Category Archives: acupuncture in cancer care

“Time for Acupuncture to Become Part of Standard Care”

The following article by Dr.Lorenzo Cohen, Ph.D., Professor and Director of the Integrative Medicine Program at the University of Texas, MD Anderson Cancer Center appeared in Huffington Post on December 7th, 2013. The article confirms many of the clinical uses for acupuncture in the area of Oncology. These uses are certainly confirmed by myself and other colleagues who have been working in this field utilizing acupuncture and herbal therapy for the past 20 years. Also medical treatment for cancer can easily feel ‘industrial’ and depersonalizing and the care received in acupuncture clinics can help people going through treatment for cancer feel re-empowered, nourished and supported.

In the article the author states that the “mechanisms are not well understood”,  this however is not true any longer with several writers/researchers outlining much of acupuncture’s modes of action in modern scientific understanding. See for example – http://www.amazon.com/Biomedical-Acupuncture-Pain-Management-Integrative/dp/0443066590 and http://www.amazon.com/Introduction-Western-Medical-Acupuncture-1e/dp/0443071772/ref=sr_1_1?s=books&ie=UTF8&qid=1386465583&sr=1-1&keywords=western+acupuncture

Thomas Martin LAc.

See also – http://www.ncbi.nlm.nih.gov/pubmed/23341529

“Acupuncture, the insertion of small, stainless steel needles into points on the body to stimulate specific areas, has been used in recent years by many cancer patients to help with symptom management. Because the mechanisms are not well understood, deciding when and how to safely add acupuncture to one’s treatment plan can be challenging. A recent systematic review conducted by researchers in the Integrative Medicine Program at the MD Anderson Cancer Center can now help patients and their oncologists make more informed choices.

The systematic review, published in the Journal of Clinical Oncology, searched the worldwide literature for randomized, controlled trials evaluating the use of acupuncture for symptom management in cancer patients.[1] Forty-one studies were found for the treatment of eight symptoms (pain — 11, nausea/vomiting — 11, postoperative ileus (constipation) — eight, xerostomia (dry mouth) — four, hot flashes — seven, fatigue — three, anxiety/depression/mood disorders — five, and sleep disturbance — three), and were rated for study quality and whether outcomes were positive or negative.

One well-designed large study undefined for the treatment of chemotherapy-induced nausea and vomiting, found electroacupuncture worked better than anti-nausea medications or sham acupuncture (minimal needling) in women with breast cancer.[2] Although less clear, the evidence also suggests acupuncture is helpful for pain control. None of the identified studies were classified as having a low risk of bias due to study weaknesses, but nine of the 11 pain studies had positive results favoring its use. For the other symptoms assessed, the quality of the studies was lower, but there is reason to believe that with larger more rigorous studies, acupuncture may be found beneficial for some of these conditions as well.

The use of acupuncture for symptom control in oncology is important to consider. Findings from this review and others indicate it is an appropriate treatment alongside conventional care for chemotherapy-induced nausea/vomiting, although additional studies are needed to better understand how it works and which patients might benefit most. For other symptoms, the specific effects of acupuncture remain undetermined, primarily due to weaknesses in the studies. As a low-risk, cost-effective treatment option, acupuncture may be helpful when combined with conventional care for patients suffering from uncontrolled treatment-related side effects or in those for whom other treatment approaches have failed.”

References:

1. Garcia MK, McQuade J, Haddad R, Patel S, Lee R, Palmer JL, Yang P, Cohen L. “Acupuncture in cancer care: a systematic review.” Journal of Clinical Oncology (Published online before print Jan. 22, 2013). doi: 10.1200/JCO.2012.43.5818)

2. Shen J, Wenger N, Glaspy J, Hays RD, Albert PS, Choi C, Shekelle PG. “Electroacupuncture for control of myeloablative chemotherapy-induced emesis: A randomized controlled trial.” JAMA 284:2755-61, 2000.

Acupuncture Improves Lung Function and Overall Health in COPD

Sixty-eight of 111 patients from the Kansai region of Japan who were diagnosed as having COPD and were receiving standard medication participated in a randomized, parallel-group, placebo-controlled trial. COPD is considered a non-reversible condition that can severely reduce lung function. It is predicted to be the third leading cause of death worldwide by 2020.

In both groups patients were treated with real or placebo needling at the same acupoints once a week for 12 weeks.The placebo needling involved an apparatus that looked like a real acupuncture needle but only pressed the skin surface.

The primary end point, or study result was the modified Borg scale score evaluated immediately after the 6-minute walk test. This is a scale used to evaluate shortness of breath after exertion.

