How do integrative experts manage stress?

Both medical groups and integrative experts provide recommendations for Managing Stress. Learn more about the approaches and meanings of recommendations: Integrative Oncology Programs and Expert Guidelines ›

Clinical practice guidelines

Society for Integrative Oncology

Two guidelines provide recommendations for managing stress among people with cancer.

Evidence-based clinical practice guidelines for integrative oncology: complementary therapies and botanicals ›

The 2009 guidelines states that “Therapies based on a philosophy of bioenergy fields are safe and may provide some benefit for reducing stress and enhancing quality of life.” Biofield therapies include these:

Clinical practice guidelines on the evidence-based use of integrative therapies during and after breast cancer treatment › This set of guidelines has been endorsed by the American Society of Clinical Oncology (ASCO).1Lyman GH, Greenlee H et al. Integrative therapies during and after breast cancer treatment: ASCO endorsement of the SIO clinical practice guideline. Journal of Clinical Oncology. 2018 Sep 1;36(25):2647-2655.

Insufficient evidence is available to make an evidence-based recommendation for art therapy, hypnosis, tai chi, myofascial release, reflexology, electrical nerve stimulation, healing touch, or reiki for stress reduction

Published programs and approaches

These programs, approaches and protocols from integrative oncologists all include Managing Stress as a component of cancer care.

Lise Alschuler, ND, FABNO, and Karolyn Gazella

Approaches are described for certain cancer types, or along with certain conventional therapy treatments, or for particular conditions such as insulin resistance.

This approach includes 5 steps to rejuvenation: rhythm, rest, relax, replenish and remediate.

Keith Block, MD

Block KI. Life over Cancer: The Block Center Program for Integrative Cancer Care. New York: Bantam Dell. 2009.

The integrative Block Program has recommendations to people who are at different places along the cancer continuum:

  • Those who’ve been recently diagnosed
  • Those in treatment
  • Those who’ve concluded treatment and need to remain vigilant to prevent recurrence

Dr. Block’s program for managing stress chemistry includes diet, avoiding overwork, improving sleep hygiene, balancing rest/activity rhythms, properly timing snacks and drinks, certain fitness adjustments, and supplements

Dr. Block and his colleagues suggest these strategies for using food to balance stress chemistry.2Block KI, Block PB et al. Making circadian cancer therapy practical. Integrative Cancer Therapies. 2009 Dec;8(4):371-86; Block K, Gyllenhaal C. Chapter 6: Nutritional Interventions in Cancer. In Abrams DI, Weil AT. Integrative Oncology. 2nd Edition. New York, NY: Oxford University Press. 2014; Block KI. Life over Cancer: The Block Center Program for Integrative Cancer Care. New York: Bantam Dell. 2009. 

Reduce stress-offender foods.

  • High amounts of coffee, caffeinated tea, chocolate, ginseng and bitter orange peel can disrupt your sleep cycle and intensify your stress response.
  • Alcohol disrupts melatonin production and is associated with waking repeatedly in the night.

Choose eating patterns that minimize disruption of stress chemistry.

  • Avoid a low-carbohydrate, high-fat, high-protein (especially animal protein) diet. Focus on eating complex carbohydrates and protein from plant sources.
  • Increase your ratio of omega-3s to omega-6s.
  • Avoid overeating.

Time your snacks and drinks to reduce stress.

  • Don’t eat during the last hour before going to bed, especially if you have heartburn at night or GERDgastroesophageal reflux disease, a condition in which stomach acid or bile flows into the esophagus and irritates the lining.
  • If you must have a snack at night, eat something that combines a whole grain with protein. This combination contains tryptophan, which raises calming serotonin levels.

Lorenzo Cohen, PhD, and Alison Jefferies, MEd

Cohen L, Jefferies A. Anticancer Living: Transform Your Life and Health with the Mix of Six. New York: Viking. 2018.

This book introduces the concept of the Mix of Six, which is identical to six of our 7 Healing Practices ›

Dr. Cohen and Ms. Jefferies explain that while each plays an inde­pendent role, the synergy created by all six factors can radically transform health, delay or prevent many cancers, support conventional treatments, and significantly improve quality of life.

