Some studies have reported that acupuncture may be effective in reducing vasomotor symptoms among postmenopausal women with breast cancer and prostate cancer patients on androgen-deprivation therapy.[41,42,43,44,45,46,47] One study randomly assigned 55 patients to acupuncture versus venlafaxine for management of vasomotor symptoms in women with hormone receptor-positive breast cancer. Acupuncture was just as effective as venlafaxine and caused fewer adverse effects.
A phase I pilot study evaluated the effect of acupuncture on tamoxifen-induced menopause symptoms. Fifteen patients with breast cancer who were taking tamoxifen were treated with acupuncture weekly for 3 months. The Greene Menopause Index was used for outcome assessments at baseline before treatment and at 1, 3, and 6 months. The results showed that anxiety, depression, and somatic and vasomotor symptoms, but not libido, were significantly improved in comparison with the baseline (P < .001).
An uncontrolled prospective case series of 50 women on tamoxifen for early breast cancer evaluated women receiving eight treatments of traditional acupuncture weekly. Mean frequency of vasomotor symptoms dropped by 49.8% (P < .0001) at the end of treatment. Seven domains of the Women's Health Questionnaire showed statistically significant improvement.
A retrospective evaluation of 194 patients with predominantly breast or prostate cancer and experiencing vasomotor symptoms found long-term relief of vasomotor symptoms associated with acupuncture and self-acupuncture. The authors suggested that overall treatment dose may be more important than point location, but favored SP6. A small RCT of EA compared with hormone therapy in women with breast cancer suggested a prolonged effect of EA on hot flushes after 24 months. Seven of 19 women initially randomly assigned to EA had 2.1 flushes in 24 hours compared with a baseline of 9.6 flushes in 24 hours. In a prospective randomized study of 84 breast cancer patients on tamoxifen treated with acupuncture versus placebo, acupuncture showed a reduction of hot flashes in both the treatment and the control arms, but there was no difference between true acupuncture and sham acupuncture. The findings from these studies are summarized in Table 4 below.
Table 4. Clinical Studies of Acupuncture: Vasomotor Symptomsa
EA = electroacupuncture; No. = number; RCT = randomized controlled trial; SSRIs = selective serotonin reuptake inhibitors.
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 < .001, versus baseline.
|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 ||Hot flashes in breast cancer patients treated with tamoxifen and aromatase inhibitors ||72; 42; 30 ||Reduction of hot flashes but no statistical difference between acupuncture and sham treatment ||Yes (SSRIs) ||1iiC |
|||RCT ||Hot flushes ||45; 27 EA; 18 hormone therapy ||Vasomotor symptoms improved ||Unknown||1iiC |
|||RCT||Hot flashes ||50; 25; 25 ||Vasomotor symptoms improved ||Yes (tamoxifen or arimidex) ||1iiC |
|||RCT||Hot flashes in breast cancer patients treated with tamoxifen||84; 74; none||Decrease in severity and frequency in hot flushes and sweating||Yes (tamoxifen)||1iiC|
|||Phase I pilot study ||Menopausal symptoms in breast cancer patients treated with tamoxifen ||15; 15 acupuncture; none ||Anxiety, depression, and somatic and vasomotor symptoms improvedf||No||3iiiC |
|||Pilot study/case series ||Hot flashes in patients with prostate cancer ||25; 22; none ||55% treatment for hot flashes ||No||3iiiC |
|||Nonconsecutive case series ||Night sweats, hot flashes in patients with cancer ||6; 6 acupuncture; none ||Symptoms improved ||Yes (not specified) ||3iiiC |
|||Nonconsecutive case series ||Vasomotor symptoms for breast and prostate cancer ||194; 194; none ||79% showed 50% or greater reduction in hot flashes ||No||3iiiC |
|||Nonconsecutive case series||Vasomotor symptoms for prostate cancer||17; 14; none||Decreased hot flashes||Yes (androgen ablation therapy)||3iiiC|
|||Prospective case series||Hot flashes and night sweats||54; 50; none||Decreased hot flashes and night sweats and improved physical and emotional well-being||Tamoxifen||3iiiC|