Integrative Oncology for Biochemical Recurrence of Epithelial Ovarian Cancer

Biochemical recurrence of epithelial ovarian cancer (EOC), defined as rising CA-125 levels without clinical or radiologic evidence of disease, is a frequent and challenging scenario. Cytotoxic therapy initiated at this stage does not improve survival and may diminish quality of life. This review evaluates integrative oncology (IO) interventions that may support women during this vulnerable period.

Mind-body therapies, including mindfulness, yoga, and cognitive behavioral therapy, have demonstrated benefits in reducing anxiety, distress, and fear of recurrence. Exercise and acupuncture improve vitality, mood, and sleep. Nutritional strategies-particularly anti-inflammatory diets, vitamin D sufficiency, and omega-3 fatty acid intake-promote resilience and overall health. Natural compounds such as green tea, medicinal mushrooms, modified citrus pectin, melatonin, and AHCC show immune-modulating or anti-tumor effects in preclinical or early clinical studies. Among repurposed non-oncologic drugs, metformin provides the strongest rationale, especially for women with type 2 diabetes. Although ovarian cancer-specific trials are limited, IO approaches are safe, feasible, and evidence-informed. They address psychosocial distress, improve quality of life, and may influence disease biology, offering meaningful options for women under surveillance during biochemical recurrence.