How do integrative experts manage anxiety?

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

Clinical practice guidelines

2013 evidence-based clinical practice guidelines provide these weak recommendations with moderate quality evidence for managing anxiety.

Massage therapy when anxiety is not controlled by usual care, and as part of a multi-modality cancer supportive care program

Mind-body approaches as part of a multidisciplinary approach: 

  • Hypnosis
  • Mindfulness-based stress reduction (MBSR)
  • Meditation
  • Music therapy
  • Psychosocial approaches, including cognitive behavioral therapy, relaxation training, imagery/visualization, psychoeducation, and behavioral approaches
  • Yoga

A dose of moderate-intensity aerobic training three times per week for 12 weeks or twice weekly combined aerobic plus resistance training for 6 to 12 weeks can significantly reduce anxiety in cancer survivors during and after treatment.

Based on sufficient evidence, it does not appear that resistance training alone reduces anxiety.

The 2022 NCCN Guidelines® on Survivorship include a recommendation to develop a plan for regular physical activity and healthy nutrition as part of management and treatment of anxiety, depression, and distress.

Society for Integrative Oncology

Two guidelines discuss managing anxiety among people with cancer.

Clinical practice guidelines on the evidence-based use of integrative therapies during and after breast cancer treatment ›

The 2017 SIO clinical practice guidelines regarding people with breast cancer provide these recommendations to professionals for managing anxiety during and after treatment for breast cancer. 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.

Offer or provide this modality (high certainty that the net benefit is substantial):

  • Meditation

Offer or provide this modality (high certainty that the net benefit is moderate):

  • Music therapy
  • Stress management (longer group programs are likely better than self-administered home programs or shorter programs)
  • Yoga

Offer or provide this modality for selected patients, depending on individual circumstances (Moderate certainty that the net benefit is small):

  • Acupuncture
  • Massage
  • Relaxation

Therapies with insufficient evidence to make a recommendation with anxiety:

  • Art therapy
  • Electrical nerve stimulation
  • Healing touch
  • Hypnosis
  • Myofascial release
  • Reflexology
  • Reiki
  • Tai chi

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

The 2009 SIO guidelines for complementary therapies and botanicals provide these recommendations for managing anxiety with cancer.

Mind-body therapies: support and psychotherapy approaches as part of a multidisciplinary approach (strong recommendation, high-quality evidence):

  • Cognitive-behavioral therapy
  • Cognitive-behavioral stress management (CBSM)
  • Support groups
  • Supportive/expressive therapy

Other mind-body therapies as part of multimodality treatment (strong recommendation, moderate-quality evidence): 

  • Hypnosis
  • Meditation
  • Music therapy and other forms of expressive arts therapies 
  • Relaxation techniques
  • Tai chi
  • Yoga

Energy therapies (strong recommendation, moderate-quality evidence), including Therapeutic Touch™, healing touch and reiki

  • Reiki
  • Polarity therapy
  • External qigong 
  • Electromagnetics 

Massage therapy delivered by an oncology-trained massage therapist as part of multimodality treatment (strong recommendation, low- or very low-quality evidence)

This 2023 guideline makes recommendations for managing anxiety symptoms among people with cancer.

Recommended both during and after cancer treatment

Mindfulness-based interventions (MBIs) (strong evidence)

Reflexology (weak evidence)

Yoga among people with breast cancer (moderate evidence, but only weak evidence regarding other types of cancer)

Recommended during cancer treatment

Hypnosis (moderate evidence) 

Lavender essential oil inhalation (weak evidence)

Music therapy or music-based interventions (moderate evidence)

Relaxation therapies (moderate evidence)

Recommended after cancer treatment

Acupuncture (weak evidence)

Tai chi and/or qigong among people with breast cancer (weak evidence)

Inconclusive evidence to make recommendations for or against use
  • Acupressure
  • Autogenica relaxation technique which involves a series of attention-focusing exercises designed to induce relaxation and enhance the body's self-healing powers training
  • Biofeedback
  • Dance/movement therapy
  • Energy healing
  • Expressive writing
  • Healing touch
  • Laughter therapy
  • Light therapy
  • Massage
  • Melatonin
  • Music therapy and music-based interventions after cancer treatment
  • Nutritional interventions
  • Psilocybin
  • Other natural products and supplements

Published programs and protocols

These protocolsa package of therapies combining and preferably integrating various therapies and practices into a cohesive design for care, programs, and approaches by leaders in integrative cancer care provide guidance for managing anxiety.

We do not recommend specific integrative protocols or programs but provide information for you to evaluate with your healthcare team.

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 including anxiety.

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

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.

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.

The relaxing breath

Shanti Norris, a yoga teacher who works with people with cancer, explains: “One cannot feel anxious as long as one is breathing slowly and deeply.” These are her instructions for managing stress with “The Relaxing Breath”2Norris S. Progressive Relaxation. Smith Center for Healing & the Arts. Viewed April 18, 2018.

  1. Sit in a comfortable position or lie on your back on the floor. Take a moment to get comfortable. Feel your body. Take a deep breath or two.
  2. Now take a breath by inhaling into the nose and exhaling out the mouth. The exhalation is like an audible sigh: AAAHHH! Do this three or four times. In through the nose and out through the mouth. AAHH. This is the most relaxing breath.
  3. Continue for one to two minutes.
  4. Let the breath come back to normal.

Author, clinical professor and CancerChoices advisor Rachel Naomi Remen, MD, demonstrates a breathing technique to help lower anxiety.

Play video

Traditional medicine

Practitioners of traditional Chinese medicine and Ayurveda offer therapies and approaches to manage anxiety.

Learn more about traditional medicine and how to find practitioners: Finding Integrative Oncologists and Other Professionals ›


Nancy Hepp, MS

Lead Researcher
View profile

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

Maria Williams

Research and Communications Consultant
View profile

Maria Williams is a research and communications consultant who brings over 15 years’ experience in research, consumer education, and science communication to CancerChoices. She has worked primarily in public health and environmental health.

Maria Williams Research and Communications Consultant


Laura Pole, MSN, RN, OCNS

Senior Clinical Consultant
View profile

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

Last update: May 24, 2024

Last full literature review: July 2021

CancerChoices provides information about u0022integrativeu0022u0022 cancer care. We review u0022complementaryu0022u0022in therapies and u0022self-careu0022u0022 practices to help patients and professionals explore and integrate the best combination of u0022conventionalu0022u0022the 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.