Individual therapies

Acupuncture

What it is: Acupuncturists put fine, sterile needles just under the skin into energy channels called meridians, which are said to regulate energy flow. Each meridian has many acupuncture points along its path.

Why use it: Acupuncture is based on the theory that the placement of needles into certain points of the body unblocks and moves qi (vital energy) to strengthen and reduce physical and emotional symptoms. Research suggests that the needles stimulate the nervous system and the connective tissue in the body, and help the body produce certain biomolecules such as hormones.

What to expect: After a consultation, which may include tongue and pulse analysis, the practitioner gently positions sterile needles into acupuncture points on your body. The needles are left in place for 30 seconds to 30 minutes, and may be stimulated manually by twirling or by using a machine (called electro-acupuncture). You may feel a tingling or dull aching sensation, but should not feel pain. Acupuncturists may also implant and cover special needles called press needles, which can remain in place for several days. Some acupuncturists use laser light instead of needles to stimulate acupuncture points (laser acupuncture).

Some people may bruise or bleed around the insertion point. Check with your doctor whether acupuncture is suitable for you, as penetration of the skin barrier by needles may increase the risk of infection or bleeding for some people having cancer treatment.

Evidence: Clinical guidelines recommend acupuncture for joint pain related to using aromatase inhibitors, and include it as an option for managing cancer pain, musculoskeletal pain, chemotherapy-induced tingling in the hands and feet (peripheral neuropathy), cancer-related fatigue and hot flushes.

Evidence suggests acupuncture may also help with chemotherapy-related nausea and vomiting, sleep disturbance and anxiety. It’s not clear whether it helps relieve dry mouth, but several studies are underway.

In Australia, use of the term acupuncturist is regulated by AHPRA and the Chinese Medicine Board.

Some registered acupuncturists in Australia have special training in treating cancer-related conditions. Ask your doctor whether acupuncture is offered at your treatment centre.

Aromatherapy

What it is: The use of essential oils extracted from plants for healing relaxation. They are used mainly during massage but can also be used in baths, inhalations or vaporisers (oil burners).

Why use it: When inhaled or absorbed through the skin during massage, the oils are thought to have a positive effect on the body’s tissues, the mind and spirit.

What to expect: The aromatherapist blends essential oils and adds them to a base (carrier) oil before applying them to your skin during a massage.

Evidence: There is limited evidence that aromatherapy may have positive short-term effects on pain and anxiety in people with cancer. There is some small evidence that aromatherapy improves sleep and quality of life.

Art therapy

What it is: A way to express feelings using visual art. Discussing the work you create with a trained art therapist can help you understand your emotions and concerns.

Why use it: The process of creating art can be a way to explore feelings and issues that are hard to put into words. Art therapy can also help with solving problems, improving mood and reducing stress.

What to expect: With the support of an art therapist, you can create any type of art: drawing, painting, collage, sculpture or digital work. Some cancer centres run art therapy programs.

Art therapy may be done individually or in a group. You don’t need to be good at art to benefit or participate – the emphasis is on the process of producing artwork, not on the result.

Evidence: There is some evidence that art therapy helps manage symptoms of fatigue and anxiety, and improves quality of life. Anecdotal evidence suggests that it improves coping skills and emotional wellbeing.

Chinese herbal medicine

What it is: Chinese herbs are a key part of Chinese medicine. Different parts of plants, such as the leaves, roots, stems, flowers and seeds, are used. Herbs may be taken as tablets or given as tea.

Why use it: Some people believe that herbs can unblock meridians and bring harmony to the forces in the body, such as Yin and Yang.

What to expect: The practitioner will take a case history and assess how your body is out of balance. This will include a tongue and pulse analysis. They will choose a combination of herbs and foods with the aim of bringing your body back into balance.

Chinese medicine practitioners make a formula tailored specifically to your condition, or they can dispense herbal medicines pre-packaged as granules, pills or raw herbs.

Evidence: As with Western herbal medicine, many Chinese herbs have been scientifically evaluated for how well they work for people with cancer. Studies have found benefits for some herbs, such as American ginseng for cancer-related fatigue. Research is continuing to examine the benefits of different herbs and different herbal combinations.

Chinese herbal medicine is a complex area and it’s best to see an experienced practitioner rather than trying to treat yourself. Visit the Chinese Medicine Board to check your practitioner is registered.

