Acupuncture in Cancer Care: Top 5 Uses

Acupuncture can be incredibly useful in cancer care in a number of ways. There are several side effects of chemotherapy and radiation that can be dealt with effectively by acupuncture and I'm going to give you the top 5. This is just one of the many complementary therapies that I can share with you to help deal with the side effects of cancer treatment.  This is not intended as medical advice. Please talk to your doctor before beginning any new health practice.

Transcript:

Hello!  Welcome to Cancer Straight Talk.  I’m Dr. Lisa Schwartz and today I am going to talk to you about how acupuncture can be really useful in cancer care.  During my radiation oncology practice, I was asked time and again about various complementary therapies that my patients wanted to use during their treatment.  Most commonly they wanted to use herbs and supplements so I started my studies of complementary therapies there.  I saw patients taking more control over their care and treatment and really feeling more empowered just from the simple fact that they could choose to take some herbs or supplements that would benefit them.  And it was their decision.  In addition, there were studies being published in the mainstream oncology literature about the benefits of certain complementary therapies like meditation, yoga, massage, and acupuncture.  The studies in acupuncture really intrigued me because here we were talking about a system of medicine that is thousands of years old, it clearly works, and we in western medicine don’t quite understand why it works.  So I took some time to learn about acupuncture and I earned a master’s degree in Traditional Chinese Medicine.  During my course of study I learned to practice acupuncture, prescribe Chinese herbs, and gained an in depth understanding of Chinese medical theory.  So I have a real appreciation for the areas in cancer care where acupuncture can have a real impact.

It's hot in here!

So let’s get started with those.  The first would be hot flashes.  There are a number of reasons that cancer patients have hot flashes.  For women it is usually from being taken off of hormone replacement therapy for menopause and going through hormone withdrawal.  It is also the most common complaint with taking a medicine called Tamoxifen which is an estrogen blocker.  Men can have hot flashes too and we see this sometimes with hormone manipulation in prostate cancer.  Most commonly hot flashes have been studied in women though.  One of the more common treatments is to put women on anti-depressants for hot flashes (not because they are depressed but these medications can decrease the number of hot flashes).  One of the problems with anti-depressants though is that there are usually a few side effects.  Acupuncture is commonly used even outside of cancer care for the treatment of hot flashes which are due to a Yin deficiency.  So there was a study done in which women who were breast cancer patients and suffering from hot flashes were randomized to be placed on an anti-depressant called venlafaxine (Effexor) or to receive acupuncture.  This was a small study with only 25 patients in each arm.  Turns out the investigators had difficulty recruiting patients because they did not want to chance being randomized to the anti-depressant—which tells me there is a lot of resistance to taking an anti-depressant but none to acupuncture.  Both groups received 12 weeks of their assigned treatment and both groups experienced a significant decrease in hot flashes.  With extended followup out to about a year both groups showed about the same improvement. So acupuncture was as effective as the drug.  In addition though, women taking the anti-depressant experienced side effects such as dry mouth, constipation, and nausea.  Women receiving acupuncture had some effects too—they described an increased libido, improvements in energy and clarity of thought, as well as a sense of well-being.  Hate it when you have side effects like that!  So if hot flashes are a problem, talk to your oncologist about giving acupuncture a try before the anti-depressants.

I'm sooooo tired!

Next is probably the most common side effect of cancer treatment because there are so many potential causes and contributing factors.  And that is fatigue.  In most patients the fatigue goes away during the recovery period from treatment.  In some cases however, chronic fatigue persists in spite of getting plenty of rest, returning to a normal diet, and resuming some physical activity.  For this group of patients fatigue can really prevent a return to normal life.  There was a study done at Memorial Sloan Kettering which is a huge and very well respected cancer hospital in NYC.  They took patients who were still having problems with fatigue an average of more than 2 years after their chemotherapy had been completed.  Everything they had tried for fatigue had failed.  They did baseline measures of fatigue and half of the patients qualified as having “severe” fatigue.  So a significant impact on their lives.  This was a phase II trial so all of the participants got acupuncture.  After just 6 weeks of treatment, the average improvement in fatigue was 31%--in a group of patients in which no other intervention had worked.  You don’t have to wait until your treatment is completed.  You can get acupuncture to treat fatigue even during your cancer treatment.

I hurt...stick me with needles!

The third top use for acupuncture in cancer care is to treat pain.  Acupuncture being used to treat pain is such a common practice that even most conventional physicians recognize its benefits.  Even though it is customary for me to quote studies when I tell you some complementary therapy is beneficial, there are so many in this area that it would bore you to tears—so I am going to refrain from referencing a bunch of data and just tell you that acupuncture has been found to be successful for post-op pain, chronic pain, pain that opioids are not quite covering, back pain, arthralgias from aromatase inhibitors (which is a very common problem in breast cancer patients), and neuropathy which some chemotherapies can cause.  Which brings up a success story with acupuncture that I can share with you.  I saw an elderly woman who had a pelvic tumor and had had numerous surgeries, chemotherapies, and radiation for her treatment.  Both her uncontrolled cancer and the treatments had caused a lot of significant side effects and at the time I saw her, she was in a wheelchair and on hospice care.  She couldn’t walk because of severe neuropathy in her feet.  I made a few recommendations for her to help with her symptoms and among those was acupuncture for her neuropathy—which she said she would do (which is the first step—you actually have to get acupuncture).  I saw her about 3 to 4 months later at the cancer center and did not recognize her at first.  She was up and walking with a cane.  She gave me a big hug and told me how much acupuncture had helped her pain from neuropathy and she was able to walk again.

I don't feel so good...

Another common problem in cancer care is nausea.  This is something we see after surgery and related to chemotherapy.  In both instances, acupuncture has a significant impact on decreasing nausea even with nausea medicines.  In other words, in trials where some patients took nausea medicines and others took nausea medicines and had acupuncture, the acupuncture provided additional nausea relief.  For patients trying to prevent or treat nausea related to their chemotherapy, I recommend getting acupuncture the day before, the morning of (if possible), the day after, and 2 to 3 days after the chemotherapy.  Chemotherapy can cause both immediate and delayed nausea and acupuncture works for both.  We have great prescription medicines for nausea so be sure you are taking those in addition to acupuncture.

Dry as a bone

Last but not least is a problem that only occurs in a small number of patients with cancer but it can have a significant impact on a patient’s quality of life.  That problem is a dry mouth or what we in white coats call xerostomia. This is most common in patients with head and neck cancer who have received radiation.  Now radiation oncologists are very sensitive to trying to prevent this problem by protecting the salivary glands from radiation.  Sometimes though this cannot be prevented just because of the areas that need to receive radiation.  Using acupuncture for this problem was first looked at by a radiation oncologist at UCSD.  What he found was that patients with dry mouth that persisted in spite of prescription medicines used to treat this condition, still had a response of improved salivary function with a short course of acupuncture.  So in a situation where conventional medicine has few treatment options, acupuncture can be really effective. 

So that’s our top 5 list.  Hot flashes, fatigue, pain, nausea, and dry mouth.  All conditions for which acupuncture has demonstrated a positive effect in clinical trials.  I want to thank you for your time and attention.  I certainly hope this has been helpful for you.  It would make me really happy if you would leave a comment below with any questions you may have and click the like button if you enjoyed this.  If you are watching this anywhere other than my blog, please go to CancerStraightTalk.com and sign up for further posts and updates.  Take care and be well.