended SoE: 5 RCTs and 2 systematic reviews and meta-analysis |
SIO 2017 | Modified version of the US Preventive Services Task Force Grading System | |
|
Stress management–for anxiety
Form: Self-administered/cognitive-behavioural stress-management Duration/Frequency: NR LoE/GoR: B/recommended SoE: 4 RCTs and 2 systematic reviews |
SIO 2017 | Modified version of the US Preventive Services Task Force Grading System | |
|
Yoga
Form: Lyengar/Patanjali’s/Pranayama Duration/Frequency: NR LoE/GoR: B/recommended SoE: 15 RCTs and several systematic reviews and meta-analyses |
SIO 2017 | Modified version of the US Preventive Services Task Force Grading System | |
|
Relaxation-for depression
Form: PMR/guided imagery/visualisation techniques/autogenic training Duration/Frequency: NR LoE/GoR: A/recommended SoE: 6 RCTs and several systematic reviews and meta-analyses |
SIO 2017 | Modified version of the US Preventive Services Task Force Grading System | |
|
Massage
Form: “classic massage (rhythmic stroking, kneading, and acupressure at select areas on the body)” (Greenlee et al., 2017, p. 212) Duration/Frequency: 30-minute massages biweekly, for total of 5 weeks or one time, 40 minutes LoE/GoR: B/recommended SoE: 6 RCTs and several systematic reviews and meta-analyses |
SIO 2017 | Modified version of the US Preventive Services Task Force grading system | |
| Chemotherapy-induced nausea and vomiting |
Acupressure
Form: Self-acupressure Duration/Frequency: NR LoE/GoR: B/recommended SoE: 3 RCTs |
SIO 2017 | Modified version of the US Preventive Services Task Force Grading System |
|
Relaxation
Form: NR Duration/Frequency: NR LoE/GoR: C/considered SoE: 2 trials |
SIO 2017 | Modified version of the US Preventive Services Task Force Grading System | |
| Fatigue |
Exercise programme
Form: NR Duration/Frequency: NR LoE/GoR: NR/recommended SoE: High-quality systematic review and meta-analysis |
NICE 2017 | SIGN criteria |
|
Exercise
Form: NR Duration/Frequency: “equivalent to 3-5 hours of moderate walking per week” (Cardoso et al., 2020, p. 1643) LoE/GoR: I/A (strongly recommended) SoE: NR |
ESO-ESMO (ABC5) 2020 | Infectious Diseases Society of America–United States Public Health Service Grading System | |
|
Meditation
Form: MBSR Duration/Frequency: NR LoE/GoR: I/B (generally recommended) SoE: NR |
ESO-ESMO (ABC5) 2020 | Infectious Diseases Society of America–United States Public Health Service Grading System | |
|
Hypnosis
Form: NR Duration/Frequency: NR LoE/GoR: I/B (generally recommended) SoE: NR |
ESO-ESMO (ABC5) 2020 | Infectious Diseases Society of America–United States Public Health Service Grading System | |
|
Yoga
Form: NR Duration/Frequency: NR LoE/GoR: I/B (generally recommended) SoE: NR |
ESO-ESMO (ABC5) 2020 | Infectious Diseases Society of America–United States Public Health Service Grading System | |
|
Physical activity
Form: NR Duration/Frequency: NR LoE/GoR: I/recommended SoE: Several RCTs |
ACS-ASCO 2016 | Not classified | |
|
Physical activity
Form: NR Duration/Frequency: NR LoE/GoR: I/recommended SoE: NR |
Sisler et al. (29) | Not classified | |
|
Hypnosis
Form: NR Duration/Frequency: NR LoE/GoR: C/considered SoE: 2 trials |
SIO 2017 | Modified version of the US Preventive Services Task Force Grading System | |
|
Yoga
Form: NR Duration/Frequency: NR LoE/GoR: C/considered SoE: 3 trials |
SIO 2017 | Modified version of the US Preventive Services Task Force Grading System | |
|
Yoga
Form: NR Duration/Frequency: NR LoE/GoR: I/suggested SoE: NR |
Sisler et al. (29) | Not specified | |
| Lymphedema |
Physiotherapy
Form: NR Duration/Frequency: NR LoE/GoR: I/A (strongly recommended) SoE: Meta-analyses of RCTs |
ESMO (EBC) | Infectious Diseases Society of America–United States Public Health Service Grading System |
|
Physiotherapy
Form: NR Duration/Frequency: NR LoE/GoR: 0/recommended SoE: NR |
ACS-ASCO 2016 | Not classified | |
|
Physiotherapy
Form: Progressive resistance training & aerobic exercise programme Duration/Frequency: Aerobic exercise program: “pole walking for 30-60 minutes, 3-5 times weekly for 8 weeks; proximal to distal exercise for 45 minutes while integrating self-massage and diaphragmatic breathing and weekly in a 1.2-m pool at 32°C-33°C.” (Davies et al., 2020, p. 1174) LoE/GoR: I-II/A (strongly recommended) SoE: RCTs |
Davies et al. (41) | Oxford Centre for Evidence-Based Medicine–levels of evidence | |
|
Weight management–risk of lymphedema
Form: NR Duration/Frequency: NR LoE/GoR: 0/recommended SoE: NR |
ACS-ASCO 2016 | Not classified | |
|
Weight management–risk of lymphedema
Form: NR Duration/Frequency: NR LoE/GoR: III/NR SoE: NR |
Sisler et al. (29) | Not classified | |
| Pain |
Healing touch–after chemotherapy
Form: NR Duration/Frequency: NR LoE/GoR: C/considered SoE: A single, large trial |
SIO 2017 | Modified version of the US Preventive Services Task Force Grading System |
