Current Treatment Options in Oncology

, Volume 11, Issue 3–4, pp 87–94 | Cite as

Acupuncture in the Oncology Setting: Clinical Trial Update

Integrative Oncology

Opinion statement

Acupuncture, the insertion of sterile needles into acupuncture points of traditional meridians on the body, is a common and effective treatment for a number of supportive care issues in oncology including acute chemotherapy-induced nausea and vomiting. In the Integrative Oncology setting, acupuncture and Traditional Oriental Medicine have become more visible and many oncology clinics, academic health centers and comprehensive cancer centers recommend and administer acupuncture treatment. Continued basic studies on the physiologic mechanisms of acupuncture and recent clinical trials of acupuncture for cancer patients are enhancing our knowledge and informing our guidelines. While debates on methodological problems confronting the study of acupuncture remain, the most recent research demonstrates that acupuncture is safe, tolerable and effective for a range of side effects resulting from conventional cancer treatments.

References and Recommended Reading

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. 1.•
    Ahn AC, Park M, Shaw JR, et al.: Electrical impedance of acupuncture meridians: the relevance of subcutaneous collagenous bands. PLoS One 2010, 5(7):e11907.CrossRefPubMedGoogle Scholar

This paper represents recent results demonstrating the relationship of collagenous bands and lower electrical impedance at acupuncture meridians. This finding may provide important insight into the nature of acupuncture meridians and mechanism of action of acupuncture.

  1. 2.
    Lee BC, Ogay V, Kim KW, et al.: Acupuncture muscle channel in the subcutaneous layer of rat skin. J Acupunct Meridian Stud 2008, 1(1):13–19.CrossRefPubMedGoogle Scholar
  2. 3.•
    Pomeranz B, Chiu D: Naloxone blockade of acupuncture analgesia: endorphin implicated. Life Sci 11, 19:1757–1762.CrossRefGoogle Scholar

The seminal paper demonstrating that acupuncture releases the neurotransmitter, beta-endorphin.

  1. 4.
    Murotani T, Ishizuka T, Nakazawa H, et al.: Possible involvement of histamine, dopamine, and noradrenalin in the periaqueductal gray in electroacupuncture pain relief. Brain Res 2010, 1306:62–68.CrossRefPubMedGoogle Scholar
  2. 5.•
    Hui KK, Marina O, Liu J, et al.: Acupuncture, the limbic system, and the anticorrelated networks of the brain. Auton Neurosci 2010, 157(1–2):81–90.CrossRefPubMedGoogle Scholar

A very well designed and reported study demonstrating CNS mechanisms of acupuncture administration.

  1. 6.
    Hui KK, Marina O, Claunch JD, et al.: Acupuncture mobilizes the brain’s default mode and its anti-correlated network in healthy subjects. Brain Res 2009, 1287:84–103.CrossRefPubMedGoogle Scholar
  2. 7.
    NIH Consensus Conference. Acupuncture. JAMA 1998, 280:1518–1524Google Scholar
  3. 8.•
    Berman BM, Lao L, Langenberg P, et al.: Effectiveness of acupuncture as adjunctive therapy in osteoarthritis of the knee: a randomized, controlled trial. Ann Intern Med 2004, 141:901–910.PubMedGoogle Scholar

The largest phase III trial of acupuncture for knee osteoarthritis.

  1. 9.••
    National Institutes of Health Consensus Panel. Acupuncture: National Institutes of Health Consensus Development Conference Statement. National Institutes of Health Web site. Accessed at on June 22, 2007. Viewed October 28, 2010

The updated consensus statement from 10 years previously (reference 7).

  1. 10.••
    Raphael J, Ahmedzai S, Hester J, et al.: Cancer pain: part 1: Pathophysiology; oncological, pharmacological, and psychological treatments: a perspective from the British Pain Society endorsed by the UK Association of Palliative Medicine and the Royal College of General Practitioners. Pain Med 2010, 11(5):742–764.CrossRefPubMedGoogle Scholar

A comprehensive analysis of thoughts on oncologic pain by a consensus of professionals in the United Kingdom.

  1. 11.
    Raphael J, Hester J, Ahmedzai S, et al.: Cancer pain: part 2: physical, interventional and complimentary therapies; management in the community; acute, treatment-related and complex cancer pain: a perspective from the British Pain Society endorsed by the UK Association of Palliative Medicine and the Royal College of General Practitioners. Pain Med 2010, 11(6):872–896.CrossRefPubMedGoogle Scholar
  2. 12.•
    Schmidt BL, Hamamoto DT, Simone DA, Wilcox GL: Mechanism of cancer pain. Mol Interv 3, 10:164–178.CrossRefGoogle Scholar

A review of the neurophysiologic mechanisms implied in oncologic pain.

  1. 13.•
    Crew KD, Capodice JL, Greenlee H, et al.: Randomized, blinded, sham-controlled trial of acupuncture for the management of aromatase inhibitor-associated joint symptoms in women with early-stage breast cancer. J Clin Oncol 2010, 28(7):1154–1160.CrossRefPubMedGoogle Scholar

A randomized, sham controlled clinical trial that follows up on a previous pilot study and cross-sectional analysis.

