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.

Ref : F26