Bottom line: Acupuncture is effective in treating some symptoms associated with cancer treatment.
Acupuncture is a component of Traditional Chinese Medicine and involves use of needles, heat (moxibustion), pressure (acupressure) or electricity to stimulate one or more points in the body to promote the flow of Qi (internal energy). The World Health Organization supports the use of acupuncture in reducing symptoms, such as depression, facial pain, headache, peripheral neuropathy, lower back pain, nausea and vomiting, neck pain, postoperative pain, shortness of breath, chronic fatigue, and side effects caused by radiotherapy and/or chemotherapy. A recent study showed that acupunture reduces symptoms of sneezing, itching, and runny nose in children with allergies. Acupuncture also improved pregnancy rates in women following in vitro fertilization. Acupuncture treatments are generally safe and well tolerated by most patients. Some conditions may require continuous treatments in order to achieve long-term effect. Cancer patients considering acupuncture should seek certified or state-licensed practitioners who have training or experience in working with cancer patients.
Pain Several clinical trials showed that acupuncture is effective in alleviating pain.
In vitro fertilization Acupuncture can improve the pregnancy rates in women following in vitro fertilization
Depression Evidence from clinical trials is inconclusive. More studies are needed
Headache This use is supported by clinical trials.
Fatigue Several clinical trials showed that acupuncture reduces fatigue
Constipation This use is supported by scientific evidence
Nausea A number of studies support the use of acupuncture in treating nausea
Cancer-related symptoms Several clinical trials support the use of acupuncture in relieving pain, nausea and vomiting, and fatigue resulting from chemotherapy and radiotherapy treatments
Cancer In a recent clinical trial, 104 breast cancer patients undergoing chemotherapy received electroacupuncture, at antiemetic acupuncture points, minimal needling at control points, or antiemetic drugs alone. Patients who received electroacupuncture reported fewer episodes of vomiting compared to those in the other groups. However, this effect was short-term and not observed at a follow-up done from days 6-14.
In another study, twenty-five cancer patients who had completed chemotherapy but experienced fatigue received acupuncture treatments twice a week for 4 weeks or once a week for 6 weeks. All patients irrespective of weekly or biweekly treatments reported a 31% improvement in fatigue level after 2 weeks following the final treatment. However, more studies involving large number of patients are needed to establish this use.
Headache In a study conducted to determine the effects of acupuncture on headache, 401 patients with chronic headache received up to 12 acupuncture treatments over 3 months or conventional treatment. Patients in the acupuncture group had fewer headaches, paid fewer visits to doctors, and their quality of life improved compared to those in the conventional care group. Researchers concluded that acupuncture is beneficial in patients suffering from chronic headache, particularly, migraine.
If you have low white blood cell count, low platelet count or heart murmur (symptom of endocarditis). Acupuncture may increase risk of infection and bleeding.
If you are pregnant (some acupuncture points can cause strong uterine contractions. Pregnant women should inform practitioners before seeking acupuncture treatment)
If you have excessive accumulation of fluid due to improper lymphatic drainage (lymphedema) (needles should not be placed in the limbs of patients with lymphedema)
If you wear pacemakers (electrical stimulation is contraindicated for patients wearing electronic medical devices)
Acupuncture, a component of Traditional Chinese Medicine, originated more than 2,000 years ago. Treatment involves stimulation of one or more predetermined points on the body with needles, heat (moxibustion), pressure (acupressure), or electricity for therapeutic effect. A Centers for Disease Control (CDC) report indicated that more than 8 million Americans use acupuncture to treat different ailments. Data from clinical trials support use of acupuncture for chronic headache (2)(3)(20), but there was no difference between true and sham acupuncture treatments; the treatments were, however, more effective compared to a no acupuncture control (18). Acupuncture is beneficial for osteoarthritis of knee (16)(23)(27), chronic mechanical neck pain (17), and symptoms associated with fibromyalgia (22). It was also superior to physical therapy (21) in treating patients with low back pain compared to usual care (24)(36) and was cost effective (25). Acupuncture also reduced high blood pressure (29); and the severity of hot flashes in postmenopausal women (26) but was ineffective in treating major depressive disorder (28). In addition, studies show benefits of acupuncture for peripheral neuropathy (30), including that associated with diabetes (31), AIDS (32)(33), and chemotherapy (34). Acupuncture also improved reproductive outcomes in women following in vitro fertilization (37)(38)(39)(40)(41), reduced symptoms of chronic prostatitis/chronic pelvic pain (43), and decreased procedural anxiety in patients undergoing lithotripsy (44). Data from a study done in children undergoing endoscopic procedures indicate benefits of acupressure in reducing preprocedural anxiety (47).
Acupuncture is being used in the palliative care of cancer to alleviate pain (5)(45), dysfunction (45), chronic fatigue (1) and to reduce post-operative (4), chemotherapy-induced (6)(13)(19)(35) nausea and vomiting, and to ameliorate xerostomia or dry mouth, commonly experienced by cancer patients following radiotherapy of the head and neck regions (7)(45).
