Acupuncture

DisclaimerThis Web site — Information About Herbs, Botanicals and Other Products — is for general health information only. This Web site is not to be used as a substitute for medical advice, diagnosis or treatment of any health condition or problem. Users of this Web site should not rely on information provided on this Web site for their own health problems. Any questions regarding your own health should be addressed to your own physician or other healthcare provider.Memorial Sloan Kettering Cancer Center makes no warranties nor express or implied representations whatsoever regarding the accuracy, completeness, timeliness, comparative or controversial nature, or usefulness of any information contained or referenced on this Web site. Memorial Sloan Kettering does not assume any risk whatsoever for your use of this website or the information contained herein. Health-related information changes frequently and therefore information contained on this Web site may be outdated, incomplete or incorrect. Statements made about products have not been evaluated by the Food and Drug Administration. Use of this Web site does not create an expressed or implied physician-patient relationship.Memorial Sloan Kettering does not record specific website user information and does not contact users of this website. You are hereby advised to consult with a physician or other professional health-care provider prior to making any decisions, or undertaking any actions or not undertaking any actions related to any health care problem or issue you might have at any time, now or in the future. In using this website you agree that neither Memorial Sloan Kettering nor any other party is or will be liable or otherwise responsible for any decision made or any action taken or any action not taken due to your use of any information presented at this website.

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. It 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 is effective in treating chronic pain and some symptoms associated with cancer treatment. Studies have shown benefit with acupuncture for postoperative pain, sleep, nausea and vomiting, dry mouth, hot flashes, peripheral neuropathy, joint pain, and other side effects caused by radiotherapy and/or chemotherapy. It may also reduce symptoms such as anxiety, depression, headache, lower back or neck pain, shortness of breath, and chronic fatigue.

Acupuncture treatments are generally safe and well tolerated by most patients, including pediatric patients and the elderly. Some conditions may require continuous treatments in order to achieve long-term effect.

How It Works

According to TCM, acupuncture points are thought to be located at specific areas along channels or meridians. Qi (pronounced chee, meaning energy) is believed to flow in this network of channels which connect different parts of the body and organs into a unified system. Pain and symptoms of disease are thought to arise when the flow of Qi is stagnated. Acupuncture treatments are used to promote the 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. Neuroimaging studies have shown that certain acupoints for dry mouth correlate to saliva production. Studies in patients with peripheral neuropathy show that acupuncture improves nerve signaling.

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

Cancer treatment symptoms
Clinical trials support the use of acupuncture to relieve pain, nausea and vomiting, dry mouth, fatigue, hot flashes, and peripheral neuropathy resulting from cancer treatments. In some studies, benefits have been noted to last 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 clinical trials in cancer patients and other populations show that acupuncture treatment improves sleep.
Fatigue
Several clinical 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
Current oncology guidelines recommend acupuncture and acupressure for chemotherapy-induced nausea and vomiting. A number of studies also support its use for postoperative nausea and vomiting and in pediatric cancer populations.
Constipation
Some evidence suggests acupuncture may be helpful for constipation.

Side Effects

Acupuncture is generally safe when performed by trained practitioners. Failure to remove needles, bleeding, hematoma, dizziness, and pain have been reported. Rare instances of collapsed lung, local infections, or burns caused by moxibustion, an herbal heat application, have occurred.

Acupuncture should be avoided or additional precautions taken 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.
You wear a pacemaker: Electrical stimulation is not advised for patients wearing electronic medical devices.
You have lymphedema: Patients with lymphedema should inform their practitioners before receiving treatment.
You are pregnant: Some acupuncture points can cause strong uterine contractions. Pregnant women should inform practitioners before seeking acupuncture 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 (NCI)-designated cancer centers offer acupuncture as part of supportive care. Clinical trials at MSK are underway to evaluate acupuncture in patients with advanced cancers, cognitive difficulties, and for chronic pain.

For Healthcare Professionals

Clinical Summary

Acupuncture is an integral component of Traditional Chinese Medicine (TCM) that originated more than 2,000 years ago. Treatment involves stimulation of one or more predetermined points on the body along with needles, heat (moxibustion), pressure (acupressure), or electricity (electroacupuncture) for therapeutic effect. Acupuncture has been evaluated in cancer patients for control of various symptoms including pain, neurological side effects, fatigue, insomnia, and nausea. It is also recommended across various oncology supportive care guidelines ⁽¹⁰⁸⁾ ⁽¹³³⁾.

Data show that acupuncture is useful for cancer pain management ⁽¹⁰⁶⁾ ⁽¹⁰⁷⁾. A recent meta-analysis found that acupuncture and/or acupressure was significantly associated with reduced cancer pain and decreased use of analgesics ⁽¹¹⁶⁾. In patients undergoing autologous hematopoietic stem cell transplantation, acupuncture prevented escalation of nausea, lack of appetite, and drowsiness, and also significantly reduced pain medication use ⁽¹⁰³⁾ ⁽¹³⁴⁾. In head and neck cancer patients, acupuncture improved xerostomia following radiotherapy ⁽³⁶⁾ ⁽⁴³⁾ ⁽⁴⁴⁾ ⁽⁶³⁾ ⁽⁷⁰⁾, with significant reductions in frequency and severity of symptoms versus standard care ⁽¹³⁶⁾. In lung cancer patients, acupuncture may improve fatigue ⁽¹⁰⁹⁾, pain, and well-being ⁽⁷⁶⁾. And larger trials show that acupuncture reduces chronic musculoskeletal pain in patients with various cancers ⁽¹³²⁾ and fatigue in breast cancer patients ⁽⁷¹⁾.

