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Acupuncture for the Treatment of Hot Flashes in Cancer Patients

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Acupuncture and Moxibustion as an Evidence-based Therapy for Cancer

Abstract

Hot flashes, a phenomenon characterized by an intense feeling of heat and visible reddening in the upper body, have frequently been described in cancer patients undergoing hormonal deprivation or hormonal ablation therapy. The occurrence of hot flashes can substantially affect the quality of life in such patients. Though several treatments are available to reduce hot flashes, many have significant side effects of their own. Acupuncture has emerged as a promising treatment modality to alleviate hot flashes in cancer patients. In prostate cancer patients, six different studies concluded that acupuncture reduces the incidence and severity of hot flashes well beyond the estimated placebo effect and the effects of alternative treatments such as venlafaxine with minimal side effects. In breast cancer patients, acupuncture trials have yielded similar results. However, there are more conflicting results among randomized clinical trials which use sham acupuncture as a control; with one study concluding that actual acupuncture is no better than sham acupuncture in reducing hot flash incidence. In fact, two systematic reviews concluded that current evidence did not suggest that acupuncture was an effective treatment for hot flashes in breast cancer and prostate cancer patients due to the paucity and poor quality of the primary data (Lee et al., Breast Cancer Research Treatments, 115:497–503, 2009; Supportive Care Cancer, 17:763–770, 2009). These conclusions are at least partly due to the inherent difficulties involved in the proper blinding of acupuncture practitioners and the development of an adequate placebo to mimic the therapeutic experience of acupuncture. Because the overall evidence from well-controlled, randomized clinical trials is currently limited, it is not possible to unequivocally state that acupuncture is more effective than venlafaxine for hot flashes – the medication that has yielded the most impressive benefits in treating hot flashes. However, since the majority of acupuncture trials have provided very encouraging results with minimal side effects, future studies are warranted to further investigate and assess the potential role of acupuncture in the treatment of hot flashes in cancer patients.

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References

  • Ashamalla, H., Jiang, M. L., Guirguis, A., Peluso, F., Ashamalla, M. (2011). Acupuncture for the alleviation of hot flashes in men treated with androgen ablation therapy. International Journal of Radiation Oncology, Biology, Physics, 79, 1358–1363.

    Article  PubMed  Google Scholar 

  • Beer, T. M., Benavides, M., Emmons, S. L., Hayes, M., Liu, G., Garzotto, M., et al. (2010). Acupuncture for hot flashes in patients with prostate cancer. Urology, 76, 1182–1188.

    Article  PubMed  Google Scholar 

  • Berendsen, H. H. (2000). The role of serotonin in hot flushes. Maturitas, 36(3), 155–164.

    Article  PubMed  CAS  Google Scholar 

  • Capodice, J. L. (2010). Acupuncture in the oncology setting: clinical trial update. Current Treatment Options of Oncology, 11(3–4), 87–94.

    Google Scholar 

  • Carpenter, J. S., Andrykowski, M. A., Cordova, M., Cunningham, L., Studts, J., McGrath, P., et al. (1998). Hot flashes in postmenopausal women treated for breast carcinoma: prevalence, severity, correlates, management, and relation to quality of life. Cancer, 82(9), 1682–1691.

    Article  PubMed  CAS  Google Scholar 

  • Casper, R. F., & Yen, S. S. (1985). Neuroendocrinology of menopausal flushes: an hypothesis of flush mechanism. Clinical Endocrinology (Oxf), 22(3), 293–312.

    Article  CAS  Google Scholar 

  • Collins, K. B., & Thomas, D. J. (2004). Acupuncture and acupressure for the management of chemotherapy-induced nausea and vomiting. Journal of American Academic Nurse Practise, 16(2), 76–80.

    Google Scholar 

  • Deng, G., Cassileth, B. R., & Yeung, K. S. (2004). Complementary therapies for cancer-related symptoms. Journal of Supportive Oncology, 2(5), 419–426; discussion 427–429.

    PubMed  Google Scholar 

  • Deng, G., Vickers, A., Yeung, S., D’Andrea, G. M., Xiao, H., Heerdt, A.S., et al. (2007). Randomized, controlled trial of acupuncture for the treatment of hot flashes in breast cancer patients. Journal of Clinical Oncology, 25(35), 5584–5590.

    Article  PubMed  Google Scholar 

  • Ernst, E. (2006). Acupuncture—a critical analysis. Journal of International Medicine, 259(2), 125–137.

