Skip to main content

Advertisement

SpringerLink
Log in

The efficacy of acupoint stimulation for the management of therapy-related adverse events in patients with breast cancer: a systematic review

  • Review
  • Published:
Breast Cancer Research and Treatment Aims and scope Submit manuscript

Abstract

The aim of the present study was to scrutinize the evidence on the use of acupoint stimulation for managing therapy-related adverse events in breast cancer. A comprehensive search was conducted on eight English and Chinese databases to identify clinical trials designed to examine the efficacy of acupressure, acupuncture, or acupoint stimulation (APS) for the management of adverse events due to treatments of breast cancer. Methodological quality of the trials was assessed using a modified Jadad scale. Using pre-determined keywords, 843 possibly relevant titles were identified. Eventually 26 papers, 18 in English and eight in Chinese, satisfied the inclusion criteria and entered the quality assessment stage. The 26 articles were published between 1999 and 2008. They assessed the application of acupoint stimulation on six disparate conditions related to anticancer therapies including vasomotor syndrome, chemotherapy-induced nausea and vomiting, lymphedema, post-operation pain, aromatase inhibitors-related joint pain and leukopenia. Modalities of acupoint stimulation used included traditional acupuncture, acupressure, electroacupuncture, and the use of magnetic device on acupuncture points. Overall, 23 trials (88%) reported positive outcomes on at least one of the conditions examined. However, only nine trials (35%) were of high quality; they had a modified Jadad score of 3 or above. Three high quality trials revealed that acupoint stimulation on P6 (NeiGuang) was beneficial to chemotherapy-induced nausea and vomiting. For other adverse events, the quality of many of the trials identified was poor; no conclusive remarks can be made. Very few minor adverse events were observed, and only in five trials. APS, in particular acupressure on the P6 acupoint, appears beneficial in the management of chemotherapy-induced nausea and vomiting, especially in the acute phase. More well-designed trials using rigorous methodology are required to evaluate the effectiveness of acupoint stimulation interventions on managing other distress symptoms.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. American cancer society (2008) Available at http://www.Cancer.Org. Accessed 02 dec 2008

  2. Department of health, roc (2009) Available at http://www.Doh.Gov.Tw. Accessed 17 feb 2009

  3. Cancer research UK (2009) Breast cancer: UK breast cancer statistics available at/http://info.Cancerresearchuk. Org/cancerstats/types/breast, accessed 17 feb 2009

  4. Boekhout AH, Beijnen JH, Schellens JHM (2006) Symptoms and treatment in cancer therapy-induced early menopause. Oncologist 11(6):641–654

    Article  CAS  PubMed  Google Scholar 

  5. Loprinzi CL, Zahasky KM, Sloan JA, Novotny PJ, Quella SK (2000) Tamoxifen induced hot flushes. Clin Breast Cancer 1:52–56. doi:10.3816/CBC

    Article  CAS  PubMed  Google Scholar 

  6. Baber R, Hickey M, Kwik M (2005) Therapy for menopausal symptoms during and after treatment for breast cancer: safety considerations. Drug Saf 28(12):1085–1100

    Article  CAS  PubMed  Google Scholar 

  7. Hickok JT, Roscoe JA, Morrow GR, Stern RM, Yang B, Flynn PJ, Hynes HE, Kirshner JJ, Rosenbluth RJ (1999) Use of 5-ht3 receptor antagonists to prevent nausea and emesis caused by chemotherapy for patients with breast carcinoma in community practice settings. Cancer 86(1):64–71

    Article  CAS  PubMed  Google Scholar 

  8. Dayes IS, Levine MN, Julian JA, Pritchard KI, D’Souza DP, Kligman L, Reise D, Wiernikowski JA, Bonilla L, Whelan TJ (2008) Lymphedema in women with breast cancer: characteristics of patients screened for a randomized trial. Breast Cancer Res Treat 110(2):337–342. doi:310.1007/s10549-10007-19727-10540

    Article  PubMed  Google Scholar 

  9. Warren AG, Brorson H, Borud LJ, Slavin SA (2007) Lymphedema: a comprehensive review. Ann Plast Surg 59(4):464–472

    Article  CAS  PubMed  Google Scholar 

  10. Crew KD, Greenlee H, Capodice J, Raptis G, Brafman L, Fuentes D, Sierra A, Hershman DL (2007) Prevalence of joint symptoms in postmenopausal women taking aromatase inhibitors for early-stage breast cancer. J Clin Oncol 25(25):3877–3883

