Dec. 5, 2000 -- Nausea and vomiting -- never a lot of fun -- can be among the most distressing and disabling side effects of chemotherapy for breast cancer patients. Now, researchers at the NIH have shown that a variation of the traditional Oriental medical practice of acupuncture, along with commonly used medications, may help.
"The results of our study suggest that among patients receiving high-dose chemotherapy, electroacupuncture was more effective in controlling vomiting than just medication alone," says Joannie Shen, MD, MPH, research associate at the NIH, whose study appears in the Dec. 6, 2000 edition of TheJournal of the American Medical Association. Electroacupuncture uses a mild electric current passed through traditional acupuncture needles placed lightly into specific points on the body.
However, it's not known from the study whether acupuncture would be as effective in women receiving standard dose-chemotherapy, she tells WebMD.
In the study, over 100 breast cancer patients receiving high-dose chemotherapy all received drugs commonly used to control nausea and vomiting. But one group of women also received electroacupuncture in addition to the drugs, and another group received drugs and minimal needling -- a kind of "sham" acupuncture intended to mimic the real thing. A third group received only the drugs and no acupuncture, according to the report.
Shen and her colleagues found that those women who had received electroacupuncture had fewer vomiting episodes than the women who only received drugs. Even the women who got the "minimal needling" did somewhat better than the women who only got drugs, she reports.
That suggests that some of the response to acupuncture could be explained by the "placebo effect" -- the concept that some patients will get better even without getting the real treatment, perhaps just from receiving more attention from caregivers. However, the acupuncture and the minimal needling was terminated at five days, and when Shen and colleagues went back to look at how the patients were faring on the ninth day, there were no longer significant differences between the three groups.
That's important, Shen says, because it supports the idea that acupuncture really had an effect on the body. "We were skeptical at the beginning, thinking that maybe it was just the extra attention, so that's why we did the follow-up," Shen tells WebMD. "It's the strongest part of our study."
Still, Shen notes that the placebo effect cannot be entirely dismissed. As for the physical effects of acupuncture, Shen says scientists believe that the ancient Chinese practice may have effects on neurotransmitters -- chemicals in the brain that control the body's response to substances that can cause vomiting.
Shen's study adds to a growing body of evidence. A 1997 NIH Consensus Statement on Acupuncture stated that "promising results have emerged" showing effectiveness of acupuncture in easing nausea and vomiting after surgery and chemotherapy.
Ian Cyrus, director of acupuncture and oriental medicine at the center for integrative medicine at Thomas Jefferson Hospital in Philadelphia, says the study corroborates what he has learned in his own practice treating cancer patients receiving chemotherapy, and that is that acupuncture works.
"It definitely makes a difference in the quality of life with respect to controlling vomiting," says Cyrus, who has treated thirty chemotherapy patients this year.
"The study clearly demonstrates the benefits of acupuncture when compared to those who are not receiving it," Cyrus tells WebMD. "The key here is that acupuncture does work, and patients receiving acupuncture and drugs receive extra benefit. This should be considered part of the entire treatment strategy for cancer patients receiving chemotherapy."
Cyrus tells WebMD that he believes acupuncture is no longer considered eccentric or out of the mainstream, but has arrived in American medicine. And he says acupuncture alone does not convey the scope of what Oriental medicine has to offer American medicine and western patients. "Acupuncture is only one modality in a family of modalities offered by Oriental medicine," he tells WebMD.
But he says that with conditions like chemotherapy-induced vomiting, it's best used in combination with western style medicine. "Studies like this clearly illustrate that acupuncture does have a significant benefit when used in conjunction with other western pharmaceutical approaches," Cyrus says. "That's the key, it is complementary."