Acupuncture is generally safe and well tolerated by patients including children (14)(15). Some conditions require continuous treatments in order to achieve long-term effect. Pregnant women, patients with lymphedema, those wearing pacemakers, and those with low platelet count should inform their practitioners before receiving treatment. Cancer patients considering acupuncture should seek certified or state-licensed practitioners who have training or experience in working with cancer patients.
Acupuncture points are located at specific areas along channels or meridians. Qi (energy) is believed to flow in this network of channels which connect different parts of the body and organs into a unified system. Practitioners believe pain and symptoms of disease arise when the flow of Qi is stagnated. Acupuncture is intended to promote the flow of Qi to relieve symptoms. Studies have demonstrated that acupuncture can induce analgesia, but that effect was blocked by naloxone, an opioid antagonist (8)(9). Further, mice lacking opiate receptors showed low analgesic effect following electroacupuncture (10). Acupuncture is also known to stimulate release of endogenous opioids and other neurotransmitters. Needles inserted in one part of the body can affect pain sensation in another region (11). Studies using functional magnetic resonance imaging (fMRI) have shown that acupuncture elicits changes in the brain that appear to correlate with neurological effects produced (12). Needling of LI-2, a point used to treat xerostomia, is associated with neuroimaging changes correlated to saliva production (46). Results from a study done in patients with peripheral neuropathy indicate that acupuncture improves nerve conduction (30). Low-frequency electroacupunture was shown to increase ovarian blood flow via the ovarian sympathetic nerves in rats (42).
Acupuncture is generally safe when performed by trained practitioners. Studies in Europe and Japan showed that less than 0.2% of all individuals treated with acupuncture experienced adverse effects. Failure to remove needles, bleeding, hematoma, dizziness, and pain are the commonly reported adverse events. Pneumothorax, local infections, and burns caused by moxibustion are rare.
Wang SM, Escalera S, Lin EC, et al. Extra-1 acupressure for children undergoing anesthesia. Anesth Analg. 2008 Sep;107(3):811-6. In this study, 52 children scheduled to receive general anesthesia for endoscopic procedures were randomized to a acupresure bead intervention at the Yin-Tang acupoint or at a sham point. Anxiety was assessed at baseline and before entry into the operating room. Researchers observed that children in the acupressure group experienced lowered anxiety compared to the sham group who reported greater anxiety. However, acupressure did not have an impact on the amount of propofol used during the procedure.
Shen J, et al. Electroacupunture for control of myeloablative chemotherapy-induced emesis. A randomized controlled trial. JAMA 2000;284(21):2755-2761. In this study, 104 breast cancer patients undergoing chemotherapy were randomly assigned to receive electroacupuncture at antiemetic acupuncture points once daily for 5 days; minimal needling at control points with mock stimulation once daily for 5 days; or antiemetic drugs alone. All the patients received the same chemotherapeutic and antiemetic drugs. At the end of 5 days, patients who received electroacupuncture reported fewer episodes of vomiting compared to those who received minimal needling or antiemetic drugs alone. However, these effects were not observed at a follow-up done from days 6-14. Researchers concluded that electroacupuncture was effective in short-term in controlling emesis associated with chemotherapeutic treatment in breast cancer patients.
Alimi D, et al. Analgesic effect of auricular acupuncture for cancer pain: A randomized, blinded, controlled trial. J Clin Oncol 2003;21(22):4120-4126. Ninety cancer patients were randomly assigned to receive two courses of true auricular acupuncture; auricular acupuncture at placebo points; or with auricular seeds fixed at placebo points. At a 2-month assessment, patients who received acupuncture reported a 36% decrease in pain from baseline compared to 2% in those who received placebo. Researchers concluded that acupuncture significantly reduced pain in cancer patients, despite being treated with analgesics.
Vickers AJ, et al. Acupuncture for postchemotherapy fatigue: A phase II study. J Clin Oncol 2004;22(9):1731-1735. This study involved cancer patients who had completed chemotherapy but experienced persistent fatigue. 25 patients received acupuncture twice a week for 4 weeks and 12 patients received acupuncture once a week for 6 weeks. Patients reported an improvement of 31% in fatigue level measured at 2 weeks after the final treatment compared to the baseline. There was no significant difference in weekly and bi-weekly treatments. The result suggests that acupuncture has benefit in treating postchemotherapy fatigue. However, this is only a preliminary study on a small number of patients and was not randomized. Further studies involving large number of patients are warranted.
Vickers AJ, et al. Acupuncture for chronic headache in primary care: large, pragmatic, randomized trial. BMJ 2004;328(7442):744-49. In this study, 401 patients with chronic headache were randomly assigned to receive up to 12 acupuncture treatments over a period of 3 months or conventional treatment. Patients in the acupuncture group reported fewer headaches, less use of medication, fewer visits to doctors, and improved quality of life compared to those who received conventional care. Researchers concluded that acupuncture offers persistent clinical benefits for patients with chronic headache, particularly migraine.
Pfister D, Vickers A, Deng G, et al. Acupuncture for pain and dysfunction after neck dissection: preliminary results of a randomized controlled trial. Proceedings from the American Society of Clinical Oncology Annual Meeting, 2008.