    Article  PubMed  Google Scholar 

  11. Carpenter JS, Johnson DH, Wagner LJ, Andrykowski MA (2002) Hot flushes and related outcomes in breast cancer survivors and matched comparison women. Oncol Nurs Forum 29(3):16–25

    Article  Google Scholar 

  12. Donnellan PP, Douglas SL, Cameron DA, Leonard RCF (2001) Aromatase inhibitors and arthralgia. J Clin Oncol 19(10):2767

    CAS  PubMed  Google Scholar 

  13. Tremblay A, Sheeran L, Aranda SK (2008) Psychoeducational interventions to alleviate hot flashes: a systematic review. Menopause 15(1):193–202

    PubMed  Google Scholar 

  14. Preston N, Seers K, Mortimer P (2004) Physical therapies for reducing and controlling lymphoedema of the limbs. Cochrane Database Syst Rev 4:CD003141

    Google Scholar 

  15. Markes M, Brockow T, Resch KL (2006) Exercise for women receiving adjuvant therapy for breast cancer. Cochrane Database Syst Rev 4. doi:10.1002/14651858

  16. Zhang M, Liu X, Li J, He L, Tripathy D (2007) Chinese medicinal herbs to treat the side-effects of chemotherapy in breast cancer patients. Cochrane Database Syst Rev 2:CD004921

  17. Cella D, Fallowfield LJ (2008) Recognition and management of treatment-related side effects for breast cancer patients receiving adjuvant endocrine therapy. Breast Cancer Res Treat 107(2):167–180

    Article  CAS  PubMed  Google Scholar 

  18. Nelson HD, Vesco KK, Haney E, Fu R, Nedrow A, Miller J, Nicolaidis C, Walker M, Humphrey L (2006) Nonhormonal therapies for menopausal hot flashes systematic review and meta-analysis. JAMA 295(17):2057–2071

    Article  CAS  PubMed  Google Scholar 

  19. Furlan AD, van Tulder MW, Cherkin DC, Tsukayama H, Lao L, Koes BW, Berman BM (2005) Acupuncture and dry-needling for low back pain. Cochrane Database Syst Rev 1:CD001351

    PubMed  Google Scholar 

  20. Xue CCL, An X, Cheung TP, Da Costa C, Lenon GB, Thien FC, Story DF (2007) Acupuncture for persistent allergic rhinitis: a randomised, sham-controlled trial. Med J Aust 187:337–341

    PubMed  Google Scholar 

  21. American academy of medical acupuncture web site: wwwmedicalacuncturecom, Accessed July 20, 2009, 2009

  22. National Institute of Health Consensus Conference (1998) Acupuncture. JAMA 280(17):1518–1524

    Article  Google Scholar 

  23. Antoine C, Vandromme J, Fastrez M, Carly B, Liebens F, Rozenberg S (2008) A survey among breast cancer survivors: treatment of the climacteric after breast cancer. Climacteric 11(4):322–328. doi:310.1080/13697130802244422

    Article  CAS  PubMed  Google Scholar 

  24. Sagar SM (2008) Acupuncture as an evidence-based option for symptom control in cancer patients. Curr Treat Options Oncol 9(2):117–126. doi:110.1007/s11864-11008-10063-11863

    Article  PubMed  Google Scholar 

  25. Wong RKW, Jones GW, Sagar SM, Babjak AF, Whelan T (2003) A phase i–ii study in the use of acupuncture-like transcutaneous nerve stimulation in the treatment of radiation-induced xerostomia in head-and-neck cancer patients treated with radical radiotherapy. Int J Radiat Oncol Biol Phys 57(2):472–480

    Article  PubMed  Google Scholar 

  26. Chen C, Zhang Z, Li H (2004) Electroacupuncture on zusangli (st36) to reduce chemotherapy induced toxicity. Xin Zhong Yi 36:46–47

    Google Scholar 

  27. An I (2004) Cam practitioners and “regular” doctors: is integration possible? Med J Aust 180(12):645–646

    Google Scholar 

  28. Lu W (2005) Acupuncture for side effects of chemoradiation therapy in cancer patients. Semin Oncol Nurs 21(3):190–195