Jeremy Geffen, MD

The late, renowned integrative oncologist Jeremy Geffen, MD, developed a healing program based on what he calls The Seven Levels of Healing. It is a program of body, mind, heart, and spirit for healing and transforming the whole person.

Geffen J. The Seven Levels of Healing. Audio CD – 2002

Geffen J. The Journey Through Cancer: An Oncologist’s Seven-Level Program for Healing and Transforming the Whole Person. New York, New York: Three Rivers Press. 2006.

Dr. Geffen presented at Cancer as a Turning Point Conference in Seattle, Washington in 2006.

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Gerald M. Lemole, MD; Pallav K. Mehta, MD; and Dwight L. McKee, MD

Lemole GM, Mehta PK, McKee DL. After Cancer Care: The Definitive Self-Care Guide to Getting and Staying Well for Patients with Cancer. New York, New York: Rodale, Inc. 2015.

These doctors present easy-to-incorporate lifestyle changes to help you “turn on” hundreds of genes that fight cancer, and “turn off” the ones that encourage cancer, while recommending lifestyle approaches to address each type.

Barbara MacDonald, ND, LAc

MacDonald B. The Breast Cancer Companion—A Complementary Care Manual: Third Edition. Self-published. 2016.

Naturopathic physician Barbara MacDonald provides information about breast cancer, its conventional treatment, and natural approaches to enhancing treatment, managing side effects, reducing risk of recurrence, and healthy living after cancer treatment is completed.

Neil McKinney, BSc, ND

McKinney N. Naturopathic Oncology, Fourth Edition. Victoria, BC, Canada: Liaison Press. 2020.

This book includes descriptions and uses of many natural and complementary protocols for cancer in general and for specific cancers. It also includes information on integrative support during conventional cancer treatment.

Ornish Diet and Lifestyle Modification Program (for prostate cancer)

Ornish Lifestyle Medicine ›

Cardiologist Dean Ornish, MD, has adapted his Ornish Heart Disease Reversal Program for use by men with prostate cancer. The program includes nutrition, fitness, stress management, and love and support.

Gurdev Parmar, ND, FABNO, and Tina Kaczor, ND, FABNO

Parmar G, Kaczor T. Textbook of Naturopathic Oncology: A Desktop Guide of Integrative Cancer Care. 1st edition. Medicatrix Holdings Ltd. 2020.

This book provides information on the treatment of 24 cancers, plus the most effective treatments of the most common symptoms affecting cancer patients while they undergo chemotherapy, radiotherapy, or surgery.

David Servan-Schreiber, MD, PhD

Servan-Schreiber D. Anticancer: A New Way of Life. New York: Penguin Books. 2009.

This book provides tips on how people living with cancer can fight it and how healthy people can prevent it.

Traditional medicine

Traditional Chinese medicine and Ayurveda include stress management in their approaches to health care. Learn more about traditional medicine and find resources for finding a practitioner: Finding Integrative Oncologists and Other Professionals ›

Other expert assessments

Oncology Association of Naturopathic Physicians

A 2018 survey identified stress reduction as one of the most frequently identified interventions used by members of the Oncology Association of Naturopathic Physicians for lung and gastroesophageal cancer care.3Seely D, Ennis JK, McDonell E, Zhao L. Naturopathic oncology care for thoracic cancers: a practice survey. Integrative Cancer Therapies. 2018 Sep;17(3):793-805.

Expert commentary

Foods that can promote stress

Integrative physicians Keith Block, MD, and Janet Spitzer, MD, inform us about foods and natural substances that promote a stress response. Some eating patterns and foods can promote stress:4Block KI. Life over Cancer: The Block Center Program for Integrative Cancer Care. New York: Bantam Dell. 2009; Spitzer J. Personal communication with Laura Pole. April 16, 2018.

