Acupuncture for Symptom Management in Cancer Patients

Dr. Anne Hermann

From the emotional impact of the diagnosis to the side effects of surgery, chemotherapy and radiation, cancer can be traumatizing. Over the past decade, acupuncture has become an accepted part of cancer treatment centers all over the country, from Harvard’s Dana-Farber to the famed Mayo Clinic. As more physicians and hospitals offer acupuncture, the medical community has become less skeptical about acupuncture. There are many well-done studies that demonstrate that acupuncture does indeed relieve pain, nausea, hot flashes, improve saliva production and reduce stress. I have taken the time to summarize the studies that demonstrate that acupuncture is helpful for cancer symptoms because I would like doctors and patients to have this information when they are deciding how to treat the symptoms below. Below is a summary of well performed studies, published in medical journals that demonstrate that acupuncture is effective for these cancer-related symptoms.

Hot Flashes: In one study, 50 patients with breast cancer received 12 weeks of acupuncture or
venlafaxine (a prescription medication for hot flashes).  Both groups had decreases in hot flashes, depression and  improvements in mental health from pre- to post-treatment.  Acupuncture was as effective as venlafaxine. Two weeks after treatment, the medication group had return of hot flashes while hot flashes in the acupuncture group remained low. The venlafaxine group experienced 18 adverse effects; the acupuncture group experienced none. Acupuncture had the additional benefit of increased sex drive, improvement in energy, clarity of thought, and sense of well-being.  Acupuncture is as effective in treating hot flashes and has no side effects compared to medication.

J Clin Oncol 2010,Feb,01;28(4):634-40

Peripheral Neuropathy: We are performing a pilot study on chemotherapy induced peripheral neuropathy at Moffitt.  So far, about 75% of patients do improve with acupuncture.   One study on people with carpel tunnel syndrome (CTS), a form of peripheral neuropathy, compared 4 weeks of prednisolone to 4 weeks of acupuncture.  After 13 months, acupuncture group reported 81.6% improvement versus 48.7% in the steroid group. The acupuncture group had a significantly better improvement on neurologic testing when compared to the steroid group as well.  It is important to note that the improvement lasted over a year.  Acupuncture has been proven to improve carpal tunnel syndrome 2:1 over steroid medication.

Yang CPWang NHLi TCHsieh CLChang HHHwang KLKo WSChang MH., A randomized clinical trial of acupuncture versus oral steroids for carpal tunnel syndrome: a long-term follow-upJ Pain. 2011 Feb;12(2):272-9., 2010 Nov 26

Nausea and Vomiting: There are so many studies that prove that acupuncture helps with nausea and vomiting, that I think it’s best to mention the Cochrane Database review of 40 trials involving 4858 participants.  This review compared sham treatment to acupuncture for nausea; vomiting, and the need for rescue nausea medications. Acupuncture was found to be as effective as standard anti-nausea medication typically used in chemotherapy.

Cochrane Database Syst Rev 2009,Jan,01;(2):CD003281

Pain after Surgery: Randomized controlled trials of acupuncture with electricity report reduction in pain after surgery.  In one study, 23% of patients having received acupuncture with electricity required no morphine-like medication after lung surgery.  They also had shorter stays in the recovery room and better tolerance to physical therapy.  Acupuncture can aid physical therapy and replace the need for medication. 

Thor Surg 1985; 39462-5

Joint Pain Caused by Chemotherapy: Breast cancer patients treated with a chemotherapy called aromatase inhibitors may experience joint pain.  A study performed at Columbia University compared true acupuncture versus sham acupuncture twice weekly for 6 weeks in women who had musculoskeletal pain related to their chemotherapy. Women treated with True Acupuncture had significant improvement of joint pain and stiffness, which was not seen with Sham Acupuncture.

Crew KDCapodice JLGreenlee HBrafman LFuentes DAwad DYann Tsai WHershman DL.  Randomized, blinded, sham-controlled trial of acupuncture for the management of aromatase inhibitor-associated joint symptoms in women with early-stage breast cancerClin Oncol. 2010 Mar 1;28(7):1154-60.  2010 Jan 25.

Xerostomia or Poor Saliva Production: A study of 46 patients with reduced saliva after radiotherapy for head-and-neck cancer .  Two 6-week courses of acupuncture were given.   Saliva production was measured at baseline and up to 1 year after treatment completion.  All acupuncture patients had improvement on questionnaire and increase in measured saliva production at 3 and 6 months aftertreatment.

Wong RKJones GWSagar SMBabjak AFWhelan T. A Phase I-II study in the use of acupuncture-like transcutaneous nerve stimulation in the treatment of radiation-induced xerostomia in head-and-neck cancer patients treated with radical radiotherapyInt J Radiat Oncol Biol Phys. 2003 Oct 1;57(2):472-80.

Depression or Anxiety: In this study, 56 patients with  depression or anxiety were randomly assigned to true acupuncture vs. sham acupuncture.   After 10 treatments, the true acupuncture group had 60.7% improvement vs. 21.4% in sham. Acupuncture addressess depression and anxiety.

Fortschr Neurol Psychiatr. 2000 Mar;68(3):137-44

Anne Hermann, MD: I treat cancer patients in my private practice and at Moffitt Cancer Center in Tampa, where I am the medical acupuncturist in the Integrative Medicine Department.   As an Internal Medicine physician and holistic medical practitioner, my goal is to help patients tolerate their treatments as well as possible.  Again, if you have any questions or comments, please feel free to contact us at (813) 902-9559 or (727) 278-3992 – Anne Hermann, MD

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