Gastrointestinal Symptoms

Gastrointestinal upsets such as nausea, vomiting, constipation, and diarrhea can be common during some cancer treatments. Finding relief can not only greatly enhance your quality of life, but may help you maintain your body weight and even complete your treatment.

Gastrointestinal symptoms at a glance

Gastrointestinal symptoms involve any upset to your gastrointestinal system. In this handbook, we discuss symptoms related to your esophagus, stomach, intestines, rectum, or anus, plus your liver, gallbladder and pancreas. These symptoms include nausea, heartburn, mucositisinflammation and ulceration of the mucous membranes lining the digestive tract, usually as an adverse effect of chemotherapy and radiotherapy treatment for cancer, vomiting, constipation, diarrhea, bloating, gas, and pain. These symptoms can be caused or triggered by cancer, by cancer treatments, by some medications and other medical conditions, and by other symptoms such as anxiety, depression, stress, or pain.

Top practices and therapies for managing gastrointestinal symptoms

Therapies and practices we have reviewed

The effects of these practices and therapies are described below on this page. Full details of evidence are on the therapy reviews, accessible through the image links below.

Constipation
Complementary therapies

Low-dose naltrexone ›

Yoga ›

Diarrhea
Heartburn/reflux or esophagitis
Self-care practices

Eating Well ›

Body position ›

Complementary therapies

Astragalus ›

Liver effects

Astragalus ›

Nausea and vomiting

Further therapies

Therapies recommended in clinical practice guidelines but that we haven’t yet reviewed; see belowUse your browser's Back button to return to this location. for guidelines ›

Chinese herbal blends

Ginger

Hypnosis

Mind-body modalities (without mentioning specific therapies)

Music therapy

Other therapies

A few other therapies have some evidence of benefit. The benefit may be meaningful or even substantial, but our reviews show the evidence so far is preliminary.

Fermented wheat germ extract

Mistletoe

Therapeutic Touch™

On this page

What are gastrointestinal symptoms?

Gastrointestinal symptoms involve any upset to your gastrointestinal tract—your esophagus, stomach, intestines, rectum, or anus, and other organs of the gastrointestinal system including the liver, gallbladder, and pancreas. They include nausea, vomiting, heartburn, mucositis, constipation, diarrhea, bloating, gas, and pain.

What are the signs or symptoms of gastrointestinal distress? 

Common gastrointestinal symptoms:

  • Inflammation (sometimes painful) of the mucous membranes in the esophagus, stomach or intestines
  • Abdominal pain
  • Queasiness
  • The urge to vomit
  • Vomiting
  • An inability to have a bowel movement
  • Either very firm or very soft/liquid bowel movements
  • Intestinal gas
  • Feelings of abdominal fullness or bloating

What may cause or trigger gastrointestinal symptoms?

Gastrointestinal symptoms may arise as side effects of some cancer treatments or of tumors causing pressure or damage to the gastrointestinal system—gastrointestinal tract, liver, pancreas, and gallbladder. 

Gastrointestinal symptoms may also be symptoms of stress, anxiety, depression, or pain. If any of these is contributing to your gastrointestinal symptoms, managing these conditions will be important in reducing your gastrointestinal symptoms.


Many different conditions and situations can cause or trigger gastrointestinal symptoms.1Mayo Clinic staff. Nausea and vomiting. Mayo Clinic. April 8, 2022. Viewed May 9, 2022; Constipation. Johns Hopkins Medicine. Viewed May 9, 2022; Diarrhea. Johns Hopkins Medicine. Viewed May 9, 2022; High calcium levels (hypercalcemia). Canadian Cancer Society. Viewed May 27, 2022.