Several studies also demonstrate benefit with acupuncture for persistent joint and nerve pain. In breast cancer patients, acupuncture alleviated aromatase inhibitor-induced joint pain ⁽¹¹⁰⁾ and stiffness, and improved physical well-being ⁽⁴⁶⁾ ⁽⁷⁴⁾ and quality of life ⁽⁹⁶⁾. Electroacupuncture significantly improved fatigue, anxiety, and depression as well as arthralgia compared with usual care ⁽⁸⁶⁾ ⁽⁸⁷⁾. In patients receiving neurotoxic chemotherapies, acupuncture improved peripheral neuropathy and other symptoms in addition to pain ⁽¹⁸⁾ ⁽¹⁹⁾ ⁽⁸⁰⁾ ⁽¹¹⁵⁾ ⁽¹²⁴⁾ ⁽¹³⁰⁾ ⁽¹³⁵⁾ with long-term improvements observed post treatment ⁽¹²⁵⁾. Benefits with acupuncture have also been observed for peripheral neuropathy associated with diabetes and AIDS ⁽¹⁵⁾ ⁽¹⁶⁾ ⁽¹⁷⁾.

Several studies on acupuncture for sleep disorders demonstrate clinically relevant improvements in insomnia ⁽¹¹²⁾ ⁽¹²²⁾ and lasting effects post-therapy ⁽¹²³⁾. Similar improvements were observed in cancer patients ⁽¹¹¹⁾, including a trial that compared acupuncture with the gold standard for insomnia treatment, cognitive behavioral therapy for insomnia (CBT-I) ⁽¹²¹⁾. Secondary analyses from this study indicate that those with clinically meaningful improvements in insomnia also had improved cognitive function ⁽¹²⁹⁾.

For hot flashes, acupuncture was as effective as standard care in breast cancer patients ⁽⁴⁵⁾, and early phase studies also suggest it may relieve hot flashes in prostate cancer patients ⁽⁶⁴⁾ ⁽⁶⁵⁾ ⁽⁶⁶⁾. In addition, electroacupuncture was more effective than gabapentin with fewer side effects ⁽⁸²⁾, and comparable to gabapentin for improving sleep quality ⁽⁹⁸⁾.

Acupuncture has long shown benefit for treatment-related nausea and vomiting ⁽³⁸⁾ ⁽³⁹⁾ ⁽⁴¹⁾ ⁽⁸¹⁾ ⁽⁹¹⁾ ⁽⁹²⁾ ⁽⁹³⁾. Studies on whether acupuncture can reduce lymphedema are mixed ⁽¹¹³⁾ ⁽¹¹⁴⁾. Acupuncture did not reduce postoperative ileus from standard surgery ⁽⁴⁰⁾ ⁽⁵⁶⁾, but electroacupuncture did reduce postoperative ileus and analgesic use after laparoscopic surgery for colorectal cancer ⁽⁷³⁾.

In palliative cancer care, acupuncture is being evaluated as an intervention to reduce cachexia and unintentional weight loss ⁽⁸⁸⁾ ⁽⁸⁹⁾, and a pilot study found auricular acupuncture safe and feasible to increase appetite and weight gain versus usual care ⁽¹³¹⁾. Other studies have found various forms of acupuncture can help alleviate pain ⁽³⁵⁾ ⁽³⁶⁾ ⁽⁶⁷⁾, and a meta-analysis determined this effect is more than just placebo ⁽¹²⁶⁾.

Acupuncture is generally safe, well tolerated ⁽⁴⁷⁾ ⁽⁴⁸⁾ ⁽⁴⁹⁾ ⁽⁶⁸⁾ ⁽⁶⁹⁾, and cost-effective ⁽⁹⁾ ⁽³³⁾ ⁽³⁴⁾. Some conditions require continuous treatments in order to achieve long-term effect. Animal studies suggest caffeine can inhibit the pain relieving effect of acupuncture ⁽¹⁰²⁾. 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. Some oncology physicians may also be board-certified acupuncturists. Clinical trials at MSK are underway to evaluate acupuncture in patients with advanced cancers, cognitive difficulties, and for chronic pain.

Purported Uses

Cancer treatment symptoms
Pain
Neuropathy
Fatigue
Sleep
Anxiety
Nausea, vomiting
Constipation

Mechanism of Action

According to TCM, acupuncture points are thought to be located at specific areas along channels or meridians. Qi (pronounced chee, meaning energy) is believed to flow in this network of channels which connect different parts of the body and organs into a unified system. Pain and symptoms of disease are thought to arise when the flow of Qi is stagnated. Acupuncture treatments are used to promote the flow of Qi to relieve symptoms. It is also known to stimulate release of endogenous opioids.

Animal studies suggest acupuncture induces analgesia through different opioid receptors under varying conditions ⁽⁵³⁾, but that effect was blocked by naloxone, an opioid antagonist ⁽⁵⁰⁾ ⁽⁵¹⁾. Further, mice lacking opiate receptors showed low analgesic effect following electroacupuncture (EA) ⁽⁵²⁾. Acupuncture also increases neuropeptide Y suggesting it may help to reduce stress and depression ⁽⁵⁹⁾ ⁽⁶⁰⁾. Acupuncture protects against cerebral ischemia by increasing blood flow to the ischemic brain region via neural regulation ⁽⁵⁵⁾. The systemic anti-inflammatory activities of EA are thought to be modulated by dopamine ⁽⁷⁹⁾.

