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What is the evidence for the use of acupuncture as an intervention for symptom management in cancer supportive and palliative care: an integrative overview of reviews

Abstract

Purpose

This study aims to systematically appraise the evidence for the use of acupuncture for symptom management in cancer and supportive care and to identify recommendations for clinical practice and future research.

Methods

A systematic search was carried out to identify reviews of the use of acupuncture in cancer supportive and palliative care, using MEDLINE, EMBASE, CINAHL, Web of Science, Cochrane Library, British Nursing Index, Index to Theses, Dissertations and Theses (via Proquest) and NHS evidence. Search terms included: acupuncture, cancer and symptoms. Data were extracted for analysis. Reviews were assessed for quality using a five-item checklist but were not excluded from the review on grounds of quality, in order to include a comprehensive scope of the subject.

Results

Seventeen reviews were included in the review. Evidence was found for the use of acupuncture for treatment-related nausea and vomiting. Benefit was reported for other cancer-related symptoms, including pain, fatigue, hot flushes, xerostomia, dyspnoea and anxiety. Reviewers found a paucity of rigorous trials and heterogeneity of populations, interventions, controls and outcome measures, which challenge the process of systematic review and meta-analysis.

Conclusion

Acupuncture should be considered for symptom management where