Utilizing complementary therapy to enhance quality of life and reduce stress and fatigue in pediatric cancer patients

Table 1 Summary of evidence about use of complimentary therapies in pediatric oncology

Type of complementary therapy	Patient-reported outcomes	Main findings	Ref.
Manipulative and body-based methods
Therapeutic massage	Mood and blood cells	Decrease depressed mood as well as to increase white blood cell and neutrophil counts in pediatric cancer patients (P < 0.05)	[21,22]
Acupuncture	Nausea and vomiting	Reduce chemotherapy-induced nausea and vomiting in children with cancer (P < 0.05)	[23]
Mind-body interventions
Music, art, and play therapy	Anxiety, pain, psychological stress, and CRF	Dance therapy may help reduce the symptoms pediatric patients experience during hospitalization, such as anxiety, pain, and fatigue. Total levels of psychological stress and CRF improved after the hospital clown intervention compared with baseline (P = 0.003) and (P = 0.04), respectively. A significant decrease in salivary cortisol after clown intervention was observed (P < 0.05)	[13,24-28]
Animal-assisted therapy program (pet-therapy)	Stress, pain, mood, anxiety, irritation, depression, quality of life, heart rate, and blood pressure	Pain, adjustment difficulties, mood changes and symptom management can be improved in inpatient pediatric cancer patients receiving animal-assisted therapy, thus improving overall quality of life. Decrease in pain (P = 0.046), irritation (P = 0.041), and stress (P = 0.005)	[29,30]
Yoga	Pain and anxiety	Adolescents and parents had a significant decrease in anxiety post yoga intervention (P < 0.05)	[31]
Meditation, hypnosis, guided imagery	Pain, nausea and vomiting	Decrease pain, nausea, and vomiting (P < 0.05)	[32,33]
Biologically based therapies
Vitamins and dietary supplements	Hepatotoxicity and febrile neutropenia	For hepatotoxicity, small studies found milk thistle, omega-3 fatty acids, and black seed oil to decrease liver enzymes (P < 0.05). For febrile neutropenia, wheat germ extract, probiotics, and honey showed promise in small studies	[34-38]

CRF: Cancer-related fatigue.