After 12 weeks, the Borg scale score after the 6-minute walk test was significantly better in the real acupuncture group compared with the placebo acupuncture group. Also improvements in nutritional status, body mass and over-all quality of life was seen in the acupuncture group.

We demonstrated clinically relevant improvements in DOE (Borg scale), nutrition status (including BMI), airflow obstruction, exercise capacity, and health-related quality of life after 3 months of acupuncture treatment 

http://archinte.jamanetwork.com/article.aspx?articleid=1151703

In clinical practice I have often seen improved breathing and voice strength following acupuncture treatment even when the lungs or chest was not the primary focus of treatment. Acupuncture can be a valuable adjunctive treatment for chronic asthma and I have seen it to be of considerable help with breathlessness in people with a cancer diagnosis. Improved wellbeing and functionality is another non-specific outcome often seen following a course of acupuncture.

 

Thomas J Martin LAc.

 

 

Acupuncture For Breast Cancer Related Lymphedema

 

A significant number of breast cancer survivors develop a long-term, difficult to treat, symptom called lymphedema. This involves swelling of the arm, shoulder or breast on the side in which breast tumors and lymph nodes were removed and or radiation treatment performed. The swelling is due to changes in flow of the fluid within lymph vessels in the area, though the exact process is unknown.

Results from a small pilot study led by Barrie r. Cassileth, chief of Memorial Sloan-Kettering’s Integrative Medicine Service, and Clifford a. Hudis, chief of the Breast Cancer Medicine Service, was published April 10 in The Journal Cancer

http://www.ncbi.nlm.nih.gov/pubmed/23576267

Study participants received acupuncture at Memorial Sloan-Kettering twice weekly for four weeks, using a regimen developed by the Integrative Medicine Service.

Researchers measured the participants’ upper-arm circumference before and after the treatments. They found that among the 33 patients who received acupuncture, 11 had a significant reduction in swelling and another 18 had at least a small reduction. When contacted several weeks later for feedback, patients reported lasting improvement in swelling.

Dr. Cassileth stated the study showed that acupuncture as a treatment for lymphedema is safe and well tolerated with no serious side effects.

http://www.mskcc.org/blog/study-shows-acupuncture-may-relieve-chronic-lymphedema-after-breast-treatment

 

These results confirm what I have seen clinically treating this condition in women diagnosed with breast cancer with acupuncture for the past 18 years. One of the main effects of acupuncture being improved blood and lymph flow.

Thomas Martin LAc.

Acupuncture for treatment of hot flashes in cancer therapy related hormone suppression

A unique study was presented September 24, 2008, at the American Society for Therapeutic Radiology and Oncology’s 50th Annual Meeting in Boston titled Acupuncture for the Treatment of Vasomotor Symptoms in Breast Cancer Patients Receiving Hormone Suppression Treatment

It involved 47 breast cancer patients undergoing estrogen suppression treatment with Tamoxifen and Arimidex, drugs that frequently result in the debilitating side effects of hot flashes, night sweats, and excessive sweating (vasomotor symptoms)

Patients were divided into two groups, one group used the antidepressant, venlafaxine (Effexor), a selective serotonin reuptake inhibitor,which is one of the most common drugs used to treat these hot flashes. The other group was given acupuncture only.

The acupuncture group showed similar reduction of hot flashes, night sweats, and excessive sweating but without the antidepressants side effects and with improvement in the sense of wellbeing and of energy. These results remained stable with followup.

Our study shows that physicians and patients have an additional therapy for something that affects the majority of breast cancer survivors and actually has benefits, as opposed to more side effects. The effect is more durable than a drug commonly used to treat these vasomotor symptoms and, ultimately, is more cost-effective for insurance companies,” Eleanor Walker, M.D., lead author of the study and a radiation oncologist at the Henry Ford Hospital Department of Radiation Oncology in Detroit, said.

 

 

Similar results have been shown with men experiencing hot flashes, sweats and other symptoms resulting from hormonal suppression for prostate cancer. These were reported in International Journal of Radiation Oncology * Biology * Physics Volume 79, Issue 5 , Pages 1358-1363, 1 April 2011 and titled Acupuncture for the Alleviation of Hot Flashes in Men Treated With Androgen Ablation Therapy

 

It was noted that “Acupuncture provides excellent control of hot flashes in men with a history of AAT (androgen ablation therapy) . The absence of side effects and the durable response at 8 months are likely to be appealing to patients.”

 

The breast cancer study confirms efficacy of acupuncture frequently seen in complementary cancer care with women undergoing breast cancer treatment. Fewer men undergoing hormonal suppression appear to use acupuncture but reduction in vasomotor symptoms seen in the prostate cancer study may involve a similar mechanism.

Thomas Martin LAC