Medications

  • Narcotics
  • Metformin
  • Statins
  • Antibiotics
  • General anesthesia

Other medical treatments

  • Radiation therapy to the whole body, the abdomen, or the brain’s vomiting center
  • Stomach, intestinal, or gallbladder surgery

Medical conditions

  • Brain tumor
  • Pancreatic cancer
  • Liver problems such as hepatitis or cancer
  • Gallbladder problems
  • Electrolyte imbalances such as low sodium or high calcium
  • Blocked intestines
  • Bacterial or viral infection
  • Bleeding in the stomach or intestines
  • Depression ›
  • Severe pain
  • Hormone imbalances
  • Hypercalcemia (high levels of calcium in the blood, the most common oncologic emergency)
  • Irritable bowel syndrome
  • Problems with intestinal function
  • Metabolic conditions such as thyroid problems

Lifestyle

  • Lack of exercise
  • Not enough liquids
  • Not enough dietary fiber
  • Ignoring the urge to have a bowel movement
  • Spicy foods, alcohol, and coffee may be irritating to the gastrointestinal tract, including the esophagus2Baker S, Fairchild A. Radiation-induced esophagitis in lung cancer. Lung Cancer (Auckland). 2016 Oct 13;7:119-127.
  • Noise may possibly trigger higher perception of gastroesophageal reflux disease symptoms

Complementary therapies

Therapies that we have reviewed that may trigger gastrointestinal symptoms as a side effect:

Personal stories

CancerChoices Senior Clinical Consultant Laura Pole, RN, MSN, OCNS: Janie Brown is an oncology nurse and co-founder of a cancer retreat program and center in Vancouver, British Columbia.

Her story is a treasure trove of helpful information. She describes how her partner with breast cancer and her team made decisions about chemotherapy, wove in useful complementary therapies to prevent and minimize treatment side effects and created a caring community. The integrative plan staved off usual chemotherapy side effects including nausea.

Why is managing gastrointestinal symptoms important?

Gastrointestinal symptoms can interfere with your appetite and nutrition, leading to weight loss, dehydration, and malnutrition. These conditions can then interfere with your healing and your immune system function.

Nausea and vomiting, diarrhea, or heartburn can interfere with restful sleep, also interfering with your healing and your immune system function and possibly leading to increased fatigue.

Resources

What approaches can help me manage gastrointestinal symptoms?

We present many approaches to reducing gastrointestinal symptoms and the evidence regarding their effectiveness. Full details of evidence are found in the linked practices and therapy reviews.

Conventional care

Nausea and vomiting

Several antinausea (antiemetica therapy effective against vomiting and nausea) drugs and other treatments are available.  Ask your oncologist for conventional treatments if you are experiencing nausea, vomiting, or other gastrointestinal problems.  

If you are prescribed pre- and posttreatment antiemetic and anti-anxiety medication, taking it as prescribed is important for best effect. Tell your doctor of any of these situations:

  • You miss a dose
  • You can’t keep the medication down
  • It isn’t working
  • It causes unpleasant or serious side effects

Some chemotherapy drugs can cause delayed nausea and vomiting up to 48 hours after treatment. Antiemetic regimens can successfully control this situation.

Anticipatory nausea and vomiting

Anticipatory nausea and vomiting (ANV) is a conditioned anxiety response. A person’s mind links the experience of nausea and vomiting with the various stimuli in the environment where the nausea and vomiting occur. If nausea and vomiting happen frequently enough, nausea and vomiting may be triggered merely by seeing the infusion center, the IV needle, or even the chemotherapy nurse.

ANV can easily be prevented by proactive measures such as administering anti-anxiety medication several hours before and again just before treatment or by preventing/minimizing nausea and vomiting, usually with antiemetics given before, during, and after treatment.

Heartburn/reflux

Conventional medications for heartburn/reflux are quite plentiful, many of them without prescription (over-the-counter). We suggest that before taking over-the-counter medications, you consult your doctor or pharmacist to check for possible interactions with other medications you use. Let your doctor know if your symptoms persist or become worse. Finding and eliminating the cause of the heartburn, when possible, is the best approach, followed by figuring out the most effective treatment.