Counselling

What it is: Through discussions with a counsellor or psychologist, you can identify goals you would like to achieve, develop ways to deal with difficult situations or relationships in your life, and look at how to manage your feelings. Counselling allows you to explore ways of resolving negative thoughts and feelings that impact on your health and day-to-day life. It is a non-judgemental and confidential process.

Why use it: Counselling sessions allow you to express your emotions in a safe and supportive environment and learn new coping skills. Counselling can strengthen your ability to deal with challenges and help you gain a new way of looking at your life choices and behaviours. It can also provide an opportunity to talk about thoughts and feelings that you might not feel comfortable sharing with family and friends. Counselling may provide strategies to help manage fear of the cancer coming back.

What to expect: Counselling appointments may be face-to-face, over the phone or online. There are different forms including cognitive behaviour therapy (CBT), grief therapy, life coaching, acceptance and commitment therapy, and person-centred therapy. Talk to the counsellor about the approach they take and whether it is suited to you. Counselling can be for you, or for family or friends affected by cancer.

Evidence: There is long-established evidence of the benefits of counselling. It can help reduce distress, anxiety and depression, and improve quality of life. CBT can help manage cancer-related fatigue.

If you are thinking about attending a group counselling session, it is important to check that it is being led by a trained counsellor. They can guide the group and offer strategies to deal with specific issues that arise during the session. 

Getting help with your emotions

If you’re interested in counselling, meditation and relaxation, you can seek help from a variety of health professionals and services. However, it is important that you find a suitably qualified counsellor you feel comfortable talking with.

Let your therapist know if you have a history of anxiety, depression or any other mental health condition, as you may be feeling more vulnerable now.

Counsellor – Counsellors can help clients come up with strategies for managing their concerns. They do not need to have any qualifications to practise, though many are qualified with a background in counselling, nursing, social work and psychology. It’s a good idea to check the counsellor’s qualifications before making an appointment. Cancer Council SA also operates a free cancer counselling program. Call Cancer Council 13 11 20 for more information.

Psychologist – Psychologists use evidence-based strategies to guide people through issues with how they think, feel and learn. They cannot prescribe medicines. A registered psychologist must complete 4 years of psychology at undergraduate level, followed by either postgraduate study or supervised clinical practice.

Psychiatrist – Psychiatrists are trained medical doctors who specialise in the diagnosis, treatment and prevention of mental illness. They can prescribe medicines to help a range of mental and emotional conditions.

How to find help

Some counsellors specialise in treating people affected by cancer. You may be able to see a psychologist or psychiatrist at your hospital or cancer treatment centre.

You can also ask your GP for a referral to a psychologist or psychiatrist, as you may be eligible for a Medicare rebate to help cover the cost. To find a psychologist in your area, visit the Australian Psychological Society.

Online self-help programs or smartphone apps can help you track how you’re feeling, and most are free to download. Visit moodgym or MindSpot. For 24-hour crisis support, visit Lifeline or call them on 13 11 14.

Flower remedies

What they are: Also known as flower essences, these are highly diluted extracts from the flowers of wild plants. There are many types of flower remedies from around the world. The most well known in Australia are the Original Bach Flower Remedies, developed in the 1930s in England, and Australian Bush Flower Essences, developed in Australia in the 1980s.

Why use them: Some people believe that flower remedies balance the mind, body and spirit, and help you cope with emotional problems, which can sometimes contribute to poor health.

What to expect: Much like a counselling session, the therapist will ask questions and listen to you talk about yourself, the problems you are  experiencing and how you feel about or approach certain situations. This enables the therapist to prepare a remedy – usually a blend of essences –
tailored specifically for you, which is taken in water several times a day.

Always confirm the actual ingredients in the suggested remedy and discuss with your cancer care team before taking them. Some herbs may interact with some cancer treatments and medicines, and cause side effects.

Evidence: Scientific evidence does not support the use of flower remedies for treating diseases. However, anecdotal evidence suggests they may be helpful for reducing fear, anxiety or depression.

Healing touch

What it is: The placement of hands in specific sequences above or on the body to assess and determine areas of energy imbalance, which are  generally experienced as temperature, texture or vibration changes.

