Complementary Therapies and Medicine During Cancer Treatment - Doctor Q&A

Complementary therapies and medicine play an increasingly important role in supporting patients during cancer treatment.

When used alongside conventional oncology care, approaches such as acupuncture, massage, nutritional therapy and gentle movement aim to relieve symptoms, reduce treatment-related side effects, and improve overall well-being.

But how do these therapies work alongside medical treatment?

Which approaches are supported by evidence, and how can patients use them safely?

When guided by trained professionals, complementary therapies can empower patients to take an active role in their care, addressing not just disease management, but also quality of life, resilience, and emotional well-being throughout the cancer journey.

If you or a loved are undergoing cancer treatment, and would like to explore the use such therapies and medicine to complement the treatment, please take this opportunity to ask our doctor questions.

Ask now, this Q&A is only for a limited time!

Clinincal Assistant Professor Rose Fok is a family medicine specialist at the National Cancer Centre Singapore (NCCS) caring for survivors of breast and gynaecological cancers and leads a risk management clinic to optimise surveillance for mutation positive patients.

A strong advocate for "cancer as a chronic disease", Clin Asst Prof Fok has contributed to the development of breast and colorectal cancer survivorship clinical practice guidelines and promotes the role of family physicians in preventive and holistic oncology care.

1. Question by L P

Hi Dr,

I was recently diagnosed with cholangiocarcinoma. And will be starting my treatment soon.

I would like to ask if there’s any benefit to do TCM while undergoing treatment i.e. at the same time as chemo.

Does TCM interfere or complement chemo/immunotherapy?

If TCM is complementary, will acupuncture be good enough?

I am less inclined to take herbs cos it might affect my liver.

Thank you.

Answer by Clin Asst Prof Rose Fok

Dear LP,

During chemotherapy/immunotherapy, TCM herbs are usually not recommended as these may interfere with the action of cancer treatment or have possibility of liver or kidney toxicities. I

n addition, concurrent use of TCM herbs and Western medicines means that the liver needs to break down both TCM and Western medicine, which may cause the liver to be ‘stressed’, and abnormalities may be observed for liver function test (i.e. raised ALT and AST levels).

Therefore, non-pharmacological complementary are preferred. Acupuncture has good evidence in reducing chemotherapy-induced nausea and vomiting, joint pains, fatigue, xerostomia (dry mouth).

Yoga, Tai Chi and Qigong has also shown benefit in helping sleep, balance mood, reduce fatigue and improve quality of life. Acupressure may also be considered for symptom management as well.

2. Question by N T

Hi Dr,

My father is going through Stage 4 Prostate cancer treatment.

His platelet now dropped to 71 after Lutetium (radio nuclear treatment) and doctor say he need to stop this treatment or any other Chemo.

Can you share what alternative treatment (TCM, etc) can raise his platelet count to above 100 so he can continue treatment?

Thank you for your advice.

Answer by Clin Asst Prof Rose Fok

Dear NT,

Unfortunately, complementary therapies like TCM are unlikely to help elevate platelet count.

However, avoiding medications/ drugs like painkillers (e.g. aspirin) will help reduce risk of further drop in platelet counts. The half-life (turnover) of platelets is short in terms of days and with good immunity and health, the body will produce more platelets, leading to recovery.

3. Question by RQ

Dear Doctor,

My daughter is undertaking chemotherapy for osteosarcoma.

She has lost considerable amount of weight, and her appetite is deteriorating with each chemo cycle. The vomiting has also become more severe and of late a very bad case of ulcers at the back of her throat.

During the periods where she is unable to keep down her food (due to the vomiting), what would be some dietary recommendations that would help provide her sufficient calories?

Is there also any alternative therapies to help with managing the nausea and psychological anxiety of vomiting?

Thank you.

Answer by Clin Asst Prof Rose Fok

Dear RQ,

Chemotherapy for osteosarcoma is commonly associated with ulcers, vomiting and resultant weight loss.

The best option is for conventional anti-vomiting western medicine given prescribed by the oncologist which are more effective and provides a quicker onset of action. Good oral hygiene and mouth wash is recommended. Eat soft food that are easy to chew and swallow and avoid food that irritates like sour, spicy and salty foods. Complementary therapies like ginger can reduce nausea.

When she feels better, try to give her small frequent meals which are nutrient dense (e.g. avocado) so that she can receive adequate calories and nutrients.

Alternatively, liquid supplements may increase total energy intake (Ensure/ Resource / Prosure etc.) Juices, soups, milk, shakes and fruit smoothies may also be more palatable.

Besides western drugs, acupuncture has been shown to reduce nausea and vomiting. However, the onset of action of acupuncture may not be immediate and at least 5 to 8 acupuncture sessions may be needed to see benefit.

Mind-body therapies like mindfulness, and meditation can help anxiety and low mood. Activity and light exercise may also help improve appetite.