    CAS  Google Scholar 

  • Frisk, J., Carlhall, S., Kallstrom, A. C., Lindh-Astrand, L., Malmstrom, 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  PubMed  CAS  Google Scholar 

  • Frisk, J., Spetz, A.C., Hjertberg, H., Petersson, B., & Hammar, M. (2009). Two modes of acupuncture as a treatment for hot flushes in men with prostate cancer—a prospective multicenter study with long-term follow-up. European Journal of Urology, 55(1), 156–163.

    Article  Google Scholar 

  • Hammar, M., Frisk, J., Grimas, O., Hook, M., Spetz, A.C., & Wyon, Y. (1999). Acupuncture treatment of vasomotor symptoms in men with prostatic carcinoma: a pilot study. Journal of Urology, 161(3), 853–856.

    Article  PubMed  CAS  Google Scholar 

  • Han, S. J. (2004). Acupuncture and endorphins. Neuroscience Letters, 361, 258–261.

    Article  PubMed  CAS  Google Scholar 

  • Harding, C., Harris, A., & Chadwick, D. (2009). Auricular acupuncture: a novel treatment for vasomotor symptoms associated with luteinizing-hormone releasing hormone agonist treatment for prostate cancer. BJU International, 103(2), 186–190.

    Article  PubMed  Google Scholar 

  • Hayes, M., Katovic, N. M., Donovan, D., Emmons, S., Benavides, M., Montalto, M., et al. (2005). Acupuncture for hot flashes in prostate cancer patients. Journal of Clinical Oncology, 23, 8160.

    Google Scholar 

  • He, J. P., Friedrich, M., Ertan, A. K., Muller, K., & Schmidt, W. (1999), Pain-relief and movement improvement by acupuncture after ablation and axillary lymphadenectomy in patients with mammary cancer. Clinical and Experimental Obstetrics Gynecology, 26(2), 81–84,

    PubMed  CAS  Google Scholar 

  • Hervik, J., & Mjaland, O. (2009). Acupuncture for the treatment of hot flashes in breast cancer patients, a randomized, controlled trial. Breast Cancer Research Treatments, 116(2), 311–316.

    Article  Google Scholar 

  • Lanfrey, P., Mottet, N., Dagues, F., Bennaoum, K., Costa, P., Louis, J.F., et al. (1996). Hot flashes and hormonal treatment of prostate cancer. Progrès en Urologie, 6(1), 17–22.

    PubMed  CAS  Google Scholar 

  • Lee, M. S., Kim, K.H., Choi, S. M., & Ernst, E. (2009a). Acupuncture for treating hot flashes in breast cancer patients: a systematic review. Breast Cancer Research Treatments, 115(3), 497–503.

    Article  Google Scholar 

  • Lee, M. S., Kim, K. H., Shin, B. C., Choi, S. M., & Ernst, E. (2009b). Acupuncture for treating hot flushes in men with prostate cancer: a systematic review. Supportive Care Cancer, 17(7), 763–770.

    Article  Google Scholar 

  • Lin, J. G., & Chen, W. L. (2008). Acupuncture analgesia: a review of its mechanisms of actions. American Journal of Chinese Medicine, 36(4), 635–645.

    Article  PubMed  CAS  Google Scholar 

  • Loprinzi, C. L., Dueck, A. C., Khoyratty, B. S., Barton, D. L., Jafar, S., Rowland, K. M. Jr., et al. (2009a). A Phase III randomized, double-blind, placebo-controlled trial of gabapentin in the management of hot flashes in men (N00CB). Annals of Oncology, 20(3), 542–559.

    Article  CAS  Google Scholar 

  • Loprinzi, C. L., Sloan, J., Stearns, V., Slack, R., Iyengar, M., Diekmann, B., et al. (2009b). Newer antidepressants and gabapentin for hot flashes: an individual patient pooled analysis. Journal of Clinical Oncology, 27(17), 2831–2837.

    Article  CAS  Google Scholar 

  • Morrow, P. K., Mattair, D. N., & Hortobagyi, G. N. (2011). Hot flashes: a review of pathophysiology and treatment modalities. Oncologist, 16(11), 1658–1664.

    Article  PubMed  CAS  Google Scholar 

  • Nedstrand, E., Wijma, K., Wyon, Y., & Hammar, M. (2005). Vasomotor symptoms decrease in women with breast cancer randomized to treatment with applied relaxation or electro-acupuncture: a preliminary study. Climacteric, 8(3), 243–250.