Long-term use of some anti-reflux drugs, such as proton pump inhibitors, can lead to serious health problems, including increased risk of stomach cancer.3Abrahami D, McDonald EG et al. Proton pump inhibitors and risk of gastric cancer: population-based cohort study. Gut. 2022 Jan;71(1):16-24. We strongly advise medical supervision.

Self-care practices

Eating Well: modest and preliminary evidence

Fewer gastrointestinal symptoms, including diarrhea, constipation, and nausea and vomiting, among people eating diets high in fiber or low in fat and lactose
(modest evidencesignificant effects in at least three small but well-designed randomized controlled trials (RCTs), or one or more well-designed, mid-sized clinical studies of reasonably good quality (RCTs or observational studies), or several small studies aggregated into a meta-analysis (this is the CancerChoices definition; other researchers and studies may define this differently))

Lower severity of esophagitis, oral mucositis and diarrhea during chemoradiotherapy among people receiving immunonutrition (modest evidence)

Less nausea and vomiting among people drinking ginger tea (preliminary evidencesignificant effects in small or poorly designed clinical studies OR conflicting results in adequate studies but a preponderance of evidence of an effect (this is the CancerChoices definition; other researchers and studies may define this differently))

Recommendation not to eat within an hour of bedtime to reduce incidence of gastroesophageal reflux disease4Block 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. 

Dietary behaviors are identified as contributors to gastroesophageal reflux disease (GERD) in a practice guideline

Recommendation to avoid coffee if you’re at risk of esophagitis from chemotherapy or radiation treatment to the chest

Moving More: modest evidence

No evidence of an effectoverall, one or more studies did not demonstrate that a treatment or intervention led to an expected outcome; this does not always mean that there is no effect in clinical practice, but that the studies may have been underpowered (too few participants) or poorly designed. Larger, well-designed studies provide more confidence in making assessments. of exercise on nausea and vomiting, constipation, or diarrhea in a combined analysis of studies

Modest evidence of fewer symptoms among people with symptoms of constipation (not specific to people with cancer) participating in exercise

Sleeping Well: modest evidence

Link between gastroesophageal reflux disease (GERD) and sleep disturbance among adults (modest evidence)

Healthy Habits

Hydrate: Especially important If you have a fever or gastrointestinal problems such as nausea, vomiting, constipation, or diarrhea

The top intervention for people with levels of calcium that are life-threatening

We are still reviewing hydration; this is from our research so far.

Body position

Your body position, especially soon after eating, may influence symptoms of heartburn (gastroesophageal reflux). Staying upright for at least 2 hours after eating, raising your head when sleeping, and lying on your left side instead of your right can all reduce symptoms.

Complementary approaches

Good or modest evidence of benefit

Good evidencesignificant effects in one large or several mid-sized and well-designed clinical studies (randomized controlled trials (RCTs) with an appropriate placebo or other strong comparison control or observational studies that control for confounds) (this is the CancerChoices definition; other researchers and studies may define this differently) indicates a relatively high degree of confidence that the therapy is linked to the outcomes as noted. Modest evidencesignificant effects in at least three small but well-designed randomized controlled trials (RCTs), or one or more well-designed, mid-sized clinical studies of reasonably good quality (RCTs or observational studies), or several small studies aggregated into a meta-analysis (this is the CancerChoices definition; other researchers and studies may define this differently) means several smaller or at least one large study have found the effect described.

Acupressure: modest evidence

Less nausea but not vomiting from chemotherapy among people treated with acupressure
(modest evidencesignificant effects in at least three small but well-designed randomized controlled trials (RCTs), or one or more well-designed, mid-sized clinical studies of reasonably good quality (RCTs or observational studies), or several small studies aggregated into a meta-analysis (this is the CancerChoices definition; other researchers and studies may define this differently))

Recommended in practice guidelines to treat nausea and vomiting

Acupuncture: mixed evidence

Less chemotherapy-induced diarrhea or nausea and vomiting among people treated with acupuncture (modest evidence)