    Article  PubMed  Google Scholar 

  29. Roscoe JA, Matteson SE, Morrow GR, Hickok JT, Bushunow P, Griggs J, Qazi R, Smith B, Kramer Z, Smith J (2005) Acustimulation wrist bands are not effective for the control of chemotherapy-induced nausea in women with breast cancer. J Pain Symptom Manage 29(4):376–384

    Article  PubMed  Google Scholar 

  30. Lee MS, Kim KH, Choi SM, Ernst E (2008) Acupuncture for treatment hot flashes in breast cancer patients: a systematic review. Breast Cancer Res Treat doi: 10.1007/s10549-10008-10230-z

  31. Ezzo JM, Richardson MA, Vickers A, Allen C, Dibble SL, Issell BF, Lao L, Pearl M, Ramirez G (2006) Acupuncture-points stimulation for chemotherapy-induced nausea or vomiting. Cochrane Database Syst Rev 2. doi:10.1002/14651858

  32. Jadad AR, Moore RA, Carroll D, Jenkinson C, Reynolds DJM, Gavaghan DJ, McQuay HJ (1996) Assessing the quality of reports of randomized clinical trials: is blinding necessary? Control Clin Trials 17(1):1–12

    Article  CAS  PubMed  Google Scholar 

  33. Schulz KF, Chalmers I, Hayes RJ, Altman DG (1995) Empirical evidence of bias. Dimensions of methodological quality associated with estimates of treatment effects in controlled trials. JAMA 273(5):408–412

    Article  CAS  PubMed  Google Scholar 

  34. Deng G, Vickers AJ, Yeung KS, D’Andrea GM, Xiao H, Heerdt AS, Sugarman S, Troso-Sandoval T, Seidman AD, Hudis CA (2007) Randomized, controlled trial of acupuncture for the treatment of hot flashes in breast cancer patients. J Clin Oncol 25(35):5584–5590

    Article  PubMed  Google Scholar 

  35. Hervik J, Mjäland O (2009) Acupuncture for the treatment of hot flashes in breast cancer patients, a randomized, controlled trial. Breast Cancer Res Treat 116(2):311–316

    Article  PubMed  Google Scholar 

  36. Frisk J, Carlhäll S, Källström A-C, Lindh-Åstrand L, Malmström A, Hammar M (2008) Long-term follow-up of acupuncture and hormone therapy on hot flushes in women with breast cancer: a prospective, randomized, controlled multicenter trial. Climacteric 11(2):166–174

    Article  CAS  PubMed  Google Scholar 

  37. Nedstrand E, Wyon Y, Hammar M, Wijma K (2006) Psychological well-being improves in women with breast cancer after treatment with applied relaxation or electro-acupuncture for vasomotor symptom. J Psychosom Obstet Gynaecol 27(4):193–199

    Article  PubMed  Google Scholar 

  38. Carpenter JS, Wells N, Lambert B, Watson P, Slayton T, Chak B, Hepworth JT, Worthington WB (2002) A pilot study of magnetic therapy for hot flashes after breast cancer. Cancer Nurs 25(2):104–109

    Article  PubMed  Google Scholar 

  39. Porzio G, Trapasso T, Martelli S, Sallusti E, Piccone C, Mattei A, Di Stanislao C, Ficorella C, Marchetti P (2002) Acupuncture in the treatment of menopause-related symptoms in women taking tamoxifen. Tumori 88(2):128–130

    PubMed  Google Scholar 

  40. Tukmachi E (2000) Treatment of hot flushes in breast cancer patients with acupuncture. Acupunct Med 18(1):22–27

    Article  Google Scholar 

  41. Dibble SL, Luce J, Cooper BA, Israel J, Cohen M, Nussey B, Rugo H (2007) Acupressure for chemotherapy-induced nausea and vomiting: a randomized clinical trial. Oncol Nurs Forum 34(4):813–820. doi:810.1188/1107

    Article  PubMed  Google Scholar 

  42. Molassiotis A, Helin AM, Dabbour R, Hummerston S (2007) The effects of p6 acupressure in the prophylaxis of chemotherapy-related nausea and vomiting in breast cancer patients. Complement Ther Med 15(1):3–12

    Article  CAS  PubMed  Google Scholar 

  43. Dibble SL, Chapman J, Mack KA, Shih AS (2000) Acupressure for nausea: results of a pilot study. Oncol Nurs Forum 21(7):41–47

