Effect of Acupuncture on Cancer Treatment-related Side Effects
Five studies published in English have addressed the use of acupuncture for pain related to cancer treatment, mostly postsurgical pain (refer to Table 2 at the end of this section). A randomized clinical trial evaluated the effect of various combinations of auricular acupuncture, Chinese herbs, and epiduralmorphine to relieve postoperative pain in 16 patients with liver cancer. The study design was complicated and had a very small sample size (n = 2 per group). On the basis of the VAS (0-100 mm), all of the combination treatment groups experienced better analgesia than did the placebo-treated control group.
A nonrandomized study investigated the effect of acupuncture in postoperative pain management and arm movement in breast cancer patients after surgical excision of the cancer and axillary lymph node dissection. Forty-eight patients were treated with acupuncture on the third, fifth, and seventh days after surgery and on the day of patient discharge. Compared with a control group of 32 patients who had the same surgery but did not receive acupuncture treatment, the acupuncture group had significant pain relief during arm movement on the fifth and seventh days following surgery and at the time of discharge. The range of arm motion also increased significantly in the treatment group, compared with the control group, during the postoperative period (P < .001). The authors concluded that acupuncture point selection based on the state of the patient and obtaining a needling"de qi" sensation were important in achieving an effective acupuncture treatment.
Arthralgias and myalgias from aromatase inhibitors
A randomized, blinded study comparing true acupuncture with sham acupuncture for aromatase-related joint symptoms enrolled 51 patients, 38 of whom were evaluable. True acupuncture was significantly more effective than sham acupuncture, as measured by Brief Pain Inventory-Short Form scores in relieving joint symptoms.
Table 2. Clinical Studies of Acupuncture: For Cancer Treatment-related Side Effect: Paina
COX-2 = cyclooxygenase 2; EA = electroacupuncture; No. = number; NSAID = nonsteroidal anti-inflammatory drug; RCT = randomized controlled trial.
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 considered by the researcher 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 anticancer 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, combination of traditional Chinese medicine (acupuncture and Chinese herbs) and epidural morphine versus placebo.
gP < .01, acupuncture treatment versus no acupuncture treatment.
|Reference Citation(s) ||Type of Study ||Condition Treated ||No. of Patients: Enrolled; Treated; Controlb||Strongest Benefit Reportedc||Concurrent Therapy (Yes/No/ Unknown)d||Level of Evidence Scoree|
|||RCT||Pain/depression||138; 93 acupuncture and massage; 45 usual care ||Increased pain relief/decreased depression ||Yes (usual care) ||1iiC|
|||RCT||Pain/depression ||16; 12 Chinese herbs, auricular EA, or epidural morphine given alone or in combination; 4 placebo controls||Combination treatment better than placebo and EA alone, Chinese herbs alone, or epidural morphine alonef||Yes (Chinese herbs; epidural morphine) ||1iC |
|||RCT||Musculoskeletal pain ||51; 23; 20 ||Improved joint pain and stiffness ||Yes (aromatase inhibitors) ||1iiC |
|||Nonrandomized controlled trial ||Local pain and limitation of arm movement after breast cancer surgery and axillary lymph node dissection ||80; 48 acupuncture; 32 no acupuncture ||Improved postoperative pain; improved range of arm motiong||Unknown||2C |
|||Pilot study ||Musculoskeletal pain related to adjuvant aromatase inhibitor therapy ||21; 19 acupuncture; none ||Reduced severity and increased functional ability ||Yes (analgesics: acetaminophen, NSAIDs, or COX-2 inhibitors and various CAM approaches) ||3iiiC |