Breast Cancer

Acupuncture for nausea and vomiting during radiotherapy – Journal of Chinese Medicine, June 2011

A Swedish pilot study has tested a modified single subject experimental design for evaluating the use of acupuncture for emesis during radiotherapy. Ten cancer patients were randomised to verum penetrating acupuncture or non-penetrating sham needles for 30 minutes, two to three times per week during radiotherapy. They answered test-retested emesis questions covering nausea, vomiting, use of antiemetics, wellbeing and activities of daily living. Overall, the patients completed 98% of the 345 emesis-questionnaire days. Ten patients experienced antiemetic effects, seven relaxation, five pain-reduction and five experienced sleep improvement. Nausea was experienced by one out of five verum acupuncture-treated patients and four out of five sham acupuncture treated patients. (Pilot testing of methods for evaluation of acupuncture for emesis during radiotherapy: a randomised single subject experimental design. Acupunct Med. 2011 Apr 3). A study published by some of the same Swedish authors has found no difference between verum and sham acupuncture for treating nausea in cancer patients undergoing radiotherapy. Two hundred and seventy-seven cancer patients were randomised to receive verum (penetrating) acupuncture at Neiguan P-6 or sham acupuncture (performed with a telescopic non-penetrating needle at a sham point) two to three times per week during radiotherapy. The acupuncture cohort was compared to a reference cohort receiving standard care. Nausea and vomiting during the preceding week was reported by 8% of the verum acupuncture group, 7% of the sham acupuncture group and 15% of the standard care group respectively. Nausea intensity was lower in the acupuncture cohort compared to the standard care cohort and 95% of the acupuncture cohort expected antiemetic effects from their treatment. Patients who expected nausea had increased risk for nausea compared to those who expected low risk for nausea. The authors conclude that patients treated with verum or sham acupuncture experienced less nausea and vomiting compared to patients receiving standard care, possibly through a general care effect or due to a high level of patient expectancy. (Getting the grip on nonspecific treatment effects: emesis in patients randomized to acupuncture or sham compared to patients receiving standard care. PLoS One. 2011 Mar 23;6(3):e14766).

Acupuncture improves symptoms after cancer therapy – Journal of Chinese Medicine, Feb 2011

Having weekly acupuncture treatment following chemoradiotherapy (CRT) head and neck cancer (HNC) may reduce patients’ symptom severity and decrease the amount of time they need to undergo tubal feeding. In a retrospective case series, ten American patients with HNC were treated with weekly manual and electroacupuncture for radiation-induced dysphagia (difficulty swallowing) and xerostomia (dry mouth). Nine out of ten patients reported subjective improvement in swallowing, xerostomia, pain and fatigue levels. Six out of seven patients had their feeding tubes removed after acupuncture, at a median duration of 114 days post CRT, which represents a relatively short time under such circumstances. (Acupuncture for dysphagia after chemoradiation therapy in head and neck cancer: a case series report. Integr Cancer Ther. 2010 Sep;9(3):284-90).

Meanwhile, a Norwegian study has examined the quality of life of breast cancer patients on anti-oestrogen medication, two years after receiving acupuncture treatment for hot flushes. Forty-one women from an acupuncture treatment group and 41 women from a sham acupuncture control group had received a course of 15 acupuncture treatments over a period of 10 weeks two years previously. Qualitative data showed that women previously treated with sham acupuncture complained that hot flushes were still a problem, whilst those previously treated with traditional Chinese acupuncture found them less problematic and generally had a more positive outlook on life. (Quality of life of breast cancer patients medicated with anti-estrogens, 2 years after acupuncture treatment: a qualitative study. Int J Womens Health. 2010 Sep 28;2:319-25).

Acupuncture alleviates breast cancer hot flushes – Journal of Chinese Medicine, Feb 2011

Traditional acupuncture (TA) offers an effective non-pharmaceutical method of managing the hot flushes and night sweats (HF&NS) associated with taking tamoxifen for breast cancer, according to British researchers. Fifty participants with early breast cancer who were taking tamoxifen were enrolled in a single-arm observational study. They received eight weekly individualised TA treatments, using a core standardised protocol designed for the treatment of HF&NS in natural menopause. The women’s mean frequency of hot flushes was reduced by 49.8% at the end of treatment (EOT) compared with baseline, and trends indicated longer-term effects at four and 18 weeks after EOT. The women also showed significant statistical and clinical improvements in other areas of physical and emotional well-being and reported their perception of HF&NS as a problem as being reduced. (Using traditional acupuncture for breast cancer-related hot flashes and night sweats. J Altern Complement Med. 2010 Oct;16(10):1047-57).