In patients with fibromyalgia, analgesic effects of acupuncture are attributed to increased mu-Opioid receptor binding potential ⁽¹²⁷⁾. In patients with peripheral neuropathy, acupuncture improves nerve conduction ⁽¹⁴⁾. Needling of LI-2, one of several acupoints used to treat xerostomia, was associated with neuroimaging changes correlated to saliva production ⁽⁵⁸⁾. Other studies using functional magnetic resonance imaging (fMRI) also show that acupuncture elicits brain changes that correlate with neurological effects produced ⁽⁵⁷⁾. A meta-analysis of fMRI research confirmed that acupuncture modulates a variety of brain activity including somatosensory, affective, and cognitive processing ⁽¹²⁷⁾.

Long-term benefits seen with EA and to a lesser extent sham-EA post-treatment for hot flashes among breast cancer survivors suggest that both interventions produce underlying physiologic changes not induced by gabapentin ⁽⁸²⁾. That sham-EA demonstrated greater effects with reduced nocebo effects than pill-placebo ⁽⁸²⁾ also may explain why some acupuncture trials find similar efficacy between active and sham interventions. Other data indicate that higher baseline expectancy predicts treatment response with sham-EA but not EA, suggesting divergent mechanisms and that patients with low expectancy may do better with EA than sham ⁽⁹⁴⁾.

Several studies have also evaluated other moderators in an effort to determine who may benefit more from acupuncture. In an exploratory study, women who were 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) were significantly more likely to respond to acupuncture for hot flashes than noncarriers ⁽¹³⁷⁾. In a meta-analyses of high-quality acupuncture trials for chronic pain, among five patient characteristics evaluated – age, sex, pain duration, pain severity, and psychological distress – only baseline pain severity potentially moderated acupuncture treatment effects ⁽¹³⁸⁾.

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 when performed by trained practitioners. Failure to remove needles, bleeding, hematoma, dizziness, and pain have been reported. Pneumothorax, local infections, and burns caused by moxibustion, an herbal heat application, are rare ⁽⁴⁹⁾ ⁽⁶⁸⁾ ⁽⁶⁹⁾.

Practitioners and Treatments

Dosage (OneMSK Only)

