Acupuncture

Purported Benefits, Side Effects & More
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Acupuncture is a therapeutic component of Traditional Chinese Medicine.

Common Names

  • Manual acupuncture
  • Electroacupuncture
  • Acustimulation
  • Acupressure

For Patients & Caregivers

Tell your healthcare providers about any dietary supplements you’re taking, such as herbs, vitamins, minerals, and natural or home remedies. This will help them manage your care and keep you safe.


What Is It

Acupuncture is a therapeutic component of Traditional Chinese Medicine. Treatment involves the use of very thin needles along with heat, pressure, or electricity to stimulate points on the body, promoting the flow and balance of internal energy.

Acupuncture treatment can help reduce

  • Pain
  • Fatigue
  • Hot flashes

It can also help improve

  • Sleep
  • Dry mouth
  • Nausea and vomiting

Cancer guidelines recommend acupuncture as part of management for cancer pain, fatigue, and hot flashes. Further, a newly released guideline from the Society for Integrative Oncology and ASCO recommends acupuncture for aromatase inhibitor–related joint pain, musculoskeletal pain, and general cancer pain.

Cancer patients considering acupuncture should seek certified or state-licensed practitioners who have training or experience in working with cancer patients. Some oncology physicians may also be board-certified acupuncturists.

The Integrative Medicine Service at MSK offers acupuncture and other integrative therapies to support the recovery and wellbeing of cancer patients. In addition, clinical trials continue to evaluate acupuncture for patients with cancer.

How It Works

According to TCM, acupuncture points are located at specific areas along channels or meridians. Qi (pronounced chee, meaning energy) is believed to flow in this network which connects different parts of the body. Pain and disease symptoms are thought to arise when Qi is not flowing. Acupuncture treatments are used to promote this flow and balance of Qi to relieve symptoms. It is also known to release pain-relieving or feel-good chemicals in the brain.

Studies in animals and humans have shown that acupuncture can stimulate pain relief and reduce stress, anxiety, and depression. Other studies have shown it can improve sleep, increases blood flow, and may help reduce inflammation, which may also explain pain-relieving effects.

MRI studies show that acupuncture causes changes in the brain that reflect changes in the body. Other studies show that certain acupoints for dry mouth correlate to saliva production. Acupuncture also improves nerve signaling in patients with nerve pain.

Researchers are continuing to examine the mechanisms by which acupuncture exerts these effects. Additional findings may help to optimize treatment regimens in the future.

Purported Uses and Benefits
  • Cancer treatment symptoms
    Clinical trials support the use of acupuncture to relieve pain, nausea and vomiting, dry mouth, fatigue, hot flashes, and nerve pain resulting from cancer treatments. In some studies, benefits lasted well after treatment.
  • Pain
    Clinical trials demonstrate that acupuncture can help reduce pain, including joint or nerve pain associated with cancer treatments as well as other types of chronic pain.
  • Sleep
    Several trials in cancer patients show that acupuncture improves sleep.
  • Fatigue
    Several trials show that acupuncture reduces fatigue, including cancer-related fatigue.
  • Anxiety
    Several studies show that acupressure and acupuncture can help relieve anxiety related to tests and procedures. It may also help with anxiety in general.
  • Nausea and vomiting
    Acupuncture can reduce chemotherapy-induced nausea and vomiting.
  • Constipation
    Some evidence suggests acupuncture may help relieve constipation.
Side Effects

Acupuncture is generally safe when performed by trained practitioners. Some conditions require continuous treatments in order to achieve long-term effects.

Pregnant women, patients who wear pacemakers, and those with lymphedema or low platelet count should inform their practitioners before receiving treatment.

Who Can Provide this Service

Cancer patients considering acupuncture should seek certified or state-licensed practitioners who have training or experience in working with this population. Some oncology physicians may also be board-certified acupuncturists.

Where Can I Get Treatment

A majority of National Cancer Institute-designated cancer centers offer acupuncture as part of supportive care.

The Integrative Medicine Service at MSK offers acupuncture and other integrative therapies to support the recovery and wellbeing of cancer patients.

Clinical trials continue to evaluate acupuncture for patients with cancer.

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For Healthcare Professionals

Clinical Summary

Acupuncture is an integral component of Traditional Chinese Medicine (TCM) that originated over 2,000 years ago. Treatment involves stimulation of predetermined body points using thin needles, sometimes along with heat (moxibustion) or electricity (electroacupuncture) for therapeutic effect.

Acupuncture treatment can help reduce

  • Pain
  • Fatigue
  • Hot flashes

It can also help improve

  • Sleep
  • Xerostomia
  • Nausea and vomiting

Oncology guidelines recommend acupuncture
Current oncology guidelines recommend acupuncture for cancer pain, fatigue, and hot flashes (1) (2). Further, a newly released guideline from the Society for Integrative Oncology and ASCO recommends acupuncture for aromatase inhibitor–related joint pain, musculoskeletal pain, and general cancer pain (3).