Why use it: Healing touch is thought to work with your personal energy field to support the body’s own natural ability to heal.

What to expect: Healing touch can be done while you are sitting, lying down or standing. The therapist may perform a meditation and assess your energy field by observation and moving their hands over your body.

Evidence: There is no scientific evidence of an energy field or that energy therapies have any benefits.

Hypnotherapy

What it is: Deep relaxation that is used to help people become more aware of their inner thoughts and to develop ways to help them manage their situation.

Why use it: Hypnotherapy can improve mental wellbeing and quality of life. It can help to overcome mental blocks that prevent people dealing with issues such as anxiety, fear, low self-esteem, pain, insomnia and unwanted habits such as smoking.

What to expect: A trained therapist will take a case history and discuss your reasons for having hypnotherapy. They will then lead you into a deeply relaxed state, known as an altered state of consciousness. Being in a relaxed state allows your subconscious to focus on your treatment goals, which then become more achievable for your conscious mind.

Evidence: Hypnotherapy has been clinically tested with good results for helping people cope with pain, anxiety, fatigue, hot flushes, nausea and vomiting related to cancer treatment.

Laughter yoga

What it is: Laughter yoga, also known as laughter therapy, combines laughter-based activities, clapping and breathing into an exercise routine to encourage overall health and wellbeing.

Why use it: The natural process of laughter is used to relieve physical and emotional stress.

What to expect: In a group setting, you’ll be taken through a number of laughter exercises. These are not based on humour or jokes, but on laughter as a physical exercise.

Evidence: Research shows laughter has a positive impact on our physical and mental wellbeing and can stimulate the release of endorphins, the feel-good hormones.

Massage

What it is: Massage involves moving (manipulating) muscles and rubbing or stroking soft tissues of the body. There are many different styles of massage. Oncology massage therapists are specially trained to adjust pressure, speed, duration and direction of strokes to provide a safe session for a person with cancer.

Why use it: All styles of massage aim to promote deep relaxation in tissue by applying pressure to muscles and pressure points. This helps to release both muscular and emotional tension. The style of massage used for people during or after cancer treatment will depend on the treatment they’re having. It may be helpful at any stage – from those newly diagnosed to people who have finished their cancer treatment.

Over the years, there has been a general concern that massage can increase the risk of cancer cells spreading to other parts of the body. However, there is no evidence that this happens.

Some types of massage can help reduce the symptoms of lymphoedema (swelling caused by a build-up of lymph fluid). This is called manual  lymphatic drainage.

What to expect: Massage usually occurs in a warm, quiet room. It can be given while you either lie on a massage table or sit in a chair. The therapist uses a variety of strokes on different parts of the body. When performing massage on a person with cancer, therapists may need to adjust their pressure and avoid certain areas of the body.

Some styles of massage are done with you fully clothed; others require you to undress to your underwear so the therapist can use oil to move their hands over your skin more easily. The therapist may place pillows under different parts of your body so they’re supported. Let the therapist know if you need anything to feel more comfortable, such as a change in pressure or another blanket. You may like to close your eyes during the massage.

Evidence: Many scientific studies have shown that oncology massage may help manage symptoms such as stress, pain, anxiety, depression and fatigue in people who have had chemotherapy or surgery for cancer.

Massage concerns for people with cancer

See an accredited oncology massage therapist or lymphoedema practitioner to ensure they know to avoid massaging near known areas of cancer,  and understand how to adapt massage to specific safety concerns relating to cancer treatments.

Chemotherapy – This drug treatment affects the whole body. If you have a chemotherapy port, massage should not be done in this area. Some people who have chemotherapy experience tingling in their hands or feet (peripheral neuropathy), or may find they bruise or bleed easily, so should avoid
deep massage.

Radiation therapy – The skin may be sensitive to touch after external radiation therapy. It may look red and appear sunburnt. If you are having  radiation therapy, you should avoid massage to the treated area once any skin changes appear or your skin becomes sensitive. Massage oils may make already irritated skin feel worse.

Surgery – Recovery after surgery takes time, and it’s important to avoid massaging the area of the operation until wounds are healed and there are no other medical issues such as blood clots, infections or trapped pockets of fluid under the skin (seroma). Ask your surgeon when you can start
scar massage after surgery. Gentle massaging with lotion can provide comfort and support.

