A third case series produced similar results. After auricular EA treatment, five patients with cancer pain reported improvements.
Although most of these studies were positive and demonstrated the effectiveness of acupuncture in cancer pain control, the findings have limited significance because of methodologic weaknesses such as small sample sizes, an absence of patient blinding to treatment in most cases, varying acupuncture treatment regimens, a lack of standard outcome measurements, and an absence of adequate randomization. Further investigations into the effects of acupuncture on cancer pain using rigorous scientific methodology are warranted.
Table 1. Clinical Studies of Acupuncture: Cancer-related Paina
EA = electroacupuncture; No. = number; NUR = Nourishing yin and Unblocking meridians Recipe; RCT = randomized controlled trial; TCM = traditional Chinese medicine; VAS = Visual Analog Scale.
a See text and the NCI Dictionary of Cancer Terms for additional information and definition of terms.
b Number of patients treated plus number of patient controls may not equal number of patients enrolled; number of patients enrolled equals number of patients initially recruited/considered by the researchers who conducted a study; number of patients treated equals number of enrolled patients who were given the treatment being studied AND for whom results were reported.
c Strongest evidence reported that the treatment under study has activity or otherwise improves the well-being of cancer patients.
d Concurrent therapy for symptoms treated (not cancer).
e For information about levels of evidence analysis and an explanation of the level of evidence scores, see Levels of Evidence for Human Studies of Cancer Complementary and Alternative Medicine.
fP < .05, acupuncture treatment versus conventional analgesics.
gP < .05, combination of traditional Chinese medicine (acupuncture and Chinese herbs) and epidural morphine versus placebo.
hP < .0001, acupuncture versus placebo.
iP < .00001, day 60 after start of acupuncture treatment versus day 0.
|Reference Citation(s)||Type of Study||Condition Treated||No. of Patients: Enrolled; Treated; Controlb||Strongest Benefit Reportedc||Concurrent Therapy Used (Yes/No/ Unknown)d||Level of Evidence Scoree|
||| RCT|| Gastric cancer pain||48; 16 acupuncture and 16 acupuncture point injection of freeze-dried human transfer factor; 16 conventional analgesics||In long-term treatment, equal or better analgesia than conventional drugsf||No||1iiC|
|||RCT||Cancer pain||41 patients treated with NUR combined with opioid analgesics. 43 patients in the control group treated with opioids alone. All the patients enrolled were differentiated as of yin deficiency and meridian blocked syndrome type of TCM. ||NUR combined with opioid analgesics in cancer pain management was more effective than opioid analgesics aloneg||Yes (combined with opioid analgesics in managing cancer pain)||1iiC|
|||RCT||Cancer pain||90; 28 auricular acupuncture; 51 acupuncture at placebo points in ear or auricular seeds fixed at placebo points with adhesive ||Pain intensity decreased by 36% at 2 monthsh||Yes (analgesics and co-analgesics, including tricyclic antidepressants and antiepileptics)||1iiC|
|||Nonconsecutive case series||Cancer pain||20; 20 auricular acupuncture; none||Average pain intensity decreased by 43%, using VAS (0-100 mm)i||Yes (analgesics)||3iiiC|
|||Nonconsecutive case series||Cancer-related pain||183; 183 acupuncture; none||95 (52%) "significantly helped"||Yes (analgesics)||3iC|
|||Nonconsecutive case series||Cancer pain||29; 29 EA; none||Pain reduced; injection of analgesics reduced or no longer required ||Yes (analgesics)||3iC|
|||Best case series||Cancer pain||5; 5 auricular EA; none||Symptoms improved||Unknown||4|