Saturday, May 1, 2010
Recent studies have shown that acupuncture can help control a number of symptoms and side effects — such as pain, fatigue, dry mouth, nausea, and vomiting — associated with a variety of cancers and their treatments. Experts from Memorial Sloan Kettering Cancer Center’s Integrative Medicine Service, who have either conducted or reviewed many of those studies, recommend that cancer patients interested in acupuncture seek a certified or licensed acupuncturist who has training or past experience working with individuals with cancer.
Acupuncture treatment, a two-thousand-year-old component of traditional Chinese medicine, involves stimulating one or more predetermined points on the body, called acupoints, with needles for therapeutic effect. Heat, pressure, or electricity may be added to intensify the effect of the acupuncture needles. According to traditional Chinese medicine beliefs, energy flows throughout the body along channels, or “meridians.” Specific acupoints are stimulated to increase energy flow along various channels throughout the body to a particular tissue, organ, or organ system.
Treatment is usually customized to treat each patient’s particular symptoms. A typical acupuncture session, which takes about 30 minutes, involves the insertion of ten to 20 very thin, stainless steel needles. Most patients receiving acupuncture experience no pain from the insertion of the needles, and there is minimal risk of injury from acupuncture treatments, with reports of fewer than one adverse event in more than 10,000 treatments.
According to the Centers for Disease Control and Prevention, each year more than eight million Americans use acupuncture to treat different ailments. Studies have demonstrated its effectiveness in the treatment of a host of non-cancer-related health issues, such as back pain, chronic headaches, osteoarthritis, high blood pressure, infertility, and hot flashes. Its use for the treatment of symptoms and side effects of a variety of cancers has recently been investigated in a number of studies and reviews.Back to top
Acupuncture for Head and Neck Cancer
For many of the more than 100,000 individuals diagnosed with head and neck cancer each year in the United States, the cancer spreads from its primary location to lymph nodes in the neck. When this occurs, nerves known as spinal accessory nerves must also be removed along with the affected lymph node, which can lead to shoulder function problems.
A recent study [PubMed Abstract] conducted by Memorial Sloan Kettering investigators and published in the April 2010 issue of the Journal of Clinical Oncology sought to determine if acupuncture could reduce pain and dysfunction in individuals with cancer of the head or neck who had received a surgical dissection of lymph nodes in their neck. The study evaluated 58 patients who were suffering from chronic pain or dysfunction as a result of neck dissection. For four weeks, study participants were randomly assigned into one of two groups: those receiving weekly acupuncture sessions and those receiving standard care, which included physical therapy, as well as pain and antiinflammatory medication.
The study found that individuals in the group receiving acupuncture experienced significant reductions in pain and dysfunction when compared with individuals receiving standard care. Individuals in the acupuncture group also reported significant improvement in xerostomia, a condition in which patients receiving adjuvant radiation therapy experience extreme dry mouth.Back to top
Acupuncture and Leukemia
Many people with leukemia try additional treatments outside their standard care, hoping to manage symptoms and, in some cases, to improve their treatment outcome. In a commentary [PubMed Abstract] on the subject in the September 2009 issue of Expert Reviews Anticancer Therapies, Memorial Sloan Kettering investigators examined the results from available studies testing the effectiveness of such approaches. They report that among the complementary therapies used to decrease symptoms and side effects, acupuncture is very beneficial for symptom management.
For some leukemia patients, cancer chemotherapy drugs can damage the peripheral nervous system (a condition known as peripheral neuropathy), causing pain, numbness, tingling, swelling, and muscle weakness in various parts of the body, especially in the hands and feet. In some cases, doctors must reduce the chemotherapy dose in order to prevent the neuropathy from progressing further. Acupuncture has been found to decrease these difficult neuropathy symptoms, allowing the maximum amount of chemotherapy to be used, thereby increasing the patient’s chance for a successful outcome.
Acupuncture is also known to reduce the effects of nausea caused by a variety of chemotherapy agents used to treat leukemia. Research has shown that timing the acupuncture sessions one to two days before chemotherapy infusion and continued weekly throughout the chemotherapy regimen produces the best results. In addition, the authors note that acupuncture has been proven safe for patients receiving the anticoagulation drugs Coumadin® or heparin during their leukemia treatment.
The review’s authors note that, in general, it is important to distinguish between complementary therapies — including acupuncture, self-hypnosis, yoga, meditation, and therapeutic massage — and alternative therapies, which are unproven and ineffective, and may interfere with mainstream cancer treatments.Back to top
Acupuncture and Breast Cancer
A significant number of breast cancers have receptors for the hormone estrogen. These receptor-positive breast tumors are more likely to respond to therapy with anti-estrogen medications, which take advantage of the cancer cells’ dependence on hormones for growth. Women with these tumors are often given treatment that blocks the production of estrogen, which is meant to slow the growth of the tumor. These treatments can induce early menopause, leading to symptoms such as hot flashes, fatigue, and excessive sweating. Because these women cannot receive hormone replacement therapy, which is usually used to treat such symptoms, doctors typically prescribe antidepressants such as the drug venlafaxine (Effexor).
A recent study examined whether acupuncture reduces some of these common side effects and produces fewer adverse effects than antidepressants. In the study [PubMed Abstract], published in the February 2010 issue of the Journal of Clinical Oncology, 50 women with hormone-receptor positive breast cancer were assigned into one of two groups. The first group received 12 weeks of acupuncture, and the second group received treatment with venlafaxine.
Both groups experienced significant decreases in hot flashes, depressive symptoms, and other quality-of-life symptoms. However, women in the group taking venlafaxine began to re-experience their symptoms about two weeks after stopping drug therapy. In comparison, it took 15 weeks for the symptoms to return for women in the group receiving acupuncture. In addition, women in the acupuncture group reported no significant side effects during treatment, while the group taking venlafaxine experienced 18 incidences of adverse effects, including nausea, dry mouth, dizziness, and anxiety.Back to top
Finding the Right Acupuncturist for Cancer Patients
The National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM) provides a list of practitioners who are nationally certified in Oriental medicine, acupuncture, Chinese herbology, and Asian bodywork therapy. The Integrative Medicine Service at Memorial Sloan Kettering Cancer Center has trained thousands of acupuncturists from across the United States and many other countries. Its previously face-to-face, three-day courses were replaced in April 2010 with Internet-based courses to facilitate international requests. The Integrative Medicine Service also maintains a list of cancer-trained acupuncturists. Our integrative medicine specialists stress the importance of using an acupuncturist who is NCCAOM certified or licensed and who has training in working with cancer patients.Back to top