Risk of lymphoedema – If you’ve had lymph nodes removed from the neck, armpit or groin during diagnosis or treatment, or if you’ve had radiation therapy to these areas, you may be at risk of developing lymphoedema. Consider seeing a trained lymphoedema therapist for massage therapy. If you have developed lymphoedema, massage therapies such as manual lymphatic drainage may help control the symptoms. Therapists not trained
in treating lymphoedema should avoid the affected area. Visit lymphoedema.org.au to find a registered lymphoedema practitioner.

Download our fact sheet ‘Understanding Lymphoedema’

Bone fragility – Radiation therapy or medicines, or the cancer itself, may cause the bones to become more fragile. Care should be taken to avoid undue pressure.

Medicinal cannabis

Some people are interested in using cannabis for medical purposes. Cannabis is a plant that contains many types of chemicals called cannabinoids. These chemicals act on certain receptors found on cells in our body. Cannabinoids can also be made in a laboratory.

Medicinal cannabis contains standard measures of cannabinoids. Two cannabinoids commonly used in medicinal cannabis are delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD).

There is no evidence that medicinal cannabis can treat or cure cancer itself. Research studies have looked at the potential benefits of using medicinal cannabis to relieve cancer symptoms and treatment side effects. There is some evidence that cannabinoids can help people who have found conventional treatment unsuccessful for some symptoms and side effects (e.g. chemotherapy-induced nausea and vomiting).

To date, published studies have shown medicinal cannabis to have little effect on appetite, weight, pain or sleep problems. Research is continuing in this area.

It is illegal to grow, possess or use cannabis in Australia. However, the Australian Government allows seriously ill people to access medicinal cannabis for medical reasons through registered medical practitioners. Most medicinal cannabis products in Australia are unapproved products. This means that before prescribing medicinal cannabis, your doctor needs to get approval from the government.

The laws about access to medicinal cannabis vary in each state and territory. These laws may affect whether it can be prescribed for you.

The TGA now allows low dose cannabis products containing up to 150 mg of CBD to be included on the Australian Register of Therapeutic Goods and sold over the counter by pharmacists. As at the time of publication, no product has been approved by the TGA.

Medicinal cannabis may interact with some other drugs and also affect your driving ability. Talk with your doctor about any precautions you should take.

For more information, visit the Therapeutic Goods Administration and search “medicinal cannabis”.

Mindfulness

What it is: Mindfulness is the quality of being present and fully engaged in the present moment — free from distraction or judgement. Mindfulness practices can include focusing on the breath and observing each rise and fall, body scan meditations, and mindful walking. Mindfulness-based stress reduction (MBSR) is a 6–8 week course designed to help you cope better and be at ease in your life.

Why use it: People practise mindfulness to change the way they think about experiences. By becoming aware of thoughts and feelings, you can choose how to handle them in the moment. This can increase attention and awareness, and strengthen wellbeing.

What to expect: Mindfulness can be practised sitting, standing or lying down. An instructor will support you to focus attention in a mindful way. This could be through following a series of exercises that focus on breath work and calming the mind.

Evidence: There is good evidence to show that MBSR lowers the levels of stress hormones in your body, which can assist in healing, and improves immune function. Clinical practice guidelines include MBSR as an option for managing cancer-related fatigue.

Studies on mindfulness show it helps improve the quality of life of people with cancer, increases coping, and can reduce pain, anxiety, depression and nausea.

Check whether your cancer centre runs mindfulness programs. There are also online programs and smartphone apps you can download.

Music therapy

What it is: A music therapist helps people engage with different aspects of music to improve their health and wellbeing.

Why use it: Music therapy can help people express themselves, feel more in control, focus on healing, feel less anxious, connect with other people and simply enjoy themselves in the moment.

What to expect: You don’t need to be musical to take part or benefit. The structure of the session will depend on the needs of the participants. You may play instruments, sing, or write lyrics, or you may simply listen to music and discuss how it affects you. Music therapy may be done in a group or one-on-one with a therapist.

Evidence: Some evidence-based studies in people with cancer have shown that music therapy can improve anxiety, depression, pain, fatigue and quality of life.

Naturopathic nutrition

What it is: This is part of a broad field of health care that focuses on the foods you eat and how they affect your health and wellbeing. This approach recognises that each person has different nutritional needs.