    Article  PubMed  CAS  Google Scholar 

  • Nelson, H. D., Vesco, K. K., Haney, E., Fu, R., Nedrow, A., Miller, J., et al. (2006). Nonhormonal therapies for menopausal hot flashes: systematic review and meta-analysis. JAMA, 295(17), 2057–2071.

    Article  PubMed  CAS  Google Scholar 

  • Pomeranz, B., & Cheng, R. (1979). Suppression of noxious responses in single neurons of cat spinal cord by electroacupuncture and its reversal by the opiate antagonist naloxone. Experimental Neurology, 64(2), 327–341.

    Article  PubMed  CAS  Google Scholar 

  • Pomeranz, B., & Paley, D. (1979). Electroacupuncture hypalgesia is mediated by afferent nerve impulses: an electrophysiological study in mice. Experimental Neurology, 66(2), 398–402.

    Article  PubMed  CAS  Google Scholar 

  • Quella, S. K., Loprinzi, C. L., Sloan, J., Novotny, P., Perez, E. A., Burch, P. A., et al. (1999). Pilot evaluation of venlafaxine for the treatment of hot flashes in men undergoing androgen ablation therapy for prostate cancer. Journal of Urology, 162(1), 98–102.

    Article  PubMed  CAS  Google Scholar 

  • Shanafelt, T. D., Barton, D. L., Adjei, A. A., & Loprinzi, C. L. (2002). Pathophysiology and treatment of hot flashes. Mayo Clinic Proceeding, 77(11), 1207–1218.

    Article  CAS  Google Scholar 

  • Sicat, B. L., & Brokaw, D. K. (2004). Nonhormonal alternatives for the treatment of hot flashes. Pharmacotherapy, 24(1), 79–93.

    Article  PubMed  CAS  Google Scholar 

  • Sloan, J. A., Loprinzi, C.L., Novotny, P. J., Barton, D. L., Lavasseur, B. I., & Windschitl, H. (2001). Methodologic lessons learned from hot flash studies. Journal of Clinical Oncology, 19(23), 4280–4290.

    PubMed  CAS  Google Scholar 

  • Spetz, A. C., Hammar, M., Lindberg, B., Spangberg, A., & Varenhorst, E. (2001). Prospective evaluation of hot flashes during treatment with parenteral estrogen or complete androgen ablation for metastatic carcinoma of the prostate. Journal of Urology, 166(2), 517–520.

    Article  PubMed  CAS  Google Scholar 

  • Spetz, A. C., Zetterlund, E. L., Varenhorst, E., & Hammar, M. (2003). Incidence and management of hot flashes in prostate cancer. Journal of Supportive Oncology, 1(4), 263–6, 269–70, 272–3; discussion 267–8, 271–2.

    PubMed  Google Scholar 

  • Vincent, A., Barton, D. L., Mandrekar, J. N., Cha, S. S., Zais, T., Wahner-Roedler, D. L., et al. (2007). Acupuncture for hot flashes: a randomized, sham-controlled clinical study. Menopause, 14(1), 45–52.

    Article  PubMed  Google Scholar 

  • Walker, E. M., Rodriguez, A. I., Kohn, B., Ball, R. M., Pegg, J., Pocock, J. R., et al. (2010). Acupuncture versus venlafaxine for the management of vasomotor symptoms in patients with hormone receptor-positive breast cancer: a randomized controlled trial. Journal of Clinical Oncology, 28(4), 634–640.

    Article  PubMed  CAS  Google Scholar 

  • Zhao, Z. Q. (2008). Neural mechanism underlying acupuncture analgesia. Progress in Neurobiology, 85(4), 355–375.

    Article  PubMed  Google Scholar 

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Correspondence to Hani Ashamalla .

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Peluso, F.C., Graves, P.R., Ashamalla, H. (2012). Acupuncture for the Treatment of Hot Flashes in Cancer Patients. In: Cho, W. (eds) Acupuncture and Moxibustion as an Evidence-based Therapy for Cancer. Evidence-based Anticancer Complementary and Alternative Medicine, vol 3. Springer, Dordrecht. https://doi.org/10.1007/978-94-007-4833-0_4

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  • DOI: https://doi.org/10.1007/978-94-007-4833-0_4

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