Acupuncture as Palliative Therapy for Physical Symptoms and Quality of Life for Advanced Cancer Patients

Leonard P. Zakim Center for Integrative Therapies, Dana-Farber Cancer Institute, 44 Binney St., Boston, MA 02115, USA.
Integrative Cancer Therapies (Impact Factor: 2.36). 06/2010; 9(2):158-67. DOI: 10.1177/1534735409360666
Source: PubMed


Acupuncture is underutilized as an adjunct cancer therapy. The main study objectives were to determine the feasibility of administering acupuncture as palliative therapy to patients with advanced ovarian or breast cancer and to assess the effect on symptoms and quality of life (QOL).
This study was a pilot, single-armed prospective clinical trial for patients with advanced cancer to receive 12 acupuncture sessions over 8 weeks with follow-up at weeks 9 and 12. Ambulatory patients with advanced ovarian or breast cancer were enrolled to receive treatments at an outpatient academic oncology center. Symptom severity was measured before and after each acupuncture session.A composite QOL assessment tool, consisting of validated instruments, was completed at 5 time points.
Forty patients enrolled in the study. Twenty-eight patients (70%; 95% confidence interval [CI] = 53%-83%) completed 4 weeks of treatment, and 26 patients (65%; 95% CI = 48%-79%) completed 8 weeks. Eight patients (20%) withdrew before receiving acupuncture, and 6 patients (15%) discontinued treatment early because of disease progression or scheduling demands. Among all 32 assessed patients, there was self-reported improvement immediately post-treatment in anxiety,fatigue, pain, and depression and significant improvement over time for patients with anxiety (P = .001) and depression(P = .02). Among patients experiencing baseline symptoms, there was improvement in anxiety (P = .001), fatigue (P = .0002),pain (P = .0002), and depression (P = .003). QOL measures of pain severity and interference, physical and psychological distress, life satisfaction, and mood states showed improved scores during treatment, with sustained benefit at 12 weeks.
This pilot study demonstrates that an 8-week outpatient acupuncture course is feasible for advanced cancer patients and produces a measurable benefit that should be evaluated in controlled trials.

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Available from: Aparna Keshaviah, Sep 29, 2014
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    • "Acupuncture was used by 3.9% patients before cancer diagnosis and by 3% patients after cancer diagnosis . Acupuncture has also been shown to be effective for chemotherapy induced nausea and vomiting [11], xerostomia induced by radiation therapy [12] [13], fatigue [14], anxiety, depression, and insomnia [15]. Furthermore, acupuncture has been used encouragingly to treat peripheral neuropathy associated with diabetes and HIV [16] [17] [18] [19] [20] [21] [22]. "
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    ABSTRACT: Chemotherapy-induced peripheral neuropathy (CIPN) is a common side effect that can be very disabling and can limit or delay the dose of chemotherapy that can be administered. Acupuncture may be effective for treating peripheral neuropathy. The aim of this study was to review the available literature on the use of acupuncture for CIPN. The systematic literature search was performed using MEDLINE, Google Scholar, Cochrane Database, CINHAL, and ISI Proceedings. Hand searching was conducted, and consensus was reached on all extracted data. Only papers in the English language were included, irrespective of study design. From 3989 retrieved papers, 8 relevant papers were identified. One was an experimental study which showed that electroacupuncture suppressed CIPN pain in rats. In addition, there were 7 very heterogeneous clinical studies, 1 controlled randomised study using auricular acupuncture, 2 randomized controlled studies using somatic acupuncture, and 3 case series/case reports which suggested a positive effect of acupuncture in CIPN. Conclusions. Only one controlled randomised study demonstrated that acupuncture may be beneficial for CIPN. All the clinical studies reviewed had important methodological limitations. Further studies with robust methodology are needed to demonstrate the role of acupuncture for treating CIPN resulting from cancer treatment.
    Evidence-based Complementary and Alternative Medicine 07/2013; 2013(4):516916. DOI:10.1155/2013/516916 · 1.88 Impact Factor
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    • "Although a Cochrane systematic review of acupuncture for insomnia in 2007 concluded that acupuncture or its variants were not more effective than the control groups [222], five clinical studies showed significant improvement in anxiety and depression over time in patients who underwent acupuncture treatment. QOL measures of pain severity and interference, physical and psychological distress, life satisfaction, and mood states also showed improved scores after acupuncture treatment [223–227]. "
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    ABSTRACT: Breast cancer is a life-threatening disease among women worldwide with annual rates of reported incidence and death increasing alarmingly. Chemotherapy is a recommended and effective treatment option for breast cancer; however, the narrow therapeutic indices and varied side effects of currently approved drugs present major hurdles in increasing its effectiveness. An increasing number of literature evidence indicate that complementary and alternative medicine (CAM) used in treatment-related symptom control and alleviation of side effects plays an important role in increasing survival rate and quality of life in breast cancer patients. This review focuses on the use of herbal medicines and acupuncture in palliative care and as adjuvants in the treatment of breast cancer. Herbal medicinal treatments, the correlation of clinical use with demonstrated in vitro and in vivo mechanisms of action, and the use of certain acupoints in acupuncture are summarized. The aim of this review is to facilitate an understanding of the current practice and usefulness of herbal medicine and acupuncture as adjuvants in breast cancer therapy.
    Evidence-based Complementary and Alternative Medicine 06/2013; 2013:437948. DOI:10.1155/2013/437948 · 1.88 Impact Factor
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    • "Acupuncture, a mind-body technique that is also classified as manipulative body-based technique and energy-based technique, has been shown to ameliorate distress in healthy adults [107]. It has also been found to reduce fatigue and distress in patients with advanced breast and ovarian cancer [108]. A recent systematic review of 15 studies of CAM interventions (acupuncture, massage, yoga and relaxation, hypnosis, vitamins, and medical qigong) in cancer-related fatigue reported most benefits from acupuncture [109]. "
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    ABSTRACT: A cancer diagnosis elicits strong psychophysiological reactions that characterize stress. Stress is experienced by all patients but is usually not discussed during patient-healthcare professional interaction; thus underdiagnosed, very few are referred to support services. The prevalence of CAM use in patients with history of cancer is growing. The purpose of the paper is to review the aspects of cancer-related stress and interventions of commonly used complementary and alternative techniques/products for amelioration of cancer-related stress. Feasibility of intervention of several CAM techniques and products commonly used by cancer patients and survivors has been established in some cancer populations. Efficacy of some CAM techniques and products in reducing stress has been documented as well as stress-related symptoms in patients with cancer such as mindfulness-based stress reduction, yoga, Tai Chi Chuan, acupuncture, energy-based techniques, and physical activity. Much of the research limitations include small study samples and variety of intervention length and content. Efficacy and safety of many CAM techniques and some herbs and vitamin B and D supplements need to be confirmed in further studies using scientific methodology. Several complementary and alternative medicine therapies could be integrated into standard cancer care to ameliorate cancer-related stress.
    Evidence-based Complementary and Alternative Medicine 07/2012; 2012(2):979213. DOI:10.1155/2012/979213 · 1.88 Impact Factor
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