Less nausea and vomiting among people treated with acupuncture without regard to treatment phase
(preliminary evidencesignificant effects in small or poorly designed clinical studies OR conflicting results in adequate studies but a preponderance of evidence of an effect (this is the CancerChoices definition; other researchers and studies may define this differently))

Quicker return of bowel function and less nausea and vomiting after colorectal cancer surgery among people treated with acupuncture (preliminary evidence)

No evidence of an effectoverall, one or more studies did not demonstrate that a treatment or intervention led to an expected outcome; this does not always mean that there is no effect in clinical practice, but that the studies may have been underpowered (too few participants) or poorly designed. Larger, well-designed studies provide more confidence in making assessments. on gastrointestinal symptoms among people treated with acupuncture in a combined analysis of studies

No evidence of additional benefit from massage therapy for nausea during autologous tissue breast reconstruction among people treated with acupuncture in a preliminary study

Recommended in practice guidelines to treat constipation, nausea or vomiting

Astragalus: good and modest evidence

Less radiation esophagitis during radiation therapy among people with lung cancer treated with Aidi injection or Shenqi Fuzheng injection, herbal mixtures based on astragalus (good evidencesignificant effects in one large or several mid-sized and well-designed clinical studies (randomized controlled trials (RCTs) with an appropriate placebo or other strong comparison control or observational studies that control for confounds) (this is the CancerChoices definition; other researchers and studies may define this differently))

Less chemotherapy-induced nausea and vomiting or diarrhea among people treated with astragalus-based Chinese medicines (modest evidence)

Less liver dysfunction related to chemotherapy among people treated with an herbal mixture containing astragalus (modest evidence)

Cannabis and cannabinoids: modest evidence

Less chemotherapy-induced nausea and vomiting among people using cannabis or cannabinoids (modest evidence)

Less vomiting among people treated with cannabinoids compared to neurolepticsalso known as antipsychotic medications, these medications block dopamine receptors in the nervous system to manage mental illnesses, such as schizophrenia and bipolar disorder, as well as psychosis (modest evidence)

Comparable effects on nausea and vomiting among people treated with cannabinoids compared to prochlorperazine (modest evidence)

Electroacupuncture: modest to weak evidence

Less vomiting among people with breast cancer undergoing chemotherapy treated with electroacupuncture (modest evidence)

Less nausea and vomiting after major breast surgery among people treated with electroacupuncture (preliminary evidence)

Less diarrhea among people with breast cancer during or after chemotherapy treated with electroacupuncture (weak evidenceone or more case studies, supported by animal evidence OR small treatment effects of limited clinical significance OR studies with no controls OR weak trends of effects (this is the CancerChoices definition; other researchers and studies may define this differently))

Recommended in a practice guideline to control nausea and vomiting during chemotherapy

Guided imagery: mixed evidence

Less nausea and vomiting during chemotherapy among people treated with guided imagery, often with relaxation (modest evidence) 

Less nausea after transplantation among people with breast cancer undergoing autologous bone marrow/peripheral blood stem cell transplantation treated with mind-body therapies including guided imagery (preliminary evidence)

No evidence of an effectoverall, one or more studies did not demonstrate that a treatment or intervention led to an expected outcome; this does not always mean that there is no effect in clinical practice, but that the studies may have been underpowered (too few participants) or poorly designed. Larger, well-designed studies provide more confidence in making assessments. of guided imagery on nausea, vomiting, or ileusa painful obstruction of the ileum or other part of the intestine from surgery among people treated with guided imagery in preliminary studies

Recommended in a practice guideline to treat nausea and vomiting and for anticipatory nausea and vomiting

Low-dose naltrexone: modest evidence

Less constipation among people with advanced illness, including cancer (modest evidence)

Moxibustion: modest evidence

Less nausea, vomiting, and diarrhea during or after conventional cancer treatments among people with cancer treated with moxibustion (modest evidence)

Recommended in practice guidelines to treat chemotherapy-associated nausea and vomiting or to relieve gastrointestinal symptoms such as vomiting

