Acupuncture in Cancer Care: An Overview of Current Clinical Research

By Antonia Balfour, L.Ac., Dipl. Ac., Dipl. CH

In 1997, the National Institutes of Health (NIH) issued a consensus statement endorsing acupuncture’s effectiveness in treating chemotherapy-induced nausea and vomiting. Since that time, the over 2,000-year-old healing modality has been increasingly used as a crucial element of integrated cancer care. Clinical trials have demonstrated successful results in cancer patients using acupuncture for treatment of a variety of conditions including pain, fatigue, nausea and vomiting, peripheral neuropathy, dry mouth, and difficulty swallowing.

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PAIN
A 2003 study published in the Journal of Clinical Oncology studied ear (auricular) acupuncture for the treatment of pain. Ninety cancer patients were randomly divided into three groups. One group received two courses of auricular acupuncture at points where an electro-dermal signal had been detected. The other two groups were placebo groups – one received auricular acupuncture at points with no electro-dermal signal (placebo points) and the other received auricular seeds fixed at placebo points. All patients experienced pain and had received analgesic treatment adapted to both the intensity and type of pain for at least one month of therapy. At a two-month assessment, patients who received acupuncture reported a 36% decrease in pain from baseline compared to 2% in those who received placebo. Researchers concluded that acupuncture significantly reduced pain in cancer patients where pain had continued despite being treated with analgesics.

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FATIGUE
A 2004 study in the Journal of Clinical Oncology involved cancer patients who had completed chemotherapy but experienced persistent fatigue. Twenty-five patients received acupuncture twice a week for 4 weeks, and twelve patients received acupuncture once a week for 6 weeks. Patients reported an improvement of 31% in fatigue level measured at 2 weeks after the final treatment compared to the baseline. There was no significant difference in weekly and bi-weekly treatments. The result suggests that acupuncture has benefit in treating post-chemotherapy fatigue. The authors concluded that further studies involving large number of patients are warranted.

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NAUSEA AND VOMITING
Up to 60% of patients undergoing chemotherapy report nausea as a side-effect despite taking antiemetic medications. Nausea, and to a lesser extent vomiting, remain significant clinical problems.
A 2000 study in the Journal of the American Medical Association researched electro-acupuncture given to breast cancer patients undergoing high-dose chemotherapy treatment. Electro-acupuncture together with antiemetic medication was more effective in controlling vomiting than minimal needling or antiemetic medication alone.
A 2005 study in the Journal of Clinical Oncology suggests a biologic effect of acupuncture-point stimulation. It concluded that electro-acupuncture has demonstrated benefit for chemotherapy-induced acute vomiting.

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PERIPHERAL NEUROPATHY
Research studies have been done showing benefits of acupuncture for peripheral neuropathy. A 2007 study in the European Journal of Neurology showed improved nerve conduction in peripheral neuropathy of unknown origin.
A 2006 study published in Acupuncture in Medicine, the journal of the British Medical Acupuncture Society showed positive results for acupuncture and neuropathy specifically associated with chemotherapy.

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DRY MOUTH & DIFFICULTY SWALLOWING
Patients with head and neck cancer commonly experience dry mouth (xerostomia), pain, and difficulty swallowing. Several research studies have shown acupuncture’s efficacy in managing these symptoms.

Cancer, the journal of The American Cancer Society, published a 2002 study concluding that acupuncture following radiation palliates dry mouth for many patients. A regimen of three to four weekly treatments followed by monthly sessions is now recommended, although some patients achieve lasting response without further therapy.
In a 2008 presentation at the annual meeting of the American Society of Clinical Oncology, preliminary results of a controlled trial were presented showing significant reductions in pain, dysfunction, and xerostomia in patients receiving acupuncture following neck dissection for cancer.

In addition, Weidong Lu at Harvard’s Dana-Farber Cancer Center received a Career Development Award from the National Institutes of Health to focus on the benefits of acupuncture on head and neck cancer patients dealing with pain, difficulty swallowing, and dry mouth. This is the first time this prestigious five-year grant has been given to an integrative therapy practitioner.

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HOT FLASHES
At the American Society for Therapeutic Radiology and Oncology annual meeting in Boston, September, 2008, Eleanor Walker, MD presented results from a clinical trial showing acupuncture helped hot flashes as much as Effexor, the antidepressant currently prescribed for women suffering the menopausal side effects of anti-estrogen drugs.
“Effexor itself has troubling side effects, but acupuncture doesn’t,” found study leader Eleanor Walker, MD, a radiation oncologist at Detroit’s Henry Ford Hospital.

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SUMMARY
Premier cancer centers around the country such as Memorial Sloan-Kettering Cancer Center and Dana-Farber/Harvard Cancer Center are now incorporating acupuncture and integrative medicine into treatment for their patients. Acupuncture, once considered an “alternative” modality, has now become mainstream as a complementary therapy in palliative care and increased quality of life for cancer patients.

Antonia Balfour is an acupuncturist and herbalist practicing in Pacific Palisades, California. She is the co-owner and Clinical Director of Oasis Palisades, a Health & Wellness Center located in Pacific Palisades (on the Westside of Los Angeles, between Santa Monica and Malibu). She is a California-licensed, NCAAOM-certified acupuncturist; and holds a certification in Acupuncture and Cancer Care from Memorial Sloan-Kettering Cancer Center.