Aromatase inhibitors (AIs) can be highly beneficial in treating postmenopausal women with estrogen receptor-positive breast cancer; however, side effects may cause a significant number of women to stop treatment. Now, a new study has shown that both real acupuncture and “sham” acupuncture may help combat those side effects.

“I was surprised that the sham acupuncture worked so well,” said study investigator Ting Bao, MD, an assistant professor of medicine at the University of Maryland, Baltimore, MD.

The study included 47 postmenopausal women with stage 0 to 3 hormone receptor-positive breast cancer who had been receiving AI therapy for at least 1 month. The median age of participants was 61 years (range: 45 to 85 years); 23 patients received eight weekly real acupuncture treatments, while 24 received eight weekly sham acupuncture treatments. The researchers collected weekly diaries regarding patient hot flashes during weeks 0 through 8 and week 12. They also used extensive questionnaires addressing menopausal symptoms, mood, sleep quality, depression, anxiety, and quality of life; these were completed at baseline and then again at weeks 4, 8, and 12.

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The study results showed the median percentage change in hot flash severity scores from baseline improved 54% for the sham acupuncture group and 31% for the real acupuncture group.1 Significant improvements were demonstrated for depression, hot flash severity and frequency, daily interference related to the hot flashes, and other menopausal symptoms among those patients receiving real acupuncture. Among those receiving sham acupuncture, statistically significant improvements were found in quality of life, hot–flash-related daily interference, and menopausal symptoms.

Dr. Bao said that the sham acupuncture, which is performed using nonpenetrating, retractable needles at non-acupuncture points in the body, may have some unexplained physiologic effects. The results of this study add to data from other studies, which have shown that the sensation of skin pricks used to simulate genuine acupuncture needle sticks might be enough to stimulate chemical changes that improve symptoms. In a previous study published in the journal, Breast Cancer Research and Treatment, Dr. Bao and her colleagues found that both real and sham acupuncture treatments could help improve musculoskeletal symptoms, including a statistically significant reduction in the inflammatory protein interleukin-17.2

“If you are skeptical, then there is less of a placebo effect. We don’t know who was skeptical in this study—that is something we will look at in the future,” said study senior author Vered Stearns, MD, professor of oncology at the Johns Hopkins University School of Medicine, Baltimore, MD.