4. Question by Clare

Dear Prof Fok,

I just had a lumpectomy done on my left breast to remove a tumor on 3/2. Based on the mri, it's 1.7x1.6x1.4cm. Biopsy results indicated invasive ductal carcinoma provisional grade 1. ER n PR positive, & HER2 negative.

As my post-surgery appointment is soon, I would like to understand more about the complementary therapies available.

Before the surgery, the doctor informed that radiotherapy will be required. Not certain about chemo yet. Thereafter, hormone therapy medicine will be needed.

While I understand radiotherapy can't be avoided, I would like to understand the necessity in taking hormone therapy medicine, as there are several side effects.

What complementary therapies can be available? Including TCM?

Aa mentioned in the article, how do these therapies work alongside medical treatment?

Which approaches are supported by evidence, and how can patients use them safely?

I am new to the above as I had been well & rarely step into a clinic for the past 61years.

I appreciate your explanation and input on my case. Thank you.

Answer by Clin Asst Prof Rose Fok

Dear Clare,

It is good that you have proceeded with surgery, and you can optimise your health while waiting for the wound to heal, before starting radiation therapy.

Focus on wellness like getting enough sleep, go for walks to relax, relieve stress ensure a balanced diet and manage mood changes from adjusting to a new diagnosis. Non-pharmacological approach is best, and acupuncture can help with symptoms like anxiety, pain and insomnia.

During radiation therapy, antioxidants like high dose vitamin C should be avoided as these may interact with radiation. After that, avoid phytoestrogens if your breast cancer is hormone positive and avoid drug interactions if you are on hormonal therapy.

Vitamin D has been shown to be beneficial in cancer patients and adequate dose of Vitamin D is recommended.

After active cancer treatment, structured exercise and balanced nutrition has been linked to improved quality of life and cancer outcomes. Exercise should be tailored to treatment phase and medical status, and can help overcome fatigue, and improve stamina and daily functioning.

5. Question by Alarice

Dear Dr,

With Singapore being a Chinese majority, it is common to see many patients trying out TCM.

What about other complementary therapies from other ethnic groups? How common are they and are they safe?

Are there more research around these areas to support such treatment alongside conventional oncology care?

Instead of checking out all the ingredients of every alternative medications that patients have, how can we ensure that patients can use them safely?

Thank you so much.

Answer by Clin Asst Prof Rose Fok

Dear Alarice,

We understand that there are other complementary therapies like Ayurvedic medicine. As our integrative oncology is a new service, we do not have expertise in non-TCM currently.

Main considerations of complementary therapies in cancer care include drug interactions and possible organ toxicity like liver and kidney, when taken in excessive doses.

A recommended website is “About Herbs” website/ app by Memorial Sloan Kettering Cancer Center and other trusted websites.

6. Question by Bee Bee

Hi Dr,

My sister is taking Cabozantinib as part of her cancer treatment. The medicine makes her weak and she is also prone to get flu easily.

We would like to check if there is any complementary therapy that she can take alongside her cancer treatment such as TCM, etc?

We are just afraid that TCM herbs (e.g cordeycep, ginseng) cannot be taken alongside her cancer drugs. Can you make some recommendations?

Thank you!

Answer by Clin Asst Prof Rose Fok

Dear Bee Bee,

It is not advisable for your sister to start on a TCM herbal prescription to be taken alongside Cabozantinib, as there are some TCM herbs that may potentially interact with her cancer treatment.

If she would like to consider TCM interventions to improve overall well-being, I would recommend non-pharmacological options, such as acupuncture and acupressure.

In addition to that, doing simple stretches and light exercises (e.g. slow walk, Tai Chi, Qi Gong) as tolerated may also help to improve her energy level.

If the symptoms experienced from the cancer treatment are intolerable and affecting your sister’s quality of life, you may also consider discussing with your oncologist on whether any adjustments can be made to her current cancer treatment.

7. Question by HS

Hi Dr,

I have a hyperbaric oxygen (HBOT) machine for home use.

My mum (88 years old) has finished her chemotherapy and radiotherapy for her uterine cancer. She still needs to receive HER2 injection for the next coming months.

I would like to someone with knowledge on HBOT to advise if she will benefit from the use of it and what should be the guidelines on usage e.g. frequency and intensive (oxygen level)

Before her cancer treatment she has used it and find it helpful with her sleep and her blood pressure.

We would like to know if she can continue using it after her cancer treatment. Thank you for your advice.

Answer by Clin Asst Prof Rose Fok

Hi HS,

Hyperbaric oxygen therapy (HBOT) is a medical treatment with clear indications like decompression sickness, wounds (non-healing, diabetic foot ulcers), late radiation injury, compromised skin flaps and grafts, carbon monoxide poisoning, burns, etc.

