Acupuncture and Cancer
Though the mechanisms of action of acupuncture are not well-understood and continue to be an area of research, hypotheses include changes in neurohormones and immunomodulation through cytokines.
Acupuncture is a traditional Chinese medicine methodology that applies stimulation to acupuncture points with the purpose of returning normal energy (qi) flow to meridians, or channels, that are thought to flow throughout the body.1 Acupuncture has been practiced for over 4,000 years in Asia and has been used in the United States for about 200 years.
A panel convened by the National Institutes of Health in 1997 stated that needle acupuncture is an effective treatment for chemotherapy-induced nausea and vomiting (CINV) and may be effective for other cancer- or cancer treatment–related conditions.1 Though the mechanisms of action of acupuncture are not well-understood and continue to be an area of research, hypotheses include changes in neurohormones and immunomodulation through cytokines.
Acupuncture has been studied in clinical trials, albeit usually of small sample sizes, for multiple supportive care issues in patients with cancer. Many trials demonstrate favorable results with few adverse events, but larger, well-controlled trials are needed to validate the results from these smaller trials.
Acupuncture in Supportive Care
A meta-analysis conducted in 2013 found that of 11 randomized controlled trials (RCTs), 1 had low risk of bias.2 This trial demonstrated that electroacupuncture significantly decreased emesis episodes compared with minimal needling (P < .001), and minimal needling was more effective than antiemetic agents (P = .01). A more recent study, however, found no difference in rates and severity of CINV with transcutaneous electrical acupoint stimulation compared with a sham procedure among 142 patients receiving cisplatin for liver cancer.3
A more recent meta-analysis conducted in 2017 evaluated the use of moxibustion, in which burning dried leaves of Asian mugwort is used to stimulate acupoints, for the treatment of CINV.4 Moxibustion resulted in significantly less severe and lower frequency CINV episodes compared with no treatment (risk ratio [RR], 2.04; 95% CI, 1.42-2.93) and provided significant improvement compared with antiemetic agents (RR, 1.87; 95% CI, 1.27-2.76).
Conducted after the 2013 meta-analysis, a blinded study of 68 patients with solid tumors randomly assigned to acupuncture or a sham procedure for a median of 10 sessions during 4 weeks demonstrated that acupunctured reduced the amount of rescue antiemetics used and decreased the severity of nausea compared with the sham.5