References

Berman BM, Lao L, Langenberg P, et al. Effectiveness of acupuncture as adjunctive therapy in osteoarthritis of the knee: a randomized, controlled trial. Ann Intern Med. Dec 21 2004;141(12):901-910.
Scharf HP, Mansmann U, Streitberger K, et al. Acupuncture and knee osteoarthritis: a three-armed randomized trial. Ann Intern Med. Jul 4 2006;145(1):12-20.
Witt CM, Jena S, Brinkhaus B, et al. Acupuncture in patients with osteoarthritis of the knee or hip: a randomized, controlled trial with an additional nonrandomized arm. Arthritis Rheum. Nov 2006;54(11):3485-3493.
White P, Lewith G, Prescott P, et al. Acupuncture versus placebo for the treatment of chronic mechanical neck pain: a randomized, controlled trial. Ann Intern Med. Dec 21 2004;141(12):911-919.
Vas J, Santos-Rey K, Navarro-Pablo R, et al. Acupuncture for fibromyalgia in primary care: a randomised controlled trial. Acupunct Med. 2016 Aug;34(4):257-66.
Hsieh LL, Kuo CH, Lee LH, et al. Treatment of low back pain by acupressure and physical therapy: randomised controlled trial. BMJ. Mar 25 2006;332(7543):696-700.
Thomas KJ, MacPherson H, Thorpe L, et al. Randomised controlled trial of a short course of traditional acupuncture compared with usual care for persistent non-specific low back pain. BMJ. Sep 23 2006;333(7569):623.
Haake M, Muller HH, Schade-Brittinger C, et al. German Acupuncture Trials (GERAC) for chronic low back pain: randomized, multicenter, blinded, parallel-group trial with 3 groups. Arch Intern Med. Sep 24 2007;167(17):1892-1898.
Ratcliffe J, Thomas KJ, MacPherson H, et al. A randomised controlled trial of acupuncture care for persistent low back pain: cost effectiveness analysis. BMJ. Sep 23 2006;333(7569):626.
Flachskampf FA, Gallasch J, Gefeller O, et al. Randomized trial of acupuncture to lower blood pressure. Circulation. Jun 19 2007;115(24):3121-3129.
Huang MI, Nir Y, Chen B, et al. A randomized controlled pilot study of acupuncture for postmenopausal hot flashes: effect on nocturnal hot flashes and sleep quality. Fertil Steril. Sep 2006;86(3):700-710.
Allen JJ, Schnyer RN, Chambers AS, et al. Acupuncture for depression: a randomized controlled trial. J Clin Psychiatry. Nov 2006;67(11):1665-1673.
Andreescu C, Glick RM, Emeremni CA, et al. Acupuncture for the treatment of major depressive disorder: a randomized controlled trial. J Clin Psychiatry. Aug 2011;72(8):1129-1135.
Schroder S, Liepert J, Remppis A, et al. Acupuncture treatment improves nerve conduction in peripheral neuropathy. Eur J Neurol. Mar 2007;14(3):276-281.
Ahn AC, Bennani T, Freeman R, et al. Two styles of acupuncture for treating painful diabetic neuropathy—a pilot randomised control trial. Acupunct Med. Jun 2007;25(1-2):11-17.
Shlay JC, Chaloner K, Max MB, et al. Acupuncture and amitriptyline for pain due to HIV-related peripheral neuropathy: a randomized controlled trial. Terry Beirn Community Programs for Clinical Research on AIDS. JAMA. Nov 11 1998;280(18):1590-1595.
Phillips KD, Skelton WD, Hand GA. Effect of acupuncture administered in a group setting on pain and subjective peripheral neuropathy in persons with human immunodeficiency virus disease. J Altern Complement Med. Jun 2004;10(3):449-455.
Xu WR, Hua BJ, Hou W, et al. [Clinical randomized controlled study on acupuncture for treatment of peripheral neuropathy induced by chemotherapeutic drugs]. Zhongguo Zhen Jiu. Jun 2010;30(6):457-460.
Donald GK, Tobin I, Stringer J. Evaluation of acupuncture in the management of chemotherapy-induced peripheral neuropathy. Acupunct Med. Sep 2011;29(3):230-233.
Vickers AJ, Rees RW, Zollman CE, et al. Acupuncture for chronic headache in primary care: large, pragmatic, randomised trial. BMJ. Mar 27 2004;328(7442):744.
Xue CC, Dong L, Polus B, et al. Electroacupuncture for tension-type headache on distal acupoints only: a randomized, controlled, crossover trial. Headache. Apr 2004;44(4):333-341.
Coeytaux RR, Kaufman JS, Kaptchuk TJ, et al. A randomized, controlled trial of acupuncture for chronic daily headache. Headache. Oct 2005;45(9):1113-1123.
Linde K, Streng A, Jurgens S, et al. Acupuncture for patients with migraine: a randomized controlled trial. JAMA. May 4 2005;293(17):2118-2125.
Westergaard LG, Mao Q, Krogslund M, et al. Acupuncture on the day of embryo transfer significantly improves the reproductive outcome in infertile women: a prospective, randomized trial. Fertil Steril. May 2006;85(5):1341-1346.
Dieterle S, Ying G, Hatzmann W, et al. Effect of acupuncture on the outcome of in vitro fertilization and intracytoplasmic sperm injection: a randomized, prospective, controlled clinical study. Fertil Steril. May 2006;85(5):1347-1351.
Smith C, Coyle M, Norman RJ. Influence of acupuncture stimulation on pregnancy rates for women undergoing embryo transfer. Fertil Steril. May 2006;85(5):1352-1358.
Manheimer E, Zhang G, Udoff L, et al. Effects of acupuncture on rates of pregnancy and live birth among women undergoing in vitro fertilisation: systematic review and meta-analysis. BMJ. Mar 8 2008;336(7643):545-549.
Moy I, Milad MP, Barnes R, et al. Randomized controlled trial: effects of acupuncture on pregnancy rates in women undergoing in vitro fertilization. Fertil Steril. Feb 2011;95(2):583-587.
Mackenzie IZ, Xu J, Cusick C, et al. Acupuncture for pain relief during induced labour in nulliparae: a randomised controlled study. BJOG. Mar 2011;118(4):440-447.