Why use it: A diet tailored to your unique needs and your body’s specific requirements may help you achieve optimal health.

What to expect: A naturopathic nutritionist develops a treatment plan that is focused on a diet of whole food and nutrient-rich food. You will be encouraged to avoid or limit artificial flavours and chemicals. You may also be prescribed specific herbs or supplements.

Evidence: Clinical evidence supports the use of a healthy diet for good health.

Qi gong

What it is: Qi gong – pronounced “chee goong” – is part of Chinese medicine. “Qi” means vital energy and “gong” means work. Qi gong combines movement with controlled breathing and meditation. It may be considered both a body-based practice and an energy therapy.

Why use it: Movements performed in qi gong are said to keep the flow of energy running through the body’s energy channels. This can help improve quality of life, including mental and physical wellbeing.

What to expect: Wear comfortable clothes. The session starts with warm-up exercises to loosen the body. The instructor then guides you through a series of slow movements, which help you become more aware of your energy. Classes might also include meditation while you are lying down, sitting, standing or walking.

Evidence: Clinical studies suggest that qi gong improves quality of life and reduces fatigue, pain and anxiety. Anecdotal evidence shows that it helps to improve general fitness.

Reflexology

What it is: A form of foot and hand massage. It’s based on the belief that certain areas on the feet and hands or “reflex points” correspond to the body’s internal organs and systems, like a map.

Why use it: Many people find reflexology relaxing. It is believed that pressing on reflex points unblocks meridians, and this can promote health on the related area of the body.

What to expect: After talking through your case history, you remove your footwear. While you are seated or lying down, the reflexologist works with their hands on your bare feet, possibly using cream or oil. It usually feels like a relaxing massage, although sometimes the therapist’s touch can be subtle.

Evidence: Clinical practice guidelines include reflexology as an option for managing chemotherapy-related peripheral neuropathy, as well as pain felt during systemic treatment. Several clinical trials have looked at using reflexology for anxiety, fatigue, breathlessness and quality of life. Studies have involved small groups of people, so it is difficult to say whether the reflexology had any effect.

Reiki

What it is: The term reiki is a Japanese word meaning universal life energy. It is a gentle hands-on therapy based on the belief that therapists can channel healing energy into another person to promote health.

Why use it: People use reiki to improve physical, emotional and spiritual wellbeing.

What to expect: During a reiki session, you sit or lie down fully clothed. The therapist places their hands in a series of positions on or slightly above your body. The aim is to enhance the body’s natural healing ability and promote wellbeing.

Evidence: There is no reliable evidence that reiki has any benefits. Anecdotal reports suggest that reiki is calming and relaxing, often helping to relieve pain and anxiety, reduce stiffness and improve posture.

Relaxation and meditation

What it is: Relaxation is a process that uses slow breathing and muscle-loosening exercises to physically and mentally calm the body. Relaxation techniques include progressive muscle relaxation, guided imagery, deep breathing, massage, aromatherapy and yoga.

Meditation is the practice of focusing awareness and attention on the present moment and on the senses of the body. It is an important part of many religions, including Buddhism and Hinduism, but you don’t have to be religious to meditate. There are different types of meditation techniques, including breath work.

Why use it: Relaxation and meditation may help to release muscle tension, reduce anxiety and depression, and help improve quality of life. They may be used to help calm and relax the body and mind.

What to expect: Serene music may be played to create a peaceful environment. The therapist will guide you through exercises to teach you the skills of relaxation and meditation, which you can then do yourself at home. Guided imagery uses sound and vision to encourage your imagination to  create pleasant thoughts. After a period of relaxation, you will usually be prompted to stay awake to enjoy your relaxed state of mind. Relaxation and meditation can be done sitting or lying down.

Evidence: Clinical practice guidelines include offering a combination of guided imagery and progressive muscle relaxation to people experiencing pain after cancer treatment. Clinical studies have shown that people being treated for cancer who practise relaxation have lower levels of anxiety, stress, pain and depression. Relaxation techniques have been shown to improve sleep.

Spiritual practices

What they are: Spirituality is a very individual concept. For some, it may mean being part of an organised religion such as Christianity, Judaism, Islam or Buddhism. For others, spirituality may reflect their own individual beliefs about the universe and their place in it, or a search for meaning and purpose in their lives.