Acupuncture benefits cancer patients – Journal of Chinese Medicine, Oct 2010

Acupuncture produces measurable benefits in symptom reduction and quality of life (QOL) for patients with advanced ovarian and breast cancer, according to US researchers. In a pilot, single-armed prospective trial, 40 patients with advanced cancer were enrolled to receive 12 acupuncture sessions over eight weeks, with follow-up at weeks nine and 12. Among all 32 assessed patients, there was self-reported improvement immediately post-treatment in anxiety, fatigue, pain and depression, and significant improvement over time in anxiety and depression. QOL measures of pain severity and interference, physical and psychological distress, life satisfaction and mood states also showed improved scores during treatment, with sustained benefit at 12 weeks. (Acupuncture as palliative therapy for physical symptoms and quality of life for advanced cancer patients. Integr Cancer Ther. 2010 Jun;9(2):158-67).

Acupuncture better than drugs for cancer hot flushes – Journal of Chinese Medicine, Jun 2010

Not only is acupuncture as effective as drug therapy at preventing hot flushes in breast cancer patients who have been receiving long-term anti-oestrogen therapy, it also increases women’s sex drive and improves their sense of well-being.  Venlafaxine (Effexor – a selective serotonin reuptake inhibitor) – the therapy of choice for such symptoms – has numerous adverse effects. An American team randomly assigned fifty patients to receive 12 weeks of acupuncture or venlafaxine treatment. Both groups exhibited significant decreases in hot flushes, depressive symptoms and other quality-of-life symptoms, including significant improvements in mental health.  These changes were similar in both groups indicating that acupuncture was as effective as venlafaxine. By two weeks post-treatment, the venlafaxine group experienced significant increases in hot flushes, whereas hot flushes in the acupuncture group remained at low levels. The venlafaxine group experienced 18 incidences of adverse effects (nausea, dry mouth, dizziness, anxiety), whereas the acupuncture group experienced no negative effects. Acupuncture had the additional benefit of increasing sex drive in some women, and most reported improvements in their energy, clarity of thought and sense of well-being. (Acupuncture versus venlafaxine for the management of vasomotor symptoms in patients with hormone receptor-positive breast cancer: a randomized controlled trial. J Clin Oncol. 2010 Feb 1;28(4):634-40).

Acupuncture helps with painful side-effects of cancer drug – Journal of Chinese Medicine, Jun 2010

Acupuncture may help to relieve the joint pain and stiffness that are a common side-effect of the use of aromatase inhibitors (AI) that suppress oestrogen production in women with breast cancer. US researchers conducted a study of 43 postmenopausal women with early breast cancer who were being treated with AI and experiencing arthralgia. They were randomised to receive true acupuncture (TA – auricular acupuncture and joint-specific point prescriptions) or sham acupuncture (SA- superficial needle insertion at non-acupoint locations) twice weekly for six weeks. Pain scores at six weeks, measured using a variety of scales, were significantly lower for the TA group compared with the SA group. (Randomized, blinded, sham-controlled trial of acupuncture for the management of aromatase inhibitor-associated joint symptoms in women with early-stage breast cancer. J Clin Oncol. 2010 Mar 1;28(7):1154-60).

Acupuncture for breast cancer drug pain – Journal of Chinese Medicine, Feb 2010

A preliminary trial by an American team has found acupuncture to be a promising way of treating arthralgia in women receiving aromatase inhibitors (AIs) for breast cancer. Twelve patients were provided with electro-acupuncture (EA) twice a week for two weeks, followed by six weekly treatments. Acupuncture was based on the TCM diagnosis of bi syndrome, with electrostimulation of needles around the painful joints. From baseline to the end of intervention patients reported reductions in pain severity (from 5.3 to 1.9), stiffness (from 6.9 to 2.4), and joint symptom interference (from 4.7 to 0.8). They considered joint symptoms ‘very much better’ and also reported a significant decrease in fatigue (from 4.4 to 1.9) and anxiety (from 7.1 to 4.8). No infection or development/worsening of lymphoedema was observed. (Feasibility trial of electroacupuncture for aromatase inhibitor-related arthralgia in breast cancer survivors. Integr Cancer Ther. 2109 Jun;8(2):123-9).

Acupuncture for chemo hot flushes – Journal of Chinese Medicine, Feb 2008

A small qualitative study carried out in the UK has found that a standardised auricular acupuncture protocol delivered in small group clinics is beneficial for women suffering from hot flushes caused by hormone treatment for breast cancer. The 16 women interviewed found the acupuncture to be helpful and relaxing. Many reported reductions in hot flush frequency, as well as improvements in overall emotional and physical wellbeing. The group treatment setting was regarded as supportive and encouraging. (Ear acupuncture for hot flushes – The perceptions of women with breast cancer. Complement Ther Clin Pract. 2007 Nov;13(4):250-7).