Lee SW, Liong ML, Yuen KH, et al. Acupuncture versus sham acupuncture for chronic prostatitis/chronic pelvic pain. Am J Med. Jan 2008;121(1):79 e71-77.
Wang SM, Punjala M, Weiss D, et al. Acupuncture as an adjunct for sedation during lithotripsy. J Altern Complement Med. Mar 2007;13(2):241-246.
Wang SM, Escalera S, Lin EC, et al. Extra-1 acupressure for children undergoing anesthesia. Anesth Analg. Sep 2008;107(3):811-816.
Brinkhaus B, Ortiz M, Witt CM, et al. Acupuncture in patients with seasonal allergic rhinitis: a randomized trial. Ann Intern Med. 2013 Feb 19;158(4):225-34.
Witt CM, Reinhold T, Jena S, et al. Cost-effectiveness of acupuncture in women and men with allergic rhinitis: a randomized controlled study in usual care. Am J Epidemiol. Mar 1 2009;169(5):562-571.
Alimi D, Rubino C, Pichard-Leandri E, et al. Analgesic effect of auricular acupuncture for cancer pain: a randomized, blinded, controlled trial. J Clin Oncol. Nov 15 2003;21(22):4120-4126.
Pfister DG, Cassileth BR, Deng GE, et al. Acupuncture for pain and dysfunction after neck dissection: results of a randomized controlled trial. J Clin Oncol. May 20 2010;28(15):2565-2570.
Vickers AJ, Straus DJ, Fearon B, et al. Acupuncture for postchemotherapy fatigue: a phase II study. J Clin Oncol. May 1 2004;22(9):1731-1735.
Gan TJ, Jiao KR, Zenn M, et al. A randomized controlled comparison of electro-acupoint stimulation or ondansetron versus placebo for the prevention of postoperative nausea and vomiting. Anesth Analg. Oct 2004;99(4):1070-1075.
Shen J, Wenger N, Glaspy J, et al. Electroacupuncture for control of myeloablative chemotherapy-induced emesis: A randomized controlled trial. JAMA. Dec 6 2000;284(21):2755-2761.
Meng ZQ, Garcia MK, Chiang JS, et al. Electro-acupuncture to prevent prolonged postoperative ileus: a randomized clinical trial. World J Gastroenterol. 2010 Jan 7;16(1):104-11.
Ezzo J, Vickers A, Richardson MA, et al. Acupuncture-point stimulation for chemotherapy-induced nausea and vomiting. J Clin Oncol. Oct 1 2005;23(28):7188-7198.
Molassiotis A, Helin AM, Dabbour R, et al. The effects of P6 acupressure in the prophylaxis of chemotherapy-related nausea and vomiting in breast cancer patients. Complement Th r Med. Mar 2007;15(1):3-12.
Meng Z, Garcia MK, Hu C, et al. Randomized controlled trial of acupuncture for prevention of radiation-induced xerostomia among patients with nasopharyngeal carcinoma. Cancer. 2012 Jul 1;118(13):3337-44.
Garcia MK, Chiang JS, Cohen L, et al. Acupuncture for radiation-induced xerostomia in patients with cancer: a pilot study. Head Neck. Oct 2009;31(10):1360-1368.
Walker EM, Rodriguez AI, Kohn B, et al. Acupuncture versus venlafaxine for the management of vasomotor symptoms in patients with hormone receptor-positive breast cancer: a randomized controlled trial. J Clin Oncol. Feb 1 2010;28(4):634-640.
Crew KD, Capodice JL, Greenlee H, et al. Randomized, blinded, sham-controlled trial of acupuncture for the management of aromatase inhibitor-associated joint symptoms in women with early-stage breast cancer. J Clin Oncol. Mar 1 2010;28(7):1154-1160.
Ng DK, Chow PY, Ming SP, et al. A double-blind, randomized, placebo-controlled trial of acupuncture for the treatment of childhood persistent allergic rhinitis. Pediatrics. Nov 2004;114(5):1242-1247.
Broide E, Pintov S, Portnoy S, et al. Effectiveness of acupuncture for treatment of childhood constipation. Dig Dis Sci. Jun 2001;46(6):1270-1275.
Adams D, Cheng F, Jou H, et al. The Safety of Pediatric Acupuncture: A Systematic Review. Pediatrics. 2011 Dec;128(6):e1575-87
Pomeranz B, Chiu D. Naloxone blockade of acupuncture analgesia: endorphin implicated. Life Sci. Dec 1 1976;19(11):1757-1762.
Pomeranz B, Warma N. Electroacupuncture suppression of a nociceptive reflex is potentiated by two repeated electroacupuncture treatments: the first opioid effect potentiates a second non-opioid effect. Brain Res. Jun 14 1988;452(1-2):232-236.
Peets JM, Pomeranz B. CXBK mice deficient in opiate receptors show poor electroacupuncture analgesia. Nature. Jun 22 1978;273(5664):675-676.
Meng X, Zhang Y, Li A, et al. The effects of opioid receptor antagonists on electroacupuncture-produced anti-allodynia/hyperalgesia in rats with paclitaxel-evoked peripheral neuropathy. Brain Res. Sep 26 2011;1414:58-65.
Stener-Victorin E, Kobayashi R, Watanabe O, et al. Effect of electro-acupuncture stimulation of different frequencies and intensities on ovarian blood flow in anaesthetized rats with steroid-induced polycystic ovaries. Reprod Biol Endocrinol. Mar 26 2004;2:16.
Zhou F, Guo J, Cheng J, et al. Electroacupuncture increased cerebral blood flow and reduced ischemic brain injury: Dependence on stimulation intensity and frequency. J Appl Physiol. 2011 Dec;111(6):1877-87.
Deng G, Wong WD, Guillem J, et al. A Phase II, Randomized, Controlled Trial of Acupuncture for Reduction of Postcolectomy Ileus. Ann Surg Oncol. 2013 Apr;20(4):1164-9.
Yoo SS, Teh EK, Blinder RA, et al. Modulation of cerebellar activities by acupuncture stimulation: evidence from fMRI study. Neuroimage. Jun 2004;22(2):932-940.
Deng G, Hou BL, Holodny AI, et al. Functional magnetic resonance imaging (fMRI) changes and saliva production associated with acupuncture at LI-2 acupuncture point: a randomized controlled study. BMC Complement Altern Med. 2008;8:37.