  1. 14.
    Mao JJ, Bruner DW, Stricker C, et al.: Feasibility trial of electroacupuncture for aromatase inhibitor-related arthralgia in breast cancer survivors. Integr Cancer Ther 2009, 8(2):123–129.Google Scholar
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    Dean-Clower E, Doherty-Gilman AM, Keshaviah A, et al.: Acupuncture as palliative therapy for physical symptoms and quality of life for advanced cancer patients. Integr Cancer Ther 2010, 9(2):158–167.CrossRefPubMedGoogle Scholar
  3. 16.•
    Luo F, Wang JY: Modulation of central nociceptive coding by acupoint stimulation. Neurochem Res 2008, 33(10):1950–1955.CrossRefPubMedGoogle Scholar

A quick review that explores many related nociceptive mechanisms of action of acupuncture including CNS and peripheral mechanisms.

  1. 17.
    Qin W, Tian J, Bai L, et al.: FMRI connectivity analysis of acupuncture effects on an amygdala-associated brain network. Mol Pain 2008, 4:55.CrossRefPubMedGoogle Scholar
  2. 18.
    Wang W, Liu L, Zhi X, et al.: Study on the regulatory effect of electro-acupuncture on hegu point (LI4) in cerebral response with functional magnetic resonance imaging. Chin J Integr Med 2007, 13(1):10–16.CrossRefPubMedGoogle Scholar
  3. 19.
    Hui KK, Liu J, Marina O, et al.: The integrated response of the human cerebro-cerebellar and limbic systems to acupuncture stimulation at ST 36 as evidenced by fMRI. Neuroimage 2005, 27(3):479–496Google Scholar
  4. 20.•
    Pfister DG, Cassileth BR, Deng GE, et al.: Acupuncture for pain and dysfunction after neck dissection: results of a randomized controlled trial. J Clin Oncol 2010, 28(15):2565–2570.CrossRefPubMedGoogle Scholar

A pilot study that examines pain and the related side effect of xerostomia in head and neck cancer patients following neck dissection.

  1. 21.
    Deng G, Rusch V, Vickers A, et al.: Randomized controlled trial of a special acupuncture technique for pain after thoracotomy. J Thorac Cardiovasc Surg 2008, 136(6):1464–1469.CrossRefPubMedGoogle Scholar
  2. 22.•
    Deng G, Hou BL, Holodny AI, et al.: Functional magnetic resonance imaging (fMRI) changes and saliva production associated with acupuncture at LI-2 acupuncture point: a randomized controlled study. BMC Complement Altern Med 2008, 8:37.CrossRefPubMedGoogle Scholar

An important clinical trial that examined both symptom amelioration and central mechanisms of acupuncture for xerostomia.

  1. 23.
    Wong RK, Sagar SM, Chen BJ, et al.: Phase II randomized trial of acupuncture-like transcutaneous electrical nerve stimulation to prevent radiation-induced xerostomia in head and neck cancer patients. J Soc Integr Oncol 2010, 8(2):35–42Google Scholar
  2. 24.
    Simcock R, Fallowfield L, Jenkins V: Group acupuncture to relieve radiation induced xerostomia: a feasibility study. Acupunct Med 2009, 27(3):109–113.CrossRefPubMedGoogle Scholar
  3. 25.
    Vickers AJ, Straus DJ, Fearon B, et al.: Acupuncture for postchemotherapy fatigue: a phase II study. J Clin Oncol 2004, 22(9):1731–1735.CrossRefPubMedGoogle Scholar
  4. 26.
    Choi JY, Jung HJ, Kim JI, et al.: A randomized pilot study of acupuncture as an adjunct therapy in adult asthmatic patients. J Asthma 2010, 47(7):774–780.CrossRefPubMedGoogle Scholar
  5. 27.
    Suzuki M, Namura K, Ohno Y, et al.: The effect of acupuncture in the treatment of chronic obstructive pulmonary disease. J Altern Complement Med 2008, 14(9):1097–1105.CrossRefPubMedGoogle Scholar
  6. 28.
    Mao JJ, Styles T, Cheville A, et al.: Acupuncture for nonpalliative radiation therapy-related fatigue: feasibility study. J Soc Integr Oncol 2009, 7(2):52–58Google Scholar
  7. 29.
    Balk J, Day R, Rosenzweig M, et al.: Pilot, randomized, modified, double-blind, placebo-controlled trial of acupuncture for cancer-related fatigue. J Soc Integr Oncol 2009, 7(1):4–11Google Scholar
  8. 30.•
    Melchart D, Weidenhammer W, Streng A, et al.: Prospective investigation of adverse effects of acupuncture in 97 733 patients. Arch Intern Med 2004, 164:104–105.CrossRefPubMedGoogle Scholar

A large review of the safety of acupuncture in 97,733 German patients.

  1. 31.•
    Ladas EJ, Rooney D, Taromina K, et al.: The safety of acupuncture in children and adolescents with cancer therapy-related thrombocytopenia. Support Care Cancer 2010, 18(11):1487–1490.CrossRefPubMedGoogle Scholar
  2. 32.•• viewed October 29, 2010. An excellent resource for researchers and clinicians reporting actively recruiting, ongoing and closed clinical trials throughout the United States

Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  1. 1.Department of UrologyColumbia University College of Physicians and SurgeonsNew YorkUSA

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