Relaxation techniques: modest evidence

Less nausea during cancer treatment among people treated with relaxation, often with other complementary therapies (modest evidence)

Lower reflux symptom ratings and total esophageal acid exposure after a stressful task among people with reflux disease receiving a relaxation intervention (preliminary evidence)

Recommended in practice guidelines to treat nausea and vomiting and heartburn

Tai chi or qigong: modest evidence

Less diarrhea or irregular defecation among people with cancer practicing qigong (modest evidence)

Yoga: modest evidence

Fewer treatment-related gastrointestinal symptoms among people practicing yoga (modest evidence)

Therapies with preliminary or weak evidence of benefit for gastrointestinal symptoms

Preliminary evidencesignificant effects in small or poorly designed clinical studies OR conflicting results in adequate studies but a preponderance of evidence of an effect (this is the CancerChoices definition; other researchers and studies may define this differently) typically indicates that not much research has been published so far, although the outcomes may be meaningful. Weak evidenceone or more case studies, supported by animal evidence OR small treatment effects of limited clinical significance OR studies with no controls OR weak trends of effects (this is the CancerChoices definition; other researchers and studies may define this differently) may mean that the effects are small or that only very preliminary research has been published.

Fermented wheat germ extract Learn moreSee Less
Mistletoe Learn moreSee Less
Therapeutic Touch Learn moreSee Less

Therapies with no evidence of benefit or evidence of harm

Healing touch ›

  • No evidence of a difference in use of antiemetic medication among people recovering from coronary artery bypass surgery treated with healing touch in a preliminary study

Ketogenic diet ›

  • People with advanced metastatic tumors following a ketogenic diet had stable diarrhea but worse nausea and vomiting over time.

Non-aspirin non-steroidal anti-inflammatory drugs (NSAIDs) ›

  • No evidence of an effect on chemotherapy-induced vomiting or diarrhea among people with stomach cancer treated with celecoxib in a preliminary study

Turmeric and curcumin ›

  • No evidence of an effect on bowel symptoms during radiotherapy among men with prostate cancer treated with curcumin in a preliminary study

Further therapies used to manage gastrointestinal symptoms

These therapies are used to manage gastrointestinal symptoms, but we have not yet reviewed their effectiveness or safety. Those in bold are recommended in at least one clinical practice guideline; see belowUse your browser's Back button to return to this location. for guidelines ›

Breathing (diaphragmatic)

Chamomile tea

Cognitive behavioral therapy

Chinese herbal blends

Ginger

Hypnosis

Indian gooseberry

Licorice or deglycyrrhizinated licorice, DGL

Mind-body modalities (without mentioning specific therapies)

Music therapy

Quince

Rikkunshito, a traditional Japanese herbal medicine

Resources for managing gastrointestinal symptoms

Cookbooks with tips and recipes for those experiencing nausea and vomiting

The Cancer-Fighting Kitchen

Katz R, Edelson M. The Cancer Fighting Kitchen ›

Berkeley, California: Ten Speed Press. 2017.

The Meals to Heal Cookbook

Bratton S, Iannota J. The Meals to Heal Cookbook ›

Savor Health, 2017.

How do integrative experts manage gastrointestinal symptoms?

Both medical groups and integrative experts provide recommendations for managing fatigue. Learn more about the approaches and meanings of recommendations.

Clinical practice guidelines

Recommendations to treat nausea and vomiting from chemotherapy or radiotherapy:

  • Mind-body modalities as part of multidisciplinary approach
  • Acupuncture or related techniques, as adjunct treatment
Chinese medicine clinical service

Development of evidence-based Chinese medicine clinical service recommendations for cancer palliative care using Delphi Approach based on the evidence to decision framework ›

A survey of experts published in 2020 found consensus to recommend moxibustion for reducing nausea and vomiting among patients receiving chemotherapy.