Eshkevari L, Egan R, Phillips D, et al. Acupuncture at ST36 prevents chronic stress-induced increases in neuropeptide Y in rat. Exp Biol Med. 2012 Jan 1;237(1):18-23.
Lim S, Ryu YH, Kim ST, et al. Acupuncture increases neuropeptide Y expression in hippocampus of maternally-separated rats. Neurosci Lett. 2003 May 29;343(1):49-52.
Tahiri M, Mottillo S, Joseph L et al. Alternative Smoking Cessation Aids: A Meta-analysis of Randomized Controlled Trials. Am J Med. 2012 Jun;125(6):576-84.
Suzuki M, Muro S, Ando Y, et al. A Randomized, Placebo-Controlled Trial of Acupuncture in Patients With Chronic Obstructive Pulmonary Disease (COPD). The COPD-Acupuncture Trial (CAT). Arch Intern Med. 2012;172(11):878-886.
Wong RK, James JL, Sagar S, et al. Phase 2 results from Radiation Therapy Oncology Group Study 0537: A phase 2/3 study comparing acupuncture-like transcutaneous electrical nerve stimulation versus pilocarpine in treating early radiation-induced xerostomia. Cancer. 2012 Sep 1;118(17):4244-52.
Ashamalla H, Jiang ML, Guirguis A, et al. Acupuncture for the alleviation of hot flashes in men treated with androgen ablation therapy. Int J Radiat Oncol Biol Phys. Apr 1 2011;79(5):1358-1363.
Beer TM, Benavides M, Emmons SL, et al. Acupuncture for hot flashes in patients with prostate cancer. Urology. Nov 2010;76(5):1182-1188.
Capodice J CP, Benson MC, et al. Acupuncture for the treatment of hot flashes in men with advanced prostate cancer. Int J Clin Med. 2011;2(1):51-55.
Vickers A, Cronin A, Maschino A, et al. Acupuncture for chronic pain: Individual patient data meta-analysis. Arch Intern Med. 2012 Oct 22;172(19):1444-53.
Melchart D, Weidenhammer W, Streng A, et al. Prospective investigation of adverse effects of acupuncture in 97 733 patients. Arch Intern Med. 2004 Jan 12;164(1):104-5.
He W, Zhao X, Li Y, Xi Q, Guo Y. Adverse events following acupuncture: a systematic review of the chinese literature for the years 1956-2010. J Altern Complement Med. 2012 Oct;18(10):892-901.
Simcock R, Fallowfield L., Monson K. et al. A randomised trial of acupuncture v oral care sessions in patients with chronic xerostomia following treatment of head and neck cancer. Ann Oncol 2013 Mar;24(3):776-83.
Molassiotis A, Bardy J, Finnegan-John J, Mackereth P, et al. Acupuncture for Cancer-Related Fatigue in Patients With Breast Cancer: A Pragmatic Randomized Controlled Trial. J Clin Oncol. 2012 Dec 20;30(36):4470-6.
Xu SB, Huang B, Zhang CY, Du P, et al. Effectiveness of strengthened stimulation during acupuncture for the treatment of Bell palsy: a randomized controlled trial. CMAJ. 2013 Apr 2;185(6):473-9.
Ng SS, Leung WW, Mak TW, et al. Electroacupuncture reduces duration of postoperative ileus after laparoscopic surgery for colorectal cancer. Gastroenterology. 2013 Feb;144(2):307-313.
Bao T, Cai L, Giles JT, Gould J, et al. A dual-center randomized controlled double blind trial assessing the effect of acupuncture in reducing musculoskeletal symptoms in breast cancer patients taking aromatase inhibitors. Breast Cancer Res Treat. 2013 Feb;138(1):167-74.
Johansson J, Redman L, Veldhuis PP, et al. Acupuncture for ovulation induction in polycystic ovary syndrome: a randomized controlled trial. Am J Physiol Endocrinol Metab. 2013 May 1;304(9):E934-43.
Kasymjanova G, Grossman M, Tran T, et al. The potential role for acupuncture in treating symptoms in patients with lung cancer: an observational longitudinal study. Curr Oncol. 2013 Jun;20(3):152-7.
MacPherson H, Richmond S, Bland M, et al. Acupuncture and counselling for depression in primary care: a randomised controlled trial. PLoS Med. 2013;10(9):e1001518.
Shih CC, Hsu YT, Wang HH, et al. Decreased risk of stroke in patients with traumatic brain injury receiving acupuncture treatment: a population-based retrospective cohort study. PLoS One. 2014;9(2):e89208.
Torres-Rosas R, Yehia G, Peña G, et al. Dopamine mediates vagal modulation of the immune system by electroacupuncture. Nat Med. 2014 Mar;20(3):291-5.
Bao T, Goloubeva O, Pelser C, et al. A Pilot Study of Acupuncture in Treating Bortezomib-Induced Peripheral Neuropathy in Patients With Multiple Myeloma. Integr Cancer Ther. 2014 Sep;13(5):396-404.
Rithirangsriroj K, Manchana T, Akkayagorn L. Efficacy of acupuncture in prevention of delayed chemotherapy induced nausea and vomiting in gynecologic cancer patients. Gynecol Oncol. 2015 Jan;136(1):82-6.
Mao JJ, Bowman MA, Xie SX, et al. Electroacupuncture Versus Gabapentin for Hot Flashes Among Breast Cancer Survivors: A Randomized Placebo-Controlled Trial. J Clin Oncol. 2015 Nov 1;33(31):3615-20.
Rusy LM, Hoffman GM, Weisman SJ. Electroacupuncture prophylaxis of postoperative nausea and vomiting following pediatric tonsillectomy with or without adenoidectomy. Anesthesiology. Feb 2002;96(2):300-305.
Di YM, May BH, Zhang AL, et al. A meta-analysis of ear-acupuncture, ear-acupressure and auriculotherapy for cigarette smoking cessation. Drug Alcohol Depend. Sep 1 2014;142:14-23.
White AR, Rampes H, Liu JP, et al. Acupuncture and related interventions for smoking cessation. Cochrane Database Syst Rev. 2014;1:Cd000009.
Mao JJ, Farrar JT, Bruner D, et al. Electroacupuncture for fatigue, sleep, and psychological distress in breast cancer patients with aromatase inhibitor-related arthralgia: a randomized trial. Cancer. Dec 1 2014;120(23):3744-3751.
