The management of cancer-related fatigue after chemotherapy with acupuncture and acupressure: A randomised controlled trial. Complementary Therapies in Medicine, 15, 228-237

University of Manchester, School of Nursing, Midwifery & Social Work, Coupland III, Coupland Street, Manchester M13 9PL, UK.
Complementary Therapies in Medicine (Impact Factor: 1.55). 12/2007; 15(4):228-37. DOI: 10.1016/j.ctim.2006.09.009
Source: PubMed


Cancer-related fatigue after chemotherapy is a difficult symptom to manage in practice and the most disruptive symptom in patients' lives. Acupuncture is a popular complementary therapy among cancer patients and some evidence exists that it could potentially alleviate fatigue by stimulating 'energy' points in the body. Hence, this study was carried out to assess the effects of acupuncture and acupressure in managing cancer-related fatigue and the feasibility of running a randomised trial with these two complementary therapies in preparation for a large trial.
This study was a randomised controlled trial. Forty-seven patients with cancer who experienced moderate to severe fatigue were randomised either to an acupuncture group (n=15), an acupressure group (n=16) or a sham acupressure group (n=16). The acupuncture group received six 20-min sessions over 2 weeks, while the patients in the two acupressure groups were taught to massage/press the points and did so daily thereafter for 2 weeks on their own. Patients completed the Multidimensional Fatigue Inventory before randomisation, at the end of the 2-week intervention and again about 2 weeks after the end of the intervention.
Significant improvements were found with regards to General fatigue (P<0.001), Physical fatigue (P=0.016), Activity (p=0.004) and Motivation (P=0.024). At the end of the intervention, there was a 36% improvement in fatigue levels in the acupuncture group, while the acupressure group improved by 19% and the sham acupressure by 0.6%. Improvements were observed even 2 weeks after treatments, although they were lower (22%, 15%, 7%, respectively). Acupuncture was a more effective method than acupressure or sham acupressure. Subjects needed a longer treatment period to have more sustained results. The trial was methodologically feasible.
Acupuncture shows great potential in the management of cancer-related fatigue. As a randomised trial with acupuncture is feasible and preliminary data shows significant improvements, it should be tested further using a large sample and a multicentre design.


Available from: Alex Molassiotis
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    • "For example , some cancer survivors find that acupuncture is helpful for management of late and long-term treatment adverse effects. One small, randomized controlled trial (N=80) suggested that acupuncture was more beneficial than fluoxetine for sleep [18], and four randomized controlled trials (patient numbers ranged from 50 to 302) suggested that acupuncture reduced depression more than medications or usual conventional medical care1819202122. Acupuncture also was found to be a better therapy for anxiety than usual care (N=302) [22]. However, data are limited and mixed (particularly from studies that randomly assigned participants to real or sham acupuncture) [23, 24]. "
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    • "In a prospective phase II study on patients with persistent fatigue who had previously completed chemotherapy, acupuncture resulted in a significant reduction in baseline fatigue scores [212]. Further four RCTs showed that acupuncture was associated with a significant improvement in general fatigue scores [213–216]. "
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    Full-text · Article · Jun 2013 · Evidence-based Complementary and Alternative Medicine
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    • "Acupuncture: Balk et al (Balk et al., 2009) claimed no subjects experienced adverse events. Molassiotis et al (Molassiotis et al., 2007) (published in 2007) reported spot bleeding in 2/90 cases, bruise in one point in 1/90 patients, 1 patient feeling nauseous after the end of treatment, no severe ones were seen. Molassiotis et al (Molassiotis et al., 2012) (published in 2012) stated that therapists completed a form verifying adverse effects after each session, but no corresponding descriptions afterwards. "
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