Why use them: Often when people are diagnosed with cancer, the spiritual aspect of their lives becomes more important. People may find comfort in prayer, meditation or quiet contemplation.

Receiving care from a spiritual care practitioner, who may also be called a pastoral carer, chaplain or priest, can often help people, even if they are not part of an organised religion.

What to expect: If you are part of a spiritual or religious community, you may benefit from:

• prayer or meditation groups
• a feeling of unity and connection from the congregation
• practical, emotional and spiritual support offered by members of your spiritual or religious community.

If you are not part of a formal community, you can find out more about your area of spiritual interest from a spiritual care practitioner, support groups, friendship groups, your local library or online. A spiritual care practitioner is often a member of the team at hospitals and cancer treatment centres.

Evidence: There is growing scientific evidence of a positive link between spiritual practices and health. They have been shown to reduce stress, instil peace and improve ability to manage challenges.

Tai chi

What it is: A part of Chinese medicine, tai chi combines gentle movement, deep breathing techniques and meditation. Movements create stability in the body, reflecting an ancient Chinese concept of balance known as Yin and Yang.

Why use it: The breath work of tai chi is calming and meditative. Creating and holding the poses helps to loosen and strengthen the muscles. Tai chi can be modified for groups that are less mobile.

What to expect: During class there will be serene music playing. The class usually starts with warm-up exercises. You will be shown different moves  and assisted to perform them. The instructor may use names to describe the poses, for example, “white crane spreads its wings”.

The movements are simple to start with, then become progressively harder, with many parts of the body needing to move to achieve the pose. The class ends with cooling down and relaxation.

Evidence: Studies have shown that tai chi improves quality of life, balance, agility, flexibility and muscle tone in cancer survivors. It may also help reduce fatigue, anxiety, depression and stress.

Western herbal medicine

What it is: Western herbal medicines are usually made from herbs traditionally grown in Europe and North America, but some come from Asia.

Why use it: Herbal medicines are often used to help with the side effects of conventional cancer treatments, such as reducing fatigue and improving wellbeing. Evidence shows they should only be used in addition to conventional therapies, rather than as an alternative.

What to expect: After taking a case history, the practitioner puts together a holistic picture of your health. They will look for underlying reasons for your ill health or symptoms, and provide a herbal mixture aimed at addressing the causes and symptoms of your illness. They may give you a pre-made herbal formula or make up a blend of herbs specifically for your needs.

Herbal medicines can be prepared as liquid extracts taken with water or as a tea (infusion), or as creams or tablets and capsules.

Evidence: There is a wide body of research into the effectiveness and safety of many herbs, and some studies show promising results. Speak to your doctor and herbal medicine practitioner about the potential side effects of any herbal preparations.

Using herbs is complex and it’s best to see an experienced practitioner rather than trying to treat yourself. Some herbs may interact with  conventional cancer treatment or medicines, and change how the treatment works or how the dose is absorbed.

Yoga

What it is: Yoga involves holding postures (asanas) with the body, being aware of breathing, and focusing the mind. Yoga originated in India and is now popular around the world. There are many styles of yoga with varying intensity – from gentle to more vigorous.

Why use it: To increase physical activity and improve emotional health.

What to expect: Wear comfortable clothes. You may be asked to remove your shoes before entering the yoga room. You usually use a yoga mat – this may be provided or you may need to bring your own. Most classes last for around one hour. A typical routine involves focusing on quietening the mind and working with the breath. A session usually begins with warm-up stretches followed by a series of yoga postures, and ends with relaxation. Some cancer centres offer yoga classes that are designed for people during cancer treatment or recovery.

Some styles of yoga may not be suitable during some stages of cancer or depending on your abilities. Talk to the yoga instructor about any precautions you should take and whether they can offer any modifications or support.

Evidence: Clinical practice guidelines on cancer pain include offering yoga to people experiencing pain related to taking aromatase inhibitors, as well as pain after treatment for some cancers. Clinical practice guidelines also suggest yoga as a way to manage cancer-related fatigue.

There is evidence that yoga has positive effects on decreasing stress and anxiety, reducing sleep disturbances, improving muscle strength and enhancing quality of life. The focus on breathing may also help reduce pain.