Acupuncture

Acupuncture is an important component of traditional Chinese medicine. The practice originated more than 2,000 years ago. It involves stimulation of one or more predetermined points on the body with sterile, filiform, disposable needles, sometimes with added heat (moxibustion), pressure (acupressure) or electricity to enhance therapeutic effect. The needles are much thinner than the hypodermic needles used for injections.

The ancient theory underlying acupuncture assumes that “qi” (pronounced “chee”), or life energy flows through vertical energy channels called meridians, which were thought to connect the internal organs. It was believed that disease occurs when the meridians become blocked. Acupuncture was thought to relieve the blockage and permit the normal flow of qi, thereby restoring health.

Acupuncture is being used in the palliative care of cancer patients, to alleviate pain and a variety of treatment side effects. It is generally safe when performed by trained practitioners and is well tolerated by patients, including children.

Some conditions require continuous treatments in order to achieve long-term effect. Cancer patients considering acupuncture should seek certified or state-licensed practitioners who have training or experience in working with cancer patients.

USES: To treat various symptoms associated with cancer and cancer treatment, including pain, fatigue, nausea and vomiting, depression, constipation, xerostomia, hot flashes, and neuropathy.

MECHANISMS: Although some acupuncture points coincide with pressure-sensitive trigger points, indicating enriched enervation at the anatomic location, biophysiologic and imaging research indicates that acupuncture can induce analgesia and activate the central nervous system.[1] Mechanisms remain an active topic of investigation.

RESEARCH: The World Health Organization supports the use of acupuncture as an effective intervention for lower back pain, postoperative pain, and adverse reactions to radiotherapy and chemotherapy.[2] A 1997 Consensus Conference at NIH concluded that acupuncture is effective in relieving pain, nausea, and osteoarthritis. Since that conference, a large research literature has expanded the evidence for additional benefits, and NIH continues to support clinical trials of acupuncture.

Current data support the use of acupuncture for chronic headache, chronic neck pain, chronic prostatitis/pelvic pain, and symptoms associated with fibromyalgia. In addition, studies show benefits against peripheral neuropathy[3] and a variety of other conditions. The role of acupuncture for symptom control in cancer is now well established, with substantial data supporting its ability to alleviate pain,[4] chronic fatigue, postoperative and chemotherapy-induced nausea and vomiting, and xerostomia.[5] Data from a recent randomized, placebo-controlled trial at Memorial Sloan-Kettering Cancer Center with 70 head and neck cancer patients confirmed the usefulness of acupuncture for pain and dysfunction as well as for xerostomia following head and neck surgery.[6]

CONTRAINDICATIONS: Neutropenia, thrombocytopenia, or history of endocarditis (acupuncture may increase risk of infection and bleeding); pregnancy (pregnant women should inform practitioners before seeking acupuncture treatment); lymphedema (needles should not be placed in lymphedematous limbs); pacemakers and other electronic medical devices.

References:

1. Yoo SS et al: Modulation of cerebellar activities by acupuncture stimulation: Evidence from fMRI study. Neuroimage 22:932-940, 2004
2. Traditional medicine, 2003. Available at www.WHO.int/mediacentre/factsheets/fs134/en/.
3. Schroder S et al: Acupuncture treatment improves nerve conduction in peripheral neuropathy. Eur J Neurol 14:276-281, 2007.
4. Alimi D et al: Analgesic effect of auricular acupuncture for cancer pain: A randomized, blinded, controlled trial. J Clin Oncol 21:4120-4126, 2003.
5. Johnstone PA et al: Acupuncture for xerostomia. Cancer 94:1151-1156, 2002.
6. Pfister D et al: Acupuncture for pain and dysfunction after neck dissection: Preliminary results of a randomized controlled trial (abstract 6016). J Clin Oncol 26(15S):320s, 2008.