    Google Scholar 

  44. Shen J, Wenger N, Glaspy J, Hays R, Albert P, Choi C (2000) Electroacupuncture for control of myeloablative chemotherapy-induced emesis: a randomized controlled trial. JAMA 284(21):2755–2761

    Article  CAS  PubMed  Google Scholar 

  45. Gu S, Yang J, Zhang M (2007) Contrast study for the effects of different administration route of dexamethasone on gastrointestinal reaction induced by chemotherapy. Nurs Adv 22(5):399–400

    Google Scholar 

  46. Ho YF (2006) Acupressure and psychological intervention for emesis due to chemotherapy on the patients with mammary cancer. Guangxi Med 28(5):738–739

    Google Scholar 

  47. Xu Y, Wang JL, Du HY (2005) Contrast observation on injection metoclopramide in acupuncture point for the treatment of emesis after chemical treatment to 100 patients with cancer. Central Plains Med J 32(15):58

    CAS  Google Scholar 

  48. Ning CH (2004) Contrast observation on injection metoclopramide in different acupuncture point for the treatment of emesis after chemical treatment to mammary cancer. Hunan Guiding J TCM 10(2):39–41

    Google Scholar 

  49. Nystrom E, Ridderstrom G, Leffler AS (2008) Manual acupuncture as an adjunctive treatment of nausea in patients with cancer in palliative care. Acupunct Med 26(1):27–32

    Article  PubMed  Google Scholar 

  50. Choo SP, Kong KH, Lim WT, Gao F, Chua K, Leong SS (2006) Electroacupuncture for refractory acute emesis caused by chemotherapy. J Altern Complement Med 12(10):963–969

    Article  PubMed  Google Scholar 

  51. Mehling WE, Jacobs B, Acree M, Wilson L, Bostrom A, West J, Acquah J, Burns B, Chapman J, Hecht FM (2007) Symptom management with massage and acupuncture in postoperative cancer patients: a randomized controlled trial. J Pain Symptom Manage 33(3):258–266

    Article  PubMed  Google Scholar 

  52. Liang J, Wang LP, Wang GN (2007) The effect of preemptive HAN’S acupoint nerve stimulator on postoperative pain in patients undergoing radical mastectomy. J Harbin Med University 41(6):607–609

    Google Scholar 

  53. He JP, Friedrich M, Ertan AK, Muller K, Schmidt W (1999) Pain-relief and movement improvement by acupuncture after ablation and axillary lymphadenectomy in patients with mammary cancer. Clin Exp Obstet Gynecol 26(2):81–84

    CAS  PubMed  Google Scholar 

  54. Crew KD, Capodice JL, Greenlee H, Apollo A, Jacobson JS, Raptis G, Blozie K, Sierra A, Hershman DL (2007) Pilot study of acupuncture for the treatment of joint symptoms related to adjuvant aromatase inhibitor therapy in postmenopausal breast cancer patients. J Cancer Surviv 1(4):283–291

    Article  PubMed  Google Scholar 

  55. Alem M, Gurgel MSC (2008) Acupuncture in the rehabilitation of women after breast cancer surgery. Acupunct Med 26(2):86–93

    Article  Google Scholar 

  56. Sun ST, Nan GY, Lee YL (2007) Observation on injection g-csf in acupuncture point for the treatment of leukopenia after chemical treatment to 102 patients with mammary cancer. World Health Digest Med Period 4(6):50

    Google Scholar 

  57. Chang BY, Lian BH (2002) Observation on injection in acupuncture point for the treatment of leukopenia after chemical treatment to 45 patients with cancer. J Pract Tradit Chin Med 18(2):30

    Google Scholar 

  58. Xie D, Tong TL, Huang M, Yang HY (2007) The effects of acupuncture treatment for chemotherapy patients with mammary cancer. Mod J Integr Tradit Chin West Med 16(36):5440–5441

    Google Scholar 

  59. Williams AF, Cert M, Vadgama A, Franks PJ, Mortimer PS (2002) A randomized controlled crossover study of manual lymphatic drainage therapy in women with breast cancer-related lymphoedema. Eur J Cancer Care 11(4):254–261

    Article  CAS  Google Scholar 

  60. Kwan W, Jackson J, Weir LM, Dingee C, McGregor G, Olivotto IA (2002) Chronic arm morbidity after curative breast cancer treatment: prevalence and impact on quality of life. J Clin Oncol 20(20):4242–4248