|
Music therapy–after surgery
Form: NR Duration/Frequency: NR LoE/GoR: C/considered SoE: 2 trials |
SIO 2017 | Modified version of the US Preventive Services Task Force Grading System | |
|
Hypnosis–after surgery
Form: NR Duration/Frequency: NR LoE/GoR: C/considered SoE: 2 trials |
SIO 2017 | Modified version of the US Preventive Services Task Force Grading System | |
|
Physical activity
Form: NR Duration/Frequency: NR LoE/GoR: I/recommended SoE: NR |
Sisler et al. (29) | Not classified | |
|
Physical activity
Form: NR Duration/Frequency: NR LoE/GoR: I/recommended SoE: NR |
Sisler et al. (29) | Not classified | |
|
Physical activity
Form: NR Duration/Frequency: NR LoE/GoR: I/recommended SoE: Many RCTs, meta-analyses of RCTs |
ACS-ASCO 2016 | Not classified | |
| Neuropathy |
Physical activity
Form: NR Duration/Frequency: NR LoE/GoR: IA/recommended SoE: NR |
ACS-ASCO 2016 | Not classified |
| Quality of life |
Regular exercise/sport
Form: NR Duration/Frequency: “equivalent to 3-5 hours of moderate walking per week” (Cardoso et al., 2020, p. 1643) LoE/GoR: I/B (generally recommended) SoE: NR |
ESO-ESMO (ABC5) 2020 | Infectious Diseases Society of America–United States Public Health Service Grading System |
|
Meditation
Form: MBSR Duration/Frequency: NR LoE/GoR: I/B (generally recommended) SoE: NR |
ESO-ESMO (ABC5) 2020 | Infectious Diseases Society of America–United States Public Health Service Grading System | |
|
Hypnosis
Form: NR Duration/Frequency: NR LoE/GoR: I/B (generally recommended) SoE: NR |
ESO-ESMO (ABC5) 2020 | Infectious Diseases Society of America–United States Public Health Service Grading System | |
|
Yoga
Form: NR Duration/Frequency: NR LoE/GoR: I/B (generally recommended) SoE: NR |
ESO-ESMO (ABC5) 2020 | Infectious Diseases Society of America–United States Public Health Service Grading System | |
|
Meditation
Form: “MBSR program/Mindful Movement Program/brain wave vibration meditation/Tibetan sound meditation/cognitively based compassion training/Transcendental Meditation” (Greenlee et al., 2017, p. 215) Duration/Frequency: NR LoE/GoR: A/recommended SoE: 7 RCTs and several systematic reviews and meta-analyses |
SIO 2017 | Modified version of the US Preventive Services Task Force Grading System | |
|
Yoga
Form: Lyengar/Patanjali’s/Pranayama/integrated yoga Duration/Frequency: NR LoE/GoR: B/recommended SoE: 12 RCTs and several systematic reviews and meta-analyses |
SIO 2017 | Modified version of the US Preventive Services Task Force Grading System | |
|
Qigong
Form: NR Duration/Frequency: NR LoE/GoR: NR/C (considered) SoE: NR |
SIO 2017 | Modified version of the US Preventive Services Task Force Grading System | |
|
Stress management
Form: NR Duration/Frequency: NR LoE/GoR: NR/C (considered) SoE: NR |
SIO 2017 | Modified version of the US Preventive Services Task Force Grading System | |
| Sleep disturbance |
Yoga
Form: NR Duration/Frequency: NR LoE/GoR: C/considered SoE: 5 trials |
SIO 2017 | Modified version of the US Preventive Services Task Force Grading System |
|
Relaxation training
Form: NR Duration/Frequency: NR LoE/GoR: NR SoE: NR |
Reese et al. (44) | No grading system | |
| Vasomotor/hot flashes |
Physical activity
Form: Exercise/yoga Duration/Frequency: 8 to 12 weeks, and follow-up 3 to 6 months varied LoE/GoR: Low/conditional SoE: 3 trials |
ONS 2020 | GRADE |
| Risk of recurrence |
Physical activity
Form: NR Duration/Frequency: NR LoE/GoR: NR SoE: Low-quality evidence from 2 cohort studies |
NICE 2018 | SIGN criteria |
|
Weight management
Form: NR Duration/Frequency: NR LoE/GoR: NR SoE: Moderate-quality evidence from 1 RCT |
NICE 2018 | SIGN criteria | |
|
Lifestyle change
Form: NR Duration/Frequency: NR LoE/GoR: NR SoE: NR |
St. Gallen 2019 | Not classified | |
|
Physical exercise
Form: NR Duration/Frequency: NR LoE/GoR: II/A (strongly recommended) SoE: NR |
SEOM 2018 | Infectious Diseases Society of America–United States Public Health Service Grading System | |
|
Weight management
Form: NR Duration/Frequency: NR LoE/GoR: II/A (strongly recommended) SoE: NR |
SEOM 2018 | Infectious Diseases Society of America–United States Public Health Service Grading System |
MBSR, mindfulness-based stress reduction; NR, not reported; LoE, level of evidence; GoR, grade of recommendation; SoE, strength of evidence; ESO, European School of Oncology; ESMO, European Society for Medical Oncology; ABC, advanced breast cancer; SIO, Society of Interventional Oncology; US, United States; RCT, randomised controlled trial; NICE, National Institute for Health and Care Excellence; SIGN, Scottish Intercollegiate Guidelines Network; ACS, American Cancer Society; ASCO, American Society of Clinical Oncology; ONS, Oncology Nursing Society; GRADE, Grading of Recommendations Assessment, Development, and Evaluation; SEOM, Sociodad Española de Oncolgía Médica.