Is acupuncture safe for cancer patients?


There is enough stress that comes with a cancer diagnosis to last a lifetime. You don’t need to also worry about your safety when you are at the acupuncturist’s office. Acupuncture is safe in cancer care, it is widely utilized by the leading cancer hospitals in the country, and it is shown to be effective in treating the side effects of cancer treatment - a huge source of anxiety for patients - as well as improving quality of life, as measured by patients themselves.


Bold claims! Let’s look at the data.



1. ACUPUNCTURE IS SAFE


The National Institute of Health (NIH) Consensus Statement on Acupuncture:


"One of the advantages of acupuncture is that the incidence of adverse effects is substantially lower than that of many drugs or other accepted medical procedures used for the same conditions." - NIH, 1997


From the Journal of American Medical Association (JAMA):


Retrospective Studies of Acupuncture Treatment Safety

The Frequency and Types of Adverse Events in 55,291 Acupuncture Treatments


99.8% of acupuncture is performed with no significant minor adverse events; During the 5 years of the study, a total of 76 acupuncturists (13 preceptors and 63 interns) participated in the study, and the total number of acupuncture treatments was 55291. A total of 64 adverse events were reported and included 11 types of events... The most frequent adverse event was failure to remove needles after treatment; no sequelae (problems) occurred after removal of the needles. The second most common adverse event was dizziness, discomfort, or perspiration probably due to transient hypotension (low blood pressure) associated with the acupuncture treatment.... We may, therefore, reasonably conclude that serious adverse events in acupuncture treatment are uncommon in the practice of adequately trained acupuncturists... ."


The most serious adverse events possible with acupuncture are pneumothorax (collapsing the lung due to puncture) and septicemia (systemic infection of the blood by bacteria); Instruction is given by both lectures and practical training and includes information about anatomically risky depth of insertion and use of aseptic procedure for puncturing... Most important, no serious events such as pneumothorax, spinal lesion, or infection were reported. JAMA, 1998



2. ACUPUNCTURE IS WIDELY UTILIZED


Acupuncture, Chinese herbal formulas, massage, and meditation - all forms of Traditional Chinese Medicine - are being researched and provided to patients by leading cancer care centers around the country, including:

  1. Dana-Farber Cancer Institute (Boston)

  2. University of California-San Diego (San Diego)

  3. Rady Children’s Hospital (San Diego)

  4. Memorial Sloan-Kettering Cancer Center (New York)

  5. M.D. Anderson Cancer Center (Houston)



3. ACUPUNCTURE IS EFFECTIVE


Acupuncture has been shown to provide significant therapeutic and palliative benefit for cancer patients when administered both before and following chemotherapy (1-3) or radiation, to ameliorate cancer-associated pain and fatigue (4,5), and to prevent chemotherapy-associated side effects, including nausea (6) and xerostomia (7). Further, some studies have suggested that myeloprotective effects of G-CSF can be provoked by acupuncture when given concurrent with chemotherapy (2, 8).


1.    Scotte, F. The importance of supportive care in optimizing treatment outcomes of patients with advanced prostate cancer. The oncologist 17 Suppl 1, 23-30 (2012).

2.    Lu, W. Acupuncture for side effects of chemoradiation therapy in cancer patients. Seminars in oncology nursing 21, 190-195 (2005).

3.    Chao, L.F., et al. The efficacy of acupoint stimulation for the management of therapy-related adverse events in patients with breast cancer: a systematic review. Breast cancer research and treatment 118, 255-267 (2009).

4.    Alimi, D., et al. Analgesic effect of auricular acupuncture for cancer pain: a randomized, blinded, controlled trial. Journal of clinical oncology : official journal of the American Society of Clinical Oncology 21, 4120-4126 (2003).

5.    Molassiotis, A., et al. Acupuncture for cancer-related fatigue in patients with breast cancer: a pragmatic randomized controlled trial. Journal of clinical oncology : official journal of the American Society of Clinical Oncology 30, 4470-4476 (2012).

6.    Rithirangsriroj, K., Manchana, T. & Akkayagorn, L. Efficacy of acupuncture in prevention of delayed chemotherapy induced nausea and vomiting in gynecologic cancer patients. Gynecologic oncology 136, 82-86 (2015).

7.    Meng, Z., et al. Sham-controlled, randomised, feasibility trial of acupuncture for prevention of radiation-induced xerostomia among patients with nasopharyngeal carcinoma. European journal of cancer 48, 1692-1699 (2012).

8.    Lu, W., et al. Acupuncture for chemotherapy-induced neutropenia in patients with gynecologic malignancies: a pilot randomized, sham-controlled clinical trial. Journal of alternative and complementary medicine 15, 745-753 (2009).



4. CANCER TREATMENT IS A SIGNIFICANT CAUSE OF ANXIETY


Anxiety and cancer treatment: response to stressful radiotherapy.

Andersen BL, Karlsson JA, Anderson B, Tewfik HH.

Abstract


Previous research with individuals undergoing surgery or diagnostic procedures provided a conceptual framework for analysis of radiation therapy, a common form of cancer treatment. The present investigation was designed to document the magnitude of anxiety patients experience in response to one particularly stressful form of radiation treatment. In addition, the change in anxiety responses with repeated exposures and individual differences among patients that may affect their adjustment were explored. In Part 1, gynecologic cancer patients receiving their first internal radiotherapy application were studied. As the time for treatment neared, subjective and physiologic indicants of anxiety and distress among the patients significantly increased. By 24 hours post-treatment, anxiety for all patients remained elevated. These post-treatment data are convergent with other investigations of post-treatment distress among cancer patients, but contrast with data obtained from those receiving treatment for benign conditions. A subset of the women who required two applications of radiotherapy participated in Part 2. These patients continued to respond negatively during the second treatment. Data on individual differences in anxiety responses (i.e., low vs. high anxiety) were obtained in both investigations and suggest that those with low levels of pre-treatment anxiety experience considerable disruption post-treatment.



4. ACUPUNCTURE IMPROVES QUALITY OF LIFE


Most patients improve after acupuncture, and a majority are satisfied with their level of care.


Patient-reported Outcomes of Acupuncture for Symptom Control in Cancer.

Thompson LM1, Osian SR2, Jacobsen PB3, Johnstone PA3.


Acupuncture is increasingly offered as a treatment option for managing cancer-related symptoms. In addition to randomized controlled trials, patient-reported outcomes may be needed to establish treatment effectiveness. This study retrospectively examined the symptoms and the satisfaction ratings of 90 patients receiving acupuncture at an integrative oncology clinic. At least two acupuncture sessions were completed by 72% of the sample. The prevalence rates of fatigue, pain, anxiety, physical distress, emotional distress, and poor quality of life before acupuncture were > 62%. Paired t tests revealed a significant reduction in symptoms from baseline until after the first acupuncture session and after the last session (p < 0.05). Fewer (21%) patients reported nausea, which was significantly reduced after the first session, but not the last session. Reductions represented clinically meaningful differences in 33-41% of patients after the first session and in 41-53% of patients after the last session for all symptoms, except nausea. A small subset of patients (0-8%) reported worsening symptoms after acupuncture. The majority were satisfied with the service. The results of this study suggest that acupuncture may be useful as an adjunct treatment for cancer symptom management. While high-quality trials are still needed to establish the treatment's efficacy, patients may benefit from these primarily safe, low-cost services.



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