Mao JJ, Xie SX, Farrar JT, et al. A randomised trial of electro-acupuncture for arthralgia related to aromatase inhibitor use. Eur J Cancer. Jan 2014;50(2):267-276.
Grundmann O, Yoon SL, Williams JJ. Influence of acupuncture on bioelectrical impedance measures in patients with gastrointestinal cancer: results of a pilot study. Acupunct Med. Feb 2015;33(1):16-22.
Yoon SL, Grundmann O, Williams JJ, et al. Novel intervention with acupuncture for anorexia and cachexia in patients with gastrointestinal tract cancers: a feasibility study. Evid Based Complement Alternat Med. Mar 2015;42(2):E102-109.
An LX, Chen X, Ren XJ, et al. Electro-acupuncture decreases postoperative pain and improves recovery in patients undergoing a supratentorial craniotomy. Am J Chin Med. 2014;42(5):1099-1109.
Lee A, Fan LT. Stimulation of the wrist acupuncture point P6 for preventing postoperative nausea and vomiting. Cochrane Database Syst Rev. 2009(2):CD003281.
Lee EJ, Frazier SK. The efficacy of acupressure for symptom management: a systematic review. J Pain Symptom Manage. Oct 2011;42(4):589-603.
Garcia MK, McQuade J, Haddad R, et al. Systematic review of acupuncture in cancer care: a synthesis of the evidence. J Clin Oncol. Mar 1 2013;31(7):952-960.
Bauml J, Xie SX, Farrar JT, et al. Expectancy in real and sham electroacupuncture: does believing make it so? J Natl Cancer Inst Monogr. 2014;50:302-307.
Ee C, Xue C, Chondros P, et al. Acupuncture for menopausal hot flashes: A randomized trial. Ann Intern Med. 2016. Feb 2;164(3):146-54.
Lesi G, Razzini G, Assunta Musti M, et al. Acupuncture As an Integrative Approach for the Treatment of Hot Flashes in Women With Breast Cancer: A Prospective Multicenter Randomized Controlled Trial (AcCliMaT). J Clin Oncol. 2016 May 20;34(15):1795-802.
Avis NE, Coeytaux RR, Levine B, et al. Trajectories of response to acupuncture for menopausal vasomotor symptoms: the Acupuncture in Menopause study. Menopause. 2017 Feb;24(2):171-179.
Garland SN, Xie SX, Li Q, Seluzicki C, Basal C, Mao JJ. Comparative effectiveness of electro-acupuncture versus gabapentin for sleep disturbances in breast cancer survivors with hot flashes: a randomized trial. Menopause. 2017 Feb;24(2):171-179.
Brinkhaus B, Roll S, Jena S, et al. Acupuncture in Patients with Allergic Asthma: A Randomized Pragmatic Trial. J Altern Complement Med. 2017 Apr;23(4):268-277.
Liu Z, Liu Y, Xu H, et al. Effect of Electroacupuncture on Urinary Leakage Among Women With Stress Urinary Incontinence: A Randomized Clinical Trial. JAMA. Jun 27 2017;317(24):2493-2501.
Wu XK, Stener-Victorin E, Kuang HY, et al. Effect of Acupuncture and Clomiphene in Chinese Women With Polycystic Ovary Syndrome: A Randomized Clinical Trial. JAMA. Jun 27 2017;317(24):2502-2514.
Fujita T, Feng C, Takano T. Presence of caffeine reversibly interferes with efficacy of acupuncture-induced analgesia. Sci Rep. Jun 13 2017;7(1):3397.
Deng G, Giralt S, Chung DJ, et al. Acupuncture for reduction of symptom burden in multiple myeloma patients undergoing autologous hematopoietic stem cell transplantation: a randomized sham-controlled trial. Support Care Cancer. 2018 Feb;26(2):657-665.
Smith CA, de Lacey S, Chapman M, et al. Effect of Acupuncture vs Sham Acupuncture on Live Births Among Women Undergoing In Vitro Fertilization: A Randomized Clinical Trial. JAMA. May 15 2018;319(19):1990-1998.
Lee HY, Kwon OJ, Kim JE, et al. Efficacy and safety of acupuncture for functional constipation: a randomised, sham-controlled pilot trial. BMC Complement Altern Med. Jun 15 2018;18(1):186.
Hu C, Zhang H, Wu W, et al. Acupuncture for Pain Management in Cancer: A Systematic Review and Meta-Analysis. Evid Based Complement Alternat Med. 2016;2016:1720239.
Paice JA, Portenoy R, Lacchetti C, et al. Management of Chronic Pain in Survivors of Adult Cancers: American Society of Clinical Oncology Clinical Practice Guideline. J Clin Oncol. Sep 20 2016;34(27):3325-3345.
Lyman GH, Greenlee H, Bohlke K, et al. Integrative Therapies During and After Breast Cancer Treatment: ASCO Endorsement of the SIO Clinical Practice Guideline. J Clin Oncol. Jun 11 2018:Jco2018792721.
Cheng CS, Chen LY, Ning ZY, et al. Acupuncture for cancer-related fatigue in lung cancer patients: a randomized, double blind, placebo-controlled pilot trial. Support Care Cancer. Dec 2017;25(12):3807-3814.
Hershman DL, Unger JM, Greenlee H, et al. Effect of Acupuncture vs Sham Acupuncture or Waitlist Control on Joint Pain Related to Aromatase Inhibitors Among Women With Early-Stage Breast Cancer: A Randomized Clinical Trial. JAMA. Jul 10 2018;320(2):167-176.
Garland SN, Xie SX, DuHamel K, et al. The effect of acupuncture versus cognitive behavior therapy on insomnia in cancer survivors: A randomized clinical trial. Presented at the American Society of Clinical Oncology Annual Meeting, Chicago, IL June 1-5, 2018 J Clin Oncol. 2018;36:(suppl; abstr 10001).
Fu C, Zhao N, Liu Z, et al. Acupuncture Improves Peri-menopausal Insomnia: A Randomized Controlled Trial. Sleep. Nov 1 2017;40(11).
Bao T, Iris Zhi W, Vertosick EA, et al. Acupuncture for breast cancer-related lymphedema: a randomized controlled trial. Breast Cancer Res Treat. Jul 2018;170(1):77-87.
Cassileth BR, Van Zee KJ, Yeung KS, et al. Acupuncture in the treatment of upper-limb lymphedema: results of a pilot study. Cancer. Jul 1 2013;119(13):2455-2461.
