Dr. Jun Mao, shown here performing acupuncture on a patient, is studying ways that people with cancer may benefit from this therapy.
Acupuncture, a form of traditional Chinese medicine, has been used as a medical treatment for more than 2,500 years. Researchers in the Integrative Medicine Service at Memorial Sloan Kettering Cancer Center (MSK) are studying the science of acupuncture to determine how people with cancer might benefit from this approach. They are also conducting clinical trials (research studies) that compare acupuncture to other treatments.
Here, Jun Mao, MD, MSCE, Chief of MSK’s Integrative Medicine Service, discusses what researchers at MSK and elsewhere are learning about acupuncture and how this approach might help relieve some of the symptoms and side effects commonly experienced by people with cancer, such as neuropathy, pain, stress and anxiety, nausea, and sleep disturbances.
What Experts Know About the Science of Acupuncture
According to traditional Chinese medicine, acupuncture points are at specific areas along channels or meridians that connect different parts of the body. Qi (pronounced chee, meaning energy) is believed to flow in these channels. With acupuncture, very thin needles are inserted in the skin to promote the flow and balance of qi and relieve symptoms that may arise when qi is blocked.
Studies in animals and humans have shown that acupuncture can stimulate pain relief; reduce stress, anxiety, and depression; improve sleep; and increase blood flow. It may also help reduce inflammation, which might explain why it relieves pain.
In addition, acupuncture appears to improve nerve signaling in people with pain and numbness in the hands and feet (peripheral neuropathy) and other nerve pain.
What Are the Types of Acupuncture?
MSK’s Integrative Medicine Service offers several types of acupuncture:
- Traditional acupuncture involves placing thin needles at predetermined points around the body
- Electroacupuncture involves attaching electrodes to the needles
- Auricular (ear) acupuncture involves placing needles in parts of the ear that correspond to different body parts
Acupuncture for Neuropathy
Some chemotherapy drugs are known to cause chemotherapy-induced peripheral neuropathy (CIPN), a type of nerve damage that can include pain, numbness, weakness, and tingling — especially in the hands and feet. This condition can greatly impair a patient’s daily life, affecting sleep, mobility, balance, and the ability to perform tasks that require fine motor control, like buttoning shirts and tying shoes.
A phase 2 clinical trial published in the European Journal of Cancer in 2018 studied whether acupuncture could prevent worsening CIPN in people who were receiving the chemotherapy drug paclitaxel (Taxol®) for the treatment of breast cancer. Researchers found that acupuncture was safe and showed preliminary evidence of being effective at reducing severe CIPN during chemotherapy.
Improvements in CIPN, along with quality of life, were seen in another study of cancer survivors, published in The Oncologist in 2021. MSK researchers are now conducting a controlled phase 3 trial to determine whether electroacupuncture can help lessen CIPN.
Acupuncture for Cancer Pain
Research conducted at MSK has looked at how acupuncture can help relieve cancer-related pain. “Pain is one of the most common and feared symptoms for cancer patients and survivors,” Dr. Mao says. “There is a critical need to study the evidence so we can make informed recommendations for clinicians and patients.”
One study published in the Journal of Clinical Oncology in 2022 examined research into treating cancer pain without drugs. The study was a two-year collaboration between the Society for Integrative Oncology and the American Society of Clinical Oncology, and the findings underscored the important role that acupuncture and other integrative therapies can play in cancer care. Specifically, investigators found that among adult patients experiencing joint pain related to certain hormone treatments, acupuncture should be recommended. They also determined that acupuncture and acupressure (applying pressure to the body’s meridians) could be effective for general cancer pain or musculoskeletal pain.
Another study published in JAMA Oncology in 2021 compared electroacupuncture and ear acupuncture to traditional cancer pain relievers — opioids and over-the-counter pain medications. Researchers found that both types of acupuncture were more effective than traditional care for reducing chronic musculoskeletal pain in cancer survivors.
Research has also focused on the ability of therapeutic massage to relieve cancer pain. Another recent study led by Dr. Mao and gastrointestinal oncologist Andrew Epstein, MD, and published in JAMA Network Open compared acupuncture and massage to each other and found that both treatments not only reduce musculoskeletal pain but also lead to improvements in feelings of fatigue and insomnia and in patients’ quality of life.
Acupuncture for Stress and Anxiety
Stress and anxiety are common in people being treated for cancer, beginning at the time of diagnosis, continuing through prognosis and treatment, and even persisting after the disease is long gone. Specific sources of stress include feelings of uncertainty, the severity of the disease, the treatments themselves, physical difficulties, fears of recurrence, and overall psychological state. All these can severely affect the quality of life.
In a paper published in Cancer, researchers studied the effect of electroacupuncture on psychological distress and other symptoms in breast cancer survivors with joint pain due to breast cancer drugs called aromatase inhibitors. They found that compared to standard care, electroacupuncture greatly improved anxiety, depression, and fatigue.
Acupuncture for Chemotherapy Nausea
Many people have nausea and vomiting while they’re getting chemotherapy. This can be caused by a number of things, including medications that affect the areas of your brain that control nausea and medications that irritate the lining of your mouth, throat, stomach, or intestines.
One study published in the journal Gynecologic Oncology found that acupuncture was more effective than ondansetron, a drug used to treat nausea and vomiting, in preventing delayed nausea and vomiting caused by chemotherapy.
A 2018 guideline produced by the Society for Integrative Oncology and endorsed by the American Society of Clinical Oncology recommends acupressure and acupuncture for reducing chemotherapy-induced nausea and vomiting in breast cancer patients.
Research has shown that acupuncture promotes the secretion of pituitary endorphins and adrenal corticosteroids, substances that inhibit the area in the brain responsible for initiating vomiting.
Acupuncture for Sleep Problems, Including Hot Flashes, Insomnia, and Fatigue
“People often say that cancer impacts sleep,” Dr. Mao says. “It’s hard for people to fall asleep, they wake up multiple times, and they feel very tired during the day. They’re looking for things that are not drugs to help them improve their sleep and quality of life.”
One study focused on breast cancer patients experiencing hot flashes, which can be caused by the surgical removal of the ovaries or by chemotherapy. These hot flashes can interfere with getting a good night’s sleep. The research, published in the journal Menopause in 2017, found that electroacupuncture produces a better overall sleep quality than gabapentin, a drug used to treat hot flashes in people with breast cancer. The investigators found that electroacupuncture can specifically improve “sleep latency,” or the time it takes to fall asleep, as well as “sleep efficiency,” meaning how much of the time in bed you’re actually sleeping.
Other research has focused on sleep problems more broadly. A study published in 2019 in the Journal of the National Cancer Institute showed that acupuncture was comparable to a treatment called cognitive behavioral therapy in reducing the severity of insomnia in cancer survivors.
One way acupuncture may help with sleep issues is by increasing the amount of brain-derived neurotrophic factor in the body. Lower levels of this substance are associated with poor sleep.
Where Can People With Cancer Receive Acupuncture Treatments?
For people receiving cancer treatment at MSK, acupuncture is available at several of our Manhattan locations:
It is also available at most of our regional locations:
For those who are not MSK patients, it’s important to receive treatment from an acupuncture specialist who is experienced in working with people who have cancer.
You can visit the website for the National Certification Commission for Acupuncture and Oriental Medicine to search for credentialed practitioners according to location and certification.
Does Insurance Usually Cover Acupuncture for Cancer?
Some insurers cover certain acupuncture treatments. Before scheduling an appointment, you can call your insurance company to understand what portion of the acupuncture costs may be covered and which symptoms (for example, pain or nausea) may be included in that coverage.
