By K. Simon Yeung, PharmD, LAc, Manager, "About Herbs" website, Memorial Sloan-Kettering Cancer Center (MSKCC)
In the last two decades, many cancer survivors have turned to complementary and alternative therapies, including acupuncture. According to the National Center of Complementary and Alternative Medicine, acupuncture is considered a form of mind-body medicine. A report by the Centers for Disease Control indicated that more than 8 million Americans use acupuncture to treat different ailments, and a recent study found that more than 10% of cancer survivors use acupuncture. Based on scientific evidence and additional research, major cancer hospitals have incorporated acupuncture using an integrative approach for more effective management of the many symptoms related to cancer and cancer treatment.
While acupuncture is thought to have originated in Asia more than 2,000 years ago, evidence indicates that it is not unique to this region. Obscure tattoo patterns found on mummified bodies in Europe and in South America suggest that treatments similar to acupuncture were used by other ancient civilizations.
However, the form of acupuncture practiced today is based mainly on a comprehensive standardized system which evolved in China around half a century ago. Other countries such as Korea and Japan also developed unique styles. Traditionally, acupuncture is often used in conjunction with herbal medicines to treat diseases. In Western medicine, it has become a viable component of supportive care to treat a range of symptoms, conditions, and treatment side effects, as well as to assist in lifestyle changes.
How does it work?
Acupuncture treatment involves the stimulation of defined acupoints on the body using ultrathin needles or electricity for therapeutic effect. In traditional Chinese medicine, the human body surface and the internal organs are thought to be connected by meridians through which “Qi,” a form of energy, flows. Pain and disease are believed to occur when the flow of Qi is blocked. Stimulating acupoints on the meridians can heal by restoring the flow of Qi.
In biomedicine, acupuncture has been shown to stimulate the secretion of beta-endorphins to relieve pain. Further research suggests that acupuncture treatment can modulate other neurotransmitters and the immune system. Some hypothesize that the positive interaction between the practitioners and patients, as well as the placebo effect may also contribute to the therapeutic properties of acupuncture. The exact mechanisms that account for the various effects of acupuncture are still under investigation.
Acupoints can also be stimulated manually using finger pressure. This is known as acupressure. Moxibustion is a related technique that uses heat generated from the burning of an herb to stimulate the acupoints. However, this method is not commonly used in the cancer setting due to emission of smoke and fire hazards.
Acupuncture is one of the most studied forms of complementary medicine. Data from clinical trials generally support its use for arthritis, migraine headache, low-back pain, menstrual pain, and to improve outcomes in women following in-vitro fertilization. Some studies have also demonstrated the cost-effectiveness of acupuncture compared with standard treatments.
Role in Cancer Treatment
While acupuncture cannot be used to treat cancer, it can address many symptoms associated with cancer and cancer therapies. Data from several major clinical studies show promising results. For example, acupuncture can control chemotherapy-induced nausea and vomiting. Stimulating a point above the wrist by electricity was more effective than antiemetic drugs in controlling nausea.
Many breast cancer survivors have hot flashes caused by drugs used to suppress estrogen. One study demonstrated that acupuncture is as effective as prescription drugs in controlling hot flashes with virtually no adverse effects. In addition, acupuncture helped increase libido in this population. Some breast cancer survivors are treated with drugs known as aromatase inhibitors to help prevent recurrence, but these drugs can cause joint pain and stiffness. One study found that acupuncture is effective in reducing these side effects, thereby allowing the drug regimen to be continued.
Acupuncture has also been shown to improve muscle weakness and dry mouth caused by chemotherapy and radiation therapy in patients with head and neck cancer. A study confirmed that by stimulating a point on the index finger, patients experienced relief from dry mouth. There are also reports showing reduced nerve pain associated with neuropathy and reduced swelling and discomfort caused by lymphedema when patients receive acupuncture treatment. Clinical trials are being developed to study these positive effects.
Safety and Contraindications
Acupuncture is generally safe and well tolerated by patients including children. Adverse events are rare but can include bleeding, bruising, infection, and puncturing of internal organs. Pregnant women, those wearing pacemakers, and those with low platelet counts should inform their practitioners before receiving acupuncture. Some conditions require continuous treatments in order to achieve long-term effect.
Acupuncturists are well-trained healthcare professionals. Most have a Master’s or more advanced degrees. Some acupuncturists also receive specialized training in treating cancer patients. Many states consider acupuncturists to be primary care providers, meaning that no special referrals are needed. When seeking a practitioner, it is important to verify their credentials and experience. Consumers can check the license or registration of practitioners online through their state medical board licensing agencies. The National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM) also maintains a Web site to help consumers locate qualified acupuncturists at www.nccaom.org/find-an-acupuncture-practitioner-directory. Acupuncture treatments are generally affordable and are covered by some healthcare insurance policies.
Acupuncture is a safe, effective, and relatively inexpensive means to address many cancer- and cancer treatment-related symptoms. Cancer survivors are encouraged to explore this option to help maintain quality of life.