Clinical Practice Guidelines

SIO is pleased to provide its updated clinical practice guidelines for breast cancer. In June 2018, ASCO announced endorsement of the guidelines. The guidelines were published in 2017. Researchers analyzed which integrative treatments are most effective and safe for patients with breast cancer. The guidelines are a resource for clinicians and patients to inform evidence-based decisions on the use of integrative therapies during breast cancer treatment. Researchers at US and Canadian institutions evaluated the efficacy and safety of more than 80 therapies.

The Journal of the National Cancer Institute Monograph has  published a special issue co-sponsored by SIO, "Advancing the Global Impact of Integrative Oncology"; including a comprehensive definition for integrative oncology. The articles in the special Monograph were all peer-reviewed.

JACM Special Issue on Integrative Palliative Care- Call for papers deadline has been extended. Read more here


Journal Cover
The Official Journal of:
Society for Acupuncture Research

Paradigm, Practice, and Policy Advancing Integrative Health
The Journal of Alternative and Complementary Medicine

Special Focus Issue on Integrative Palliative Care


 iocenters 2673328 1280 BoardRoomImage

SIO 2020 Call for Board Nominations is Open

The Society for Integrative Oncology (SIO) is accepting nominations from SIO members to fill anticipated vacancies on its Board of Trustees. SIO welcomes the nomination of individuals who are researchers, clinicians, clinical researchers, patients and patient advocates. The submission deadline is March 31, 2020.

Eligibility: To be eligible, candidates must meet the following criteria:
• Current SIO Member (or will join)
• Interested in and committed to advancing and maintaining the integrity of integrative oncology
• Willing to contribute at least 5-10 hours per month toward SIO activities
• Willing to participate in SIO advancement, including fund raising
• Willing to participate in the annual SIO conference (2020 conference will be held October 16-18 in Baltimore, MD)
• Willing to participate in teleconference call meetings every other month and attend and participate in one annual Board retreat and meeting at the SIO Conference. (The 2020 daylong retreat to be held October 15 from 8 a.m.-4 p.m. in Baltimore, MD.)
• Willing to co-chair an SIO Committee, Task Force and/or Special Interest Group

Read complete details here.

SIO2019 Conference Video Presentations Available on VuMedi

As a resource to SIO conference attendees, presentations from SIO's 16th International Conference in NYC are now accessible through, a video hosting platform that posts content from a broad range of healthcare organizations and medical professionals.

There are a total of 29 videos available, which were recorded in Gramercy East/West conference room over the course of the three-day conference. The conference program is also available and downloadable through is a complimentary service, but you do need to join the site before viewing presentations. Please follow the link provided here and scroll to the bottom of the page to create your account. It may take up to one hour for your account profile to be accepted, and you will receive a notification via email. You will not be able to view the presentations until you have received the acceptance notification.For those who are already VuMedi members, simply sign in and enter Society for Integrative Oncology in the search bar.Oral abstracts and presentations are also available to conference attendees through the Member portal of the SIO website. These presentations are restricted to conference attendees for three months. We will make them available to the general membership in February 2020. 


Tao WW; Tao XM; Song CL.


Effects of non-pharmacological supportive care for hot flushes in breast cancer: a meta-analysis.


Supportive Care in Cancer. 25(7):2335-2347, 2017 Jul.


PURPOSE: To assess the efficacy of non-pharmacological therapies for hot flashes (HFs) in women with breast cancer (BC).

METHODS: Nine databases (MEDLINE, Cochrane Central Register of Controlled Trials, EMBASE, PsycINFO, CINAHL, China National Knowledge Infrastructure (CNKI), Chinese Scientific Journal Database (VIP), China Biology Medicine (CBM), and Wan Fang Database) were searched from their inceptions to October 2016. We also hand-searched reference lists of reviews and included articles, reviewed conference proceedings, and contacted experts. Finally, randomized controlled trials (RCTs) were aggregated to evaluate the therapeutic effect of acupuncture for HFs in women with BC.

RESULTS: Sixteen trials were included in the meta-analysis. Significant combined effects of non-pharmacological therapies were observed in reducing frequency and severity of HFs after treatment (d = -0.57, P < 0.001). These effects were sustained, albeit reduced in part, during follow-up (d = -0.36, P < 0.001), with the exception of frequency (P = 0.41). Meta-analysis according to therapy types showed that for hypnosis, HFs scores instead of scores of HFs-related daily interference scale (HFRDIS) were significantly lowered at the post-treatment time point (d =-13.19, P < 0.001); for acupuncture, a small but significant effect on HFRDIS was found at the post-treatment time point (d = -3.34, P < 0.001). The effect was sustained during follow-up; however, no effect was evident for HFs frequency; for cognitive behavioral therapy (CBT), at the post-treatment time point, but not during follow-up, a small but significant effect was documented for HFs score (d = -0.88, P < 0.01). No serious adverse effect was reported in the included studies.

CONCLUSIONS: Various types of non-pharmacological therapies were associated with significant effects on HFs in women with BC.




Gentry-Maharaj A; Karpinskyj C; Glazer C; Burnell M; Bailey K; Apostolidou S; Ryan A; Lanceley A; Fraser L; Jacobs I; Hunter MS; Menon U.


Prevalence and predictors of complementary and alternative medicine/non-pharmacological interventions use for menopausal symptoms within the UK Collaborative Trial of Ovarian Cancer Screening.


Climacteric. 20(3):240-247, 2017 Jun.


OBJECTIVES: The negative publicity about menopausal hormone therapy (MHT) has led to increased use of complementary and alternative medicines (CAM) and non-pharmacological interventions (NPI) for menopausal symptom relief.  We report on the prevalence and predictors of CAM/NPI among UK postmenopausal women.

METHOD: Postmenopausal women aged 50-74 years were invited to participate in the UK Collaborative Trial of Ovarian Cancer Screening (UKCTOCS). A total of 202638 women were recruited and completed a baseline questionnaire. Of these, 136 020 were sent a postal follow-up-questionnaire between September 2006 and May 2009 which included ever-use of CAM/NPI for menopausal symptom relief. Both questionnaires included MHT use.

RESULTS: A total of 88430 (65.0%) women returned a completed follow-up-questionnaire; 22206 (25.1%) reported ever-use of one or more CAM/NPI. Highest use was reported for herbal therapies (43.8%; 9725/22206), vitamins (42.6%; 9458/22206), lifestyle approaches (32.1%; 7137/22206) and phytoestrogens (21.6%; 4802/22206). Older women reported less ever-use of herbal therapies, vitamins and phytoestrogens. Lifestyle approaches, aromatherapy/reflexology/acupuncture and homeopathy were similar across age groups. Higher education, Black ethnicity, MHT or previous oral contraceptive pill use were associated with higher CAM/NPI use. Women assessed as being less hopeful about their future were less likely to use CAM/NPI.

CONCLUSION: One in four postmenopausal women reported ever-use of CAM therapies/NPI for menopausal symptom relief, with lower use reported by older women. Higher levels of education and previous MHT use were positive predictors of CAM/NPI use.




Yeh CH; Lin WC; Kwai-Ping Suen L; Park NJ; Wood LJ; van Londen GJ; Howard Bovbjerg D.


Auricular Point Acupressure to Manage Aromatase Inhibitor-Induced Arthralgia in Postmenopausal Breast Cancer Survivors: A Pilot Study.


Oncology Nursing Forum. 44(4):476-487, 2017 Jul 01.


PURPOSE/OBJECTIVES: To assess the feasibility of auricular point acupressure to manage aromatase inhibitor-induced arthralgia.

DESIGN: Wait list control design.

SETTING: Outpatient clinics and oncology center.

SAMPLE: 20 women with aromatase inhibitor-induced arthralgia.

METHODS: After baseline data were collected, participants waited one month before they received acupressure once per week for four weeks at a convenient time. The baseline data served as the control comparison.  Self-reported measures and blood samples were obtained at baseline, at preintervention, weekly during the intervention, and at post-intervention.

MAIN RESEARCH VARIABLES: The primary outcomes included pain intensity, pain interference, stiffness, and physical function. Inflammatory cytokines and chemokines were tested.

 FINDINGS: After the four-week intervention, participants reported decreases in worst pain and pain interference, and improvements in physical function, cancer-related symptom severity, and interference. The proinflammatory cytokines and chemokines displayed a trend of a mean percentage reduction. The anti-inflammatory cytokine interleukin-13 increased from pre- to postintervention.

CONCLUSIONS: Auricular point acupressure is feasible and may be effective in managing arthralgia in breast cancer survivors.

IMPLICATIONS FOR NURSING: Nurses can administer acupressure in clinical settings, which could enhance the management of aromatase inhibitor-induced arthralgia and contribute to a shift from traditional disease-based biomedical models to a broader, integrative, medical paradigm for managing aromatase inhibitor-induced arthralgia.




Chen L; Lin CC; Huang TW; Kuan YC; Huang YH; Chen HC; Kao CY; Su CM; Tam KW.


Effect of acupuncture on aromatase inhibitor-induced arthralgia in patients with breast cancer: A meta-analysis of randomized controlled trials.


 Breast. 33:132-138, 2017 Jun.


PURPOSE: Aromatase inhibitor (AI)-induced arthralgia (AIA) is a common side effect that may lead to premature discontinuation of effective hormonal therapy in patients with breast cancer. Acupuncture may relieve joint pain in patients with AIA. We conducted a meta-analysis of randomized controlled trials (RCTs) to evaluate the effectiveness of acupuncture in pain relief in AIA.

METHODS: The PubMed, Embase, Cochrane Library, and Scopus databases and the registry were searched for studies published before February 2017. Individual effect sizes were standardized, and a meta-analysis was conducted to calculate the pooled effect size by using a random effect model. Pain was assessed using the Brief Pain Inventory (BPI) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) at 3-4, 6-8, and 12 weeks. Secondary outcomes included disability level, upper extremity function, physical performance, and quality of life.

RESULTS: Five trials involving 181 patients were reviewed. Significant pain reduction was observed after 6-8 weeks of acupuncture treatment.  Patients receiving acupuncture showed a significant decrease in the BPI worst pain score (weighted mean difference [WMD]: -3.81, 95% confidence interval [CI]: -5.15 to -2.47) and the WOMAC pain score (WMD: -130.77, 95% CI: -230.31 to -31.22) after 6-8 weeks of treatment. One of the 4 trials reported 18 minor adverse events in 8 patients during 398 intervention episodes.

CONCLUSION: Acupuncture is a safe and viable nonpharmacologic treatment that may relieve joint pain in patients with AIA. Additional studies involving a higher number of RCTs are warranted.




Choi TY; Kim JI; Lim HJ; Lee MS.


Acupuncture for Managing Cancer-Related Insomnia: A Systematic Review of Randomized Clinical Trials.


Integrative Cancer Therapies. 16(2):135-146, 2017 Jun.


BACKGROUND: Insomnia is a prominent complaint of cancer patients that can significantly affect their quality of life and symptoms related to sleep quality. Conventional drug approaches have a low rate of success in alleviating those suffering insomnia. The aim of this systematic review was to assess the efficacy of acupuncture in the management of cancer-related insomnia.

METHODS: A total of 12 databases were searched from their inception through January 2016 without language restriction. Randomized controlled trials (RCTs) and quasi-RCTs were included if acupuncture was used as the sole intervention or as an adjunct to another standard treatment for any cancer-related insomnia. The data extraction and the risk of bias assessments were performed by 2 independent reviewers.

RESULTS: Of the 90 studies screened, 6 RCTs were included. The risk of bias was generally unclear or low. Three RCTs showed equivalent effects on the Pittsburgh Sleep Quality Index and 2 RCTs showed the similar effects on response rate to those of conventional drugs at the end of treatment. The other RCT showed acupuncture was better than hormone therapy in the numbers of hours slept each night and number of times woken up each night. The 3 weeks of follow-up in 2 RCTs showed superior effects of acupuncture compared with conventional drugs, and a meta-analysis showed significant effects of acupuncture. Two RCTs tested the effects of acupuncture on cancer-related insomnia compared with sham acupuncture. One RCT showed favourable effects, while the other trial failed to do so.

CONCLUSION: There is a low level of evidence that acupuncture may be superior to sham acupuncture, drugs or hormones therapy. However, the number of studies and effect size are small for clinical significance. Further clinical trials are warranted.


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