Reductions in pain, fatigue, and other lingering symptoms
Data show that acupuncture helps manage cancer pain (3) (4) (5) (6) (7), including persistent neuropathy (8) (9) (10) (11) (12) (13) and arthralgia (3) (14) (15) (16). Long-term benefits have been shown in patients with aromatase-inhibitor related joint pain (17), and a meta-analysis determined that effects on chronic pain are more than just placebo (18). Acupuncture can also decrease fatigue (19) (20) (21) and pain medication use (22) (23) (24), and improve sleep (25) (26) (27), cognitive function (28), and health-related quality of life (29).

Improvements in other symptoms caused by specific treatments
Acupuncture reduces treatment-related nausea and vomiting (30) (31) (32), hot flashes associated with hormonal therapy (33) (34) (35) (36), and xerostomia from radiotherapy (4) (37) (38) (39) (40) (41). Studies are mixed on whether it can reduce lymphedema (42) (43) or postoperative ileus (44) (45).

Cancer patients considering acupuncture should seek certified or state-licensed practitioners who have training or experience in working with cancer patients. Some oncology physicians may also be board-certified acupuncturists.

The Integrative Medicine Service at MSK offers acupuncture and other integrative therapies to support the recovery and wellbeing of cancer patients. In addition, clinical trials continue to evaluate acupuncture for patients with cancer.

Purported Uses and Benefits
  • Cancer treatment symptoms
  • Pain
  • Neuropathy
  • Fatigue
  • Sleep
  • Anxiety
  • Nausea, vomiting
  • Constipation
Mechanism of Action

According to TCM, acupuncture points are located at specific areas along channels or meridians. Qi (pronounced chee, meaning energy) is believed to flow in this network connecting different parts of the body. Pain and disease symptoms are thought to arise with stagnant Qi, and acupuncture treatments are used to promote Qi flow to relieve symptoms. It is also known to stimulate release of endogenous opioids.

Animal studies suggest acupuncture induces analgesia through different opioid receptors (46), an effect that can be blocked by naloxone (47). Further, mice lacking opiate receptors showed low analgesic effect following electroacupuncture (48).

In humans, an exploratory analysis showed acupuncture significantly increased serum BDNF, the decrease of which is associated with poor sleep (49) . In patients with fibromyalgia, analgesic effects are attributed to increased mu-Opioid receptor binding potential (50). In patients with peripheral neuropathy, it improved nerve conduction (51). fMRI studies show that acupuncture elicits brain changes correlating with neurological effects (52), and that needling of LI-2, one of several acupoints used to treat xerostomia, correlates to saliva production (53). fMRI research also confirms that acupuncture modulates a variety of brain activity including somatosensory, affective, and cognitive processing (54).

In hot flashes, moderators that may determine who benefits more from acupuncture include being carriers of at least 1 of 6 genotypes: ADORA1 rs41264025-GA or rs16851029-GG or rs12744240-GT, COMT rs6269-GA, TCL1A rs2369049-GG, and TRPV1 rs8065080-TT (55).

In a meta-analyses of high-quality acupuncture trials for chronic pain, among 5 patient characteristics – age, sex, pain duration, pain severity, and psychological distress – only baseline pain severity potentially moderated acupuncture treatment effects (56).

Contraindications
  • Neutropenia, thrombocytopenia, or history of endocarditis
    Acupuncture may increase risk of infection and bleeding. Use with caution.
  • Pregnancy
    Pregnant women should inform practitioners before seeking acupuncture treatment.
  • Pacemakers
    Electrical stimulation is contraindicated for patients wearing electronic medical devices.
Adverse Reactions

Acupuncture is generally safe for cancer patients (57) and well tolerated (58) (59). Some conditions require continuous treatments for long-term effects.

Cancer patients considering acupuncture should seek certified or state-licensed practitioners who have training or experience in working with cancer patients. Some oncology physicians may also be board-certified acupuncturists.

Pregnant women, patients who wear pacemakers, and those with lymphedema or low platelet count should inform their practitioners before receiving treatment.

Practitioners and Treatments

Cancer patients considering acupuncture should seek certified or state-licensed practitioners who have training or experience in working with this population. Some oncology physicians may also be board-certified acupuncturists.

A majority of National Cancer Institute-designated cancer centers offer acupuncture as part of supportive care. The Integrative Medicine Service at MSK offers acupuncture and other integrative therapies to support the recovery and wellbeing of cancer patients. In addition, clinical trials continue to evaluate acupuncture for patients with cancer.

Dosage (OneMSK Only)
References
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  2. National Comprehensive Cancer Network. NCCN Guidelines: Supportive Care.
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