More information may be obtained from the Hyperbaric & Diving Medicine Centre in SGH.

However, there is no strong evidence that HBPT improve insomnia or blood pressure.

8. Question by Nana

Hi Dr,

I did a lumpectomy on my breast in Dec & results out required me to do a sentinel lymph node biopsy on Feb 2026.

While waiting for my lymph node results, what kind of food I should avoid n what kind of meals I should eat?

The breast surgeon termed my diagnosis as stage 1 breast cancer.

Answer by Clin Asst Prof Rose Fok

Dear Nana,

While waiting for the results and further treatment, it is important to have a balanced diet with portions according to the My Healthy Plate, with a quarter of grains, lean meat/ fish and half plate of vegetables/ fruits.

Use fresh ingredients and avoid highly processed food ingredients or those with many additives.

Try to be “plant-based”, but it doesn’t have to be totally vegetarian or vegan.

Preferred food preparation includes boiling, steaming and baking.

Limit grilling animal proteins. Minimise deep fried foods, BBQ, and smoked foods.

Ensure that you have good sleep, stay active and manage anxiety and stress.

9. Question by Lily

Dear Prof Fok, 

I’m a stage 2A breast cancer survivor diagnosed in 2014 and completed radiation, chemo and targeted therapy end of 2015.

I have Chemotherapy-Induced Peripheral Neuropathy (CIPN) on both my hands and feet with my feet being affected most.

I would like to know if there is any TCM treatment that could help to alleviate the stabbing pain that I feel from time to time and had noticed that the right foot numbness seem to have progressively become worse, would foot reflexology help or how about acupuncture?

My breast surgeon doesn’t really approve of foot reflexology as he is afraid touching the meridian points may move minute cancer cells around the body.

I have never been able to get a clear answer from the oncologists if foot reflexology or acupuncture is okay to do for the nerve issue caused by chemo treatment and also wonder if these therapies will help with the condition or any other thing I could do to help with the condition?

Any advice please. Thank you.

Answer by Clin Asst Prof Rose Fok

Hi Lily,

Although we do have doctors in NCCS referring patients for acupuncture treatment for the management of CIPN, we would advise you to discuss with your oncologist on a potential referral for acupuncture.

10. Question by Zachary

Hi Prof Fok,

My mom had surgery for stage 4 GIST in May 2025 and the surgeons did a great job at removing the primary tumor and all the metastasis. She is now on adjuvant Imatinib and is NED.

While we trust the medicine to work, I do understand that the overall health of the patient and their immune system also play a synergistic role in preventing cancer recurrence.

From our end, those two are things well within our control, which is why I've taken a keen interest and done my best to read up on how I can assist my mom with those. That being said, it has been really difficult to find doctors or even TCM practitioners to get advice on supplements and nutrition.

Regardless, my questions are:

a) I have read that certain mushroom extracts (like Reishi, Turkey Tail and Maitake) can help strengthen the immune system. I have actually gone to a TCM practitioner to get their advice on it, but they explained that TCM uses whole mushrooms and not the extracts and thereby they could not offer any opinion. Meanwhile, the doctors we have seen are also not aware of these mushroom extracts. What are your thoughts on these mushroom extracts?

b) Nutritional status seems very important and far too overlooked. Things like having optimal Vitamin D levels can optimise immune function and possibly reduce the risk of cancer recurrence. Yet, nutritional deficiency tests are not available at NCC. Integrative oncology services still seem to be lacking in Singapore's healthcare system, which is why I was heartened to read that doctors like yourself have an interest in it and are trying to establish it in NCCS. Prof Fok, do you know the ETA for it to be formalised? What would the criteria be for patients to qualify?

c) As an aside, until that happens, are there any doctors I can approach to provide advice on integrative oncology? Is there anyone I can approach to request for a referral for my mom?

Thank you for taking the time to read this. I look forward to hearing from you. Any advice will be much appreciated.

Answer by Clin Asst Prof Rose Fok

Dear Zachary,

(a) There is potential for Reishi, Turkey Tail and Maitake extract to interfere with the metabolism/breakdown of Imatinib. Hence, it is not advisable to take these supplements while on Imatinib treatment. As your mother is currently doing well while on this treatment, I would advise not taking any other supplements, which may have the potential to affect her current treatment.

I would recommend for her to strengthen immunity via having a balanced diet and doing simple exercises as tolerated.

(b) Recent studies have shown benefit of adequate vitamin D with patient outcomes. In NCCS, oncologists are increasingly checking levels of Vitamin D and replacing as necessary.

(c) The Integrative Oncology service at NCCS has started and receives referrals from oncologists in SingHealth for wellness, TCM advice and symptom assessment/ management. More information can be obtained from Patient Information Leaflet available in NCCS.

A brief write-up is available at this link:
Can TCM be part of cancer care?

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