Recommendations: 

  • Specific herbal blends for each pattern of constipation
  • Acupuncture at specific points for three of the four patterns of constipation

Recommend rikkunshito in addition to standard conventional therapy

Complementary therapies used to treat nausea and vomiting:

  • Acupressure
  • Acupuncture
  • Guided imagery
  • Hypnosis
  • Music therapy
  • Relaxation techniques

Shown to be helpful for anticipatory nausea and vomiting:

  • Guided imagery
  • Hypnosis

Things you can try that may help with nausea and vomiting:

  • Hydration
Shanghai Association of Chinese Integrative Medicine multidisciplinary working group

Clinical practice guidelines for the treatment of primary liver cancer with integrative traditional Chinese and Western medicine ›

Weak recommendation for acupuncture and moxibustion to relieve gastrointestinal symptoms such as vomiting

Society for Integrative Oncology

Two guidelines discuss managing nausea and vomiting among people with cancer.

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).10Lyman 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.

Recommendations to treat chemotherapy-induced nausea and vomiting

These therapies can be considered as an addition to anti-emetics drugs to control nausea and vomiting during chemotherapy:

  • Acupressure
  • Acupuncture
  • Electroacupuncture
  • Ginger
  • Relaxation techniques

Insufficient evidence for treating chemotherapy-induced nausea and vomiting:

  • Agaricus silvaticus
  • Aromatherapy
  • Yoga

Should not be recommended:

Glutamine should not be recommended for improving nausea and vomiting during chemotherapy

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

Recommendation: acupuncture to treat nausea and vomiting from chemotherapy or surgical anesthesia (strong recommendation)

Integrative programs and protocols

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 gastrointestinal symptoms.

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

Raymond Chang, MD, FACP

Chang R. Beyond the Magic Bullet: The Anti-Cancer Cocktail. New York: Square One Publishers. 2012.

This book describes a “new therapy based on the knowledge that certain off-label drugs, nutrients, and therapies are each somewhat effective against cancer.” Dr. Chang combines approaches for added benefit.

 

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.

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.

Traditional medicine

Practitioners of traditional medical systems offer therapies and approaches to manage gastrointestinal symptoms. Several traditional Chinese therapies are described above in clinical practice guidelines.

Learn more about traditional medicine and how to find practitioners.

Explore other side effects and symptoms

Are you a health professional?

This section does not replicate the other information on this page but provides additional details or context most relevant to professionals.

Professional resources

Practice guidelines for professionals

Recommendations regarding gastroesophageal reflux disease (GERD):

Clinicians should provide standardized educational material on GERD mechanisms, weight management, lifestyle and dietary behaviors, relaxation strategies, and awareness about the brain-gut axis relationship to patients with reflux symptoms.

Clinicians should provide pharmacologic neuromodulation, and/or referral to a behavioral therapist for hypnotherapy, cognitive behavioral therapy, diaphragmatic breathing, and relaxation strategies in patients with functional heartburn or reflux disease associated with esophageal hypervigilance reflux hypersensitivity and/or behavioral disorders.

More clinical practice guidelines are listed in How do integrative experts manage gastrointestinal symptoms? ›

Journal articles

Sheikhi MA, Ebadi A, Talaeizadeh A, Rahmani H. Alternative methods to treat nausea and vomiting from cancer chemotherapy. Chemotherapy Research and Practice. 2015;2015:818759.

Clinical Pearls from Cancer Strategies Journal

Winter 2013: see Suggestions to Treat Diarrhea from Chemotherapy Treatments

Fall 2013: see Fasting as Part of Cancer Treatment

Fall 2014: see From the Mederi Roundtable Discussion Group

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Authors

Laura Pole, RN, MSN, 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, RN, MSN, OCNS Senior Clinical Consultant

Nancy Hepp, MS

Lead Researcher and Program Manager
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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, program manager, and writer for CancerChoices. 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 and Program Manager

Last update: July 8, 2022

Last full literature review: April 2022

CancerChoices provides information about integrativein 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 psychosocialtherapy, and acupuncture therapies and self carelifestyle 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.

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