Bao T, Seidman AD, Piulson L, A phase IIA trial of acupuncture to reduce chemotherapy-induced peripheral neuropathy severity during neoadjuvant or adjuvant weekly paclitaxel chemotherapy in breast cancer patients. Eur J Cancer. 2018 Sep;101:12-19.
He Y, Guo X, May BH, et al. Clinical Evidence for Association of Acupuncture and Acupressure With Improved Cancer Pain: A Systematic Review and Meta-Analysis. JAMA Oncol. 2020 Feb 1;6(2):271-278.
Seca S, Patricio M, Kirch S, et al. Effectiveness of Acupuncture on Pain, Functional Disability, and Quality of Life in Rheumatoid Arthritis of the Hand: Results of a Double-Blind Randomized Clinical Trial. J Altern Complement Med. Jan 2019;25(1):86-97.
MacPherson H, Vertosick EA, Foster NE, et al. The persistence of the effects of acupuncture after a course of treatment: a meta-analysis of patients with chronic pain. Pain. May 2017;158(5):784-793.
Liu B, Liu Y, Qin Z, et al. Electroacupuncture Versus Pelvic Floor Muscle Training Plus Solifenacin for Women With Mixed Urinary Incontinence: A Randomized Noninferiority Trial. Mayo Clin Proc. Jan 2019;94(1):54-65.
Suzuki M, Muro S, Fukui M, et al. Effects of acupuncture on nutritional state of patients with stable chronic obstructive pulmonary disease (COPD): re-analysis of COPD acupuncture trial, a randomized controlled trial. BMC Complement Altern Med. Oct 24 2018;18(1):287.
Garland SN, Xie SX, DuHamel K, et al. Acupuncture Versus Cognitive Behavioral Therapy for Insomnia in Cancer Survivors: A Randomized Clinical Trial. J Natl Cancer Inst. Dec 1 2019;111(12):1323-1331.
Huang W, Johnson TM, Kutner NG, et al. Acupuncture for Treatment of Persistent Disturbed Sleep: A Randomized Clinical Trial in Veterans With Mild Traumatic Brain Injury and Posttraumatic Stress Disorder. J Clin Psychiatry. Dec 11 2018;80(1):18m12235.
Yin X, Gou M, Xu J, et al. Efficacy and safety of acupuncture treatment on primary insomnia: a randomized controlled trial. Sleep Med. Sep 2017;37:193-200.
Zhi WI, Ingram E, Li SQ, et al. Acupuncture for Bortezomib-Induced Peripheral Neuropathy: Not Just for Pain. Integr Cancer Ther. Dec 2018;17(4):1079-1086.
Molassiotis A, Suen LKP, Cheng HL, et al. A Randomized Assessor-Blinded Wait-List-Controlled Trial to Assess the Effectiveness of Acupuncture in the Management of Chemotherapy-Induced Peripheral Neuropathy. Integr Cancer Ther. Jan-Dec 2019;18:1534735419836501.
Vickers AJ, Vertosick EA, Lewith G, et al. Acupuncture for Chronic Pain: Update of an Individual Patient Data Meta-Analysis. J Pain. May 2018;19(5):455-474.
Harris RE, Zubieta JK, Scott DJ, et al. Traditional Chinese acupuncture and placebo (sham) acupuncture are differentiated by their effects on mu-opioid receptors (MORs). Neuroimage. Sep 2009;47(3):1077-1085.
Huang W, Pach D, Napadow V, et al. Characterizing acupuncture stimuli using brain imaging with FMRI—a systematic review and meta-analysis of the literature. PLoS One. 2012;7(4):e32960.
Liou KT, Root JC, Garland SN, et al. Effects of acupuncture versus cognitive behavioral therapy on cognitive function in cancer survivors with insomnia: A secondary analysis of a randomized clinical trial. Cancer. 2020 Jul 1;126(13):3042-3052.
Bao T, Patil S, Chen C, et al. Effect of Acupuncture vs Sham Procedure on Chemotherapy-Induced Peripheral Neuropathy Symptoms: A Randomized Clinical Trial. JAMA Netw Open. 2020 Mar 2;3(3):e200681.
Sun L, Mao JJ, Liu Q, et al. Effects of auricular acupuncture on appetite in patients with advanced cancer: A pilot randomized controlled trial. Ann Palliat Med. 2020 Jul;9(4):1804-1811.
Mao JJ, Liou KT,Baser RE, et al. Effectiveness of Electroacupuncture or Auricular Acupuncture vs Usual Care for Chronic Musculoskeletal Pain Among Cancer Survivors: The PEACE Randomized Clinical Trial. JAMA Oncol. 2021 May 1;7(5):720-727.
National Comprehensive Cancer Network. NCCN Guidelines for Supportive Care. Accessed September 10, 2021.
Deng G, Giralt S, Chung DJ, et al. Reduction of Opioid Use by Acupuncture in Patients Undergoing Hematopoietic Stem Cell Transplantation: Secondary Analysis of a Randomized, Sham-Controlled Trial. Pain Med. Mar 1 2020;21(3):636-642.
Lu W, Giobbie-Hurder A, Freedman RA, et al. Acupuncture for Chemotherapy-Induced Peripheral Neuropathy in Breast Cancer Survivors: A Randomized Controlled Pilot Trial. Oncologist. Apr 2020;25(4):310-318.
Garcia MK, Meng Z, Rosenthal DI, et al. Effect of True and Sham Acupuncture on Radiation-Induced Xerostomia Among Patients With Head and Neck Cancer: A Randomized Clinical Trial. JAMA Netw Open. Dec 2 2019;2(12):e1916910.
Romero SAD, Li QS, Orlow I, et al. Genetic predictors to acupuncture response for hot flashes: an exploratory study of breast cancer survivors. Menopause. Aug 2020;27(8):913-917.
Witt CM, Vertosick EA, Foster NE, et al. The Effect of Patient Characteristics on Acupuncture Treatment Outcomes: An Individual Patient Data Meta-Analysis of 20,827 Chronic Pain Patients in Randomized Controlled Trials. Clin J Pain. May 2019;35(5):428-434.

Email your questions and comments to aboutherbs@mskcc.org.

Last Updated

Friday, September 10, 2021

Changing how the world understands and treats cancer

Training the next generation of clinicians and scientists

We’re here for you.

Make an appointment

Speak to a care advisor

Partner with us to treat your patient’s cancer.

Call Physician Access Team

We treat every type of cancer, including the most important one: yours.

We’re always leading the fight against cancer.