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Lorenzo Cohen, Ph.D. Headshot

Time for Acupuncture to Become Part of Standard Care

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Acupuncture, the insertion of small, stainless steel needles into points on the body to stimulate specific areas, has been used in recent years by many cancer patients to help with symptom management. Because the mechanisms are not well understood, deciding when and how to safely add acupuncture to one's treatment plan can be challenging. A recent systematic review conducted by researchers in the Integrative Medicine Program at the MD Anderson Cancer Center can now help patients and their oncologists make more informed choices.

The systematic review, published in the Journal of Clinical Oncology, searched the worldwide literature for randomized, controlled trials evaluating the use of acupuncture for symptom management in cancer patients.[1] Forty-one studies were found for the treatment of eight symptoms (pain -- 11, nausea/vomiting -- 11, postoperative ileus (constipation) -- eight, xerostomia (dry mouth) -- four, hot flashes -- seven, fatigue -- three, anxiety/depression/mood disorders -- five, and sleep disturbance -- three), and were rated for study quality and whether outcomes were positive or negative.

One well-designed large study, undefined for the treatment of chemotherapy-induced nausea and vomiting, found electroacupuncture worked better than anti-nausea medications or sham acupuncture (minimal needling) in women with breast cancer.[2] Although less clear, the evidence also suggests acupuncture is helpful for pain control. None of the identified studies were classified as having a low risk of bias due to study weaknesses, but nine of the 11 pain studies had positive results favoring its use. For the other symptoms assessed, the quality of the studies was lower, but there is reason to believe that with larger more rigorous studies, acupuncture may be found beneficial for some of these conditions as well.

The use of acupuncture for symptom control in oncology is important to consider. Findings from this review and others indicate it is an appropriate treatment alongside conventional care for chemotherapy-induced nausea/vomiting, although additional studies are needed to better understand how it works and which patients might benefit most. For other symptoms, the specific effects of acupuncture remain undetermined, primarily due to weaknesses in the studies. As a low-risk, cost-effective treatment option, acupuncture may be helpful when combined with conventional care for patients suffering from uncontrolled treatment-related side effects or in those for whom other treatment approaches have failed.

References:

1. Garcia MK, McQuade J, Haddad R, Patel S, Lee R, Palmer JL, Yang P, Cohen L. "Acupuncture in cancer care: a systematic review." Journal of Clinical Oncology (Published online before print Jan. 22, 2013). doi: 10.1200/JCO.2012.43.5818)

2. Shen J, Wenger N, Glaspy J, Hays RD, Albert PS, Choi C, Shekelle PG. "Electroacupuncture for control of myeloablative chemotherapy-induced emesis: A randomized controlled trial." JAMA 284:2755-61, 2000.

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