    Article  PubMed  Google Scholar 

  61. Zijlstra FJ, Berg-de Lange I, Huygen F, Klein J (2003) Anti-inflammatory actions of acupuncture. Mediators Inflamm 12(2):59–69

    Article  CAS  PubMed  Google Scholar 

  62. Zhao X, Wang H, Cao D (1999) Influence of acupuncture and moxibustion on serum csf activity of patients with leukopenia caused by chemotherapy. Zhen Ci Yan Jiu 24(1):17–19

    Google Scholar 

  63. Ernst G, Strzyz H, Hagmeister H (2003) Incidence of adverse effects during acupuncture therapy—a multicentre survey. Complement Ther Med 11(2):93–97. doi:10.1016/S0965-2299(1003)00004-00009

    Article  CAS  PubMed  Google Scholar 

  64. Craig JC, Irwig LM, Stockler MR (2001) Evidence-based medicine: useful tools for decision making. Med J Aust 174(5):248–253

    CAS  PubMed  Google Scholar 

  65. Moher D, Pham B, Jones A, Cook DJ, Jadad AR, Moher M, Tugwell P, Klassen TP (1998) Does quality of reports of randomised trials affect estimates of intervention efficacy reported in meta-analyses? Lancet 352:609–613

    Article  CAS  PubMed  Google Scholar 

  66. Bardychev MS, Guseva LI, Zubova ND (1988) Acupuncture in edema of the extremities following radiation or combination therapy of cancer of the breast and uterus. Vopr Onkol 34(3):319–322

    CAS  PubMed  Google Scholar 

  67. Kuz’mina EG, Degtiareva AA (1987) Restoration of immunologic indices following reflexotherapy in the combination treatment of radiation-induced edema of the upper limbs. Meditsinskaia radiologiia 32(7):42–46

    PubMed  Google Scholar 

  68. Kuz’mina EG, Degtiareva AA, Zubova ND, Guseva LI, Klimanov ME (1987) Effectiveness of various therapeutic schemes for patients with radiation edema of the extremities. Meditsinskaia radiologiia 32(3):18–22

    PubMed  Google Scholar 

  69. Davies FM (2001) The effect of acupuncture treatment on the incidence and severity of hot flushes experienced by women following treatment for breast cancer: a comparison of traditional and minimal acupuncture. Eur J Cancer 37:S438. doi:410.1016/S0959-8049(1001)82079-82077

    Article  Google Scholar 

  70. Walker EM, Rodriguez AI, Kohn B, Pegg J, Bell RM, Levine RA (2008) Acupuncture for the treatment of vasomotor symptoms in breast cancer patients receiving hormone suppression treatment. Int J Radiat Oncol Biol Phys 72:103–104. doi:110.1016/j.ijrobp.2008.1006.1000

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. School of Nursing, Chang Gung University, Gueishan, Taoyuan, Taiwan, ROC

    Li-Fen Chao & Hsueh-Erh Liu

  2. Department of Nursing, Chang Gung Institute of Technology, Taoyuan, Taiwan, ROC

    Li-Fen Chao

  3. Discipline of Chinese Medicine, RMIT University, Melbourne, VIC, Australia

    Anthony Lin Zhang

  4. Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Chang Gung College of Medicine, Chang Gung University, Gueishan, Taoyuan, Taiwan, ROC

    Ming-Huei Cheng

  5. Department of General Surgery, Mackay Memorial Hospital, Taipei, Taiwan, ROC

    Hung-Bun Lam

  6. Faculty of Arts and Sciences, Hong Kong Institute of Education, 10 Lo Ping Road, Tai Po, New Territories, Hong Kong

    Sing Kai Lo

Authors
  1. Li-Fen Chao
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Anthony Lin Zhang
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Hsueh-Erh Liu
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Ming-Huei Cheng
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Hung-Bun Lam
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Sing Kai Lo
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Sing Kai Lo.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Chao, LF., Zhang, A.L., Liu, HE. et al. The efficacy of acupoint stimulation for the management of therapy-related adverse events in patients with breast cancer: a systematic review. Breast Cancer Res Treat 118, 255–267 (2009). https://doi.org/10.1007/s10549-009-0533-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10549-009-0533-8

Keywords

Search

Navigation