Low-carb, high-fat diet

Low-carb, high-protein diet

Foods containing caffeine


High ratio of omega-6 to omega-3 fatty
acids ›

Timing of snacks and drinks:

  • Eating within one hour of bedtime
  • Eating a heavy evening meal or snack

Bringing stress under control

CancerChoices Senior Clinical Consultant Laura Pole, RN, MSN, OCNS: An integrative cancer care plan will include mind-body therapies, Eating Well, Moving More, and possibly natural products to manage stress. Promising evidence suggests that complementary therapies such as acupuncture or supplements such as omega-3 fatty acids may treat depression––that can be linked to stress. 

Sometimes, however, these therapies may not be enough. If natural treatments alone are inadequate, then symptoms of stress can persist. As CancerChoices advisor and integrative physician Keith Block, MD, points out, people may resist medical treatments for stress or depression. If you are concerned about medication side effects, the time commitment of counseling, or the financial burden of mental health treatment, talk with your doctor and/or cancer team. They can help you make informed decisions. Managing stress is a key component of wellness.

CancerChoices Senior Clinical Consultant Laura Pole, RN, MSN, OCNS, explains the importance of Managing Stress and offers a guided meditation from CancerChoices advisor Rachel Naomi Remen, MD.

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Diet for managing stress

Janet Spitzer, MD, April 16, 2018: According to the Chinese 5 Element Theory, it would be helpful to ‘cool’ or at least not overheat the Fire element (heart, pericardium). Salty flavor would help cool the heat, while sour and excessively bitter flavors would tend to aggravate the heart. Alcohol also powerfully ‘heats’ the Heart-Fire element.

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Laura Pole, MSN, RN, OCNS

Senior Clinical Consultant
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Laura Pole is senior clinical consultant for CancerChoices. Laura is an oncology clinical nurse specialist who has been providing integrative oncology clinical care, navigation, consultation, and education services for over 40 years. She is the co-creator and co-coordinator of the Integrative Oncology Navigation Training at Smith Center for Healing and the Arts in Washington, DC. Laura also manages the “Media Watch Cancer News That You Can Use” listserv for Smith Center/Commonweal. In her role as a palliative care educator and consultant, Laura has served as statewide Respecting Choices Faculty for the Virginia POST (Physician Orders for Scope of Treatment) Collaborative as well as provided statewide professional education on palliative and end-of-life care for the Virginia Association for Hospices and Palliative Care.

For CancerChoices, Laura curates content and research, networks with clinical and organizational partners, brings awareness and education of integrative oncology at professional and patient conferences and programs, and translates research into information relevant to the patient experience as well as clinical practice.

Laura sees her work with CancerChoices as a perfect alignment of all her passions, knowledge and skills in integrative oncology care. She is honored to serve you.

Laura Pole, MSN, RN, OCNS Senior Clinical Consultant

Nancy Hepp, MS

Lead Researcher
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Ms. Hepp is a researcher and communicator who has been writing and editing educational content on varied health topics for more than 20 years. She serves as lead researcher and writer for CancerChoices and also served as the first program manager. Her graduate work in research and cognitive psychology, her master’s degree in instructional design, and her certificate in web design have all guided her in writing and presenting information for a wide variety of audiences and uses. Nancy’s service as faculty development coordinator in the Department of Family Medicine at Wright State University also provided experience in medical research, plus insights into medical education and medical care from the professional’s perspective.

Nancy Hepp, MS Lead Researcher

Last update: May 1, 2024

Last full literature review: November 2021

CancerChoices provides information about integrative in cancer care, a patient-centered approach combining the best of conventional care, self care and evidence-informed complementary care in an integrated plan cancer care. We review complementaryin cancer care, complementary care involves the use of therapies intended to enhance or add to standard conventional treatments; examples include supplements, mind-body approaches such as yoga or psychosocial therapy, and acupuncture therapies and self-care lifestyle actions and behaviors that may impact cancer outcomes; examples include eating health-promoting foods, limiting alcohol, increasing physical activity, and managing stress practices to help patients and professionals explore and integrate the best combination of conventionalthe cancer care offered by conventionally trained physicians and most hospitals; examples are chemotherapy, surgery, and radiotherapy and complementary therapies and practices for each person.

Our staff have no financial conflicts of interest to declare. We receive no funds from any manufacturers or retailers gaining financial profit by promoting or discouraging therapies mentioned on this site.