Nutritional approaches, music therapy, and Mindfulness are integrated care strategies for patients facing cancer, chronic illness, or neurodegenerative diseases. These methodologies are increasingly at the heart of personalized, multidisciplinary, and synergistic care.
On the occasion of the World Day of the Sick, observed today, February 11, these are some efficacy findings from therapies that are less “programmed” and included within integrated care pathways.
The literature shows that a multifunctional approach promotes the reduction of significant physical, psychological, and emotional side effects that undermine therapeutic outcomes across a broad cluster of patients.
Widespread Malnutrition
In Italy, roughly 60% of cancer patients are at risk of malnutrition at diagnosis, rising to as high as 80% in advanced stages with cachexia and sarcopenia, which has a major impact by increasing mortality by about 250%, tripling complications, and significantly extending hospital stays by around 30%.
Within this framework, specialized medical nutrition—particularly Oral Nutritional Supplements (ONS)—is confirmed as an effective clinical tool capable of mitigating cancer-related complications, reducing prolonged hospitalizations and readmissions, and delivering meaningful savings and sustainability for the national health system at both hospital and community levels.
However, despite the recent passage of Italy’s 2026 Budget Law to launch oncologic nutritional screening, access to ONs remains fragmented and uneven, with strong regional disparities and the urgent need for formal recognition within the LEA (Livelli Essenziali di Assistenza / Essential Levels of Care).
A recent systematic review and dose‑response meta-analysis of randomized clinical trials sought to determine the effects of ONs in cancer patients undergoing chemotherapy (and radiotherapy). The investigation considered body weight, body mass index (BMI), serum albumin, fatigue, quality of life (QOL), the patient-generated subjective global assessment (PG-SGA), and C-reactive protein (CRP). The findings demonstrate the nutritional approach’s capacity to contribute to better management of several cancer-related complications, including reductions in fatigue, BMI maintenance, and QoL improvement.
Less evident, however, were the impacts on serum albumin, CRP, or PG-SGA scores. With the same nutritional support goals in mind, Special Medical Foods (SMFs)—specifically formulated and intended for the dietary management of patients under medical supervision—remain crucial for oncology patients.
The Benefits of Music Therapy
Music therapy is gaining recognition as a complementary approach in cancer care. A recent review specifically explored its impact on the tumor microenvironment (TME), focusing on immune signaling and cell‑level inflammation. The evidence shows that music therapy alleviates psychological symptoms such as anxiety and depression, and physical discomfort including pain, fatigue, and nausea.
Beyond symptom relief, it also modulates immune responses, particularly among populations of immune cells that influence tumor‑associated inflammation and cancer progression, potentially improving treatment effectiveness.
Despite its noninvasive, cost-effective nature and high acceptability among patients, music therapy remains underutilized in oncology, even though data suggest it could be a promising component of an integrative care plan to support patient recovery and immune homeostasis. Positive effects of music therapy are also observed in the management of comorbidities, for instance in respiratory settings.
Active recreational music therapy methods—group singing, improvisation, playing an instrument, receptive music listening, and music therapy in general—can be considered adjunct therapies to support symptom management and enhance well-being, in addition to standard therapeutic strategies. In dementia and several other neurological disorders, including Huntington’s disease, stroke, traumatic brain injury, spinal cord injury, and disorders of consciousness, music- and dance-based rehabilitation has proven to be a resource for promoting social engagement and improving motor, cognitive, and mood domains.
Evidence indicates, for example, significant effects on behavioral outcomes and neuroimaging endpoints, showing structural and functional neuroplastic changes in critical areas for perception and memory in patients at risk of dementia, as well as in regions essential for language processing, emotional regulation, and motor control in both acute and chronic stroke patients.
The Efficacy of Mindfulness
Several studies support the effectiveness of this technique in oncology. In particular, Mindfulness-Based Stress Reduction (MBSR), Mindfulness-Based Cognitive Therapy (MBCT), and Mindfulness-Based Cancer Recovery (MBCR) appear to help reduce symptoms of depressive mood, anxiety, and cancer‑related fatigue. Benefits are also observed among cancer survivors in terms of reduced distress and improved psychological well-being. The gains extend to family members and caregivers as well.
Patients with advanced cancer and their families who assist them often rely on avoidant coping strategies, such as postponing discussions about advance care planning, which can contribute to a decline in quality of life. Mindfulness-based interventions have shown promise in improving quality of life in this population, notably through the group intervention Mindfulness to Enhance Quality of Life and Support Advance Care Planning (MEANING).
Positive evidence also appears in the holistic approach to treating Parkinson’s disease (PD), linked to two mindfulness practices—meditation and yoga—showing favorable outcomes across biopsychosocial domains, including anxiety, depressive symptoms, motor and non-motor symptoms, health-related quality of life (HRQOL), mindfulness, and biomarkers of stress and inflammation, compared with standard care. In chronic obstructive pulmonary disease (COPD), mindfulness techniques help manage and reduce symptoms, improving quality of life. These findings point to the potential benefits of integrating mindfulness-based interventions as a complementary health approach for symptom management.
The role of integrative medicine is crucial. Other strategies, such as herbal medicine and acupuncture, are therefore supportive for patients in managing symptoms and treatment-related adverse effects, as part of a broader approach to conventional, traditional care pathways.
Sources
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Fu Y, Wu K, Zhuang J et al. Music therapy in modulating immune responses and enhancing cancer treatment outcomes. Front Immunol, 2025, 16:1639047. Doi: 10.3389/fimmu.2025.1639047
Lee AL, Clark IL, Lewis A. Harnessing music therapy and music medicine in chronic respiratory disease management. Expert Rev Respir Med, 2025, 19(7):639-654. Doi: 10.1080/17476348.2025.2501279
Blasi V, Rapisarda L, Cacciatore DM et al. Structural and functional neuroplasticity in music and dance-based rehabilitation: a systematic review. J Neurol, 2025, 272(5):329. Doi: 10.1007/s00415-025-13048-6
Chayadi E, Baes N, Kiropoulos L. The effects of mindfulness-based interventions on symptoms of depression, anxiety, and cancer-related fatigue in oncology patients: A systematic review and meta-analysis. PLoS One, 2022, 17(7):e0269519. Doi: 10.1371/journal.pone.0269519
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Mosher CE, Beck-Coon KA, Wu W et al. Mindfulness to enhance quality of life and support advance care planning: a pilot randomized controlled trial for adults with advanced cancer and their family caregivers. BMC Palliat Care, 2024, 23(1):232. Doi: 10.1186/s12904-024-01564-7.
Kwok JYY, Chan LML, Lai CA et al. Effects of Meditation and Yoga on Anxiety, Depression and Chronic Inflammation in Patients with Parkinson’s Disease: A Randomized Clinical Trial. Psychother Psychosom, 2025;94(2):101-118. Doi: 10.1159/000543457.
Von Visger TT, Wardlaw K, Li CS et al. Associations between mindfulness and symptom severity among adults living with chronic obstructive pulmonary disease (COPD). Heart Lung, 2025, 70:163-169. Doi: 10.1016/j.hrtlng.2024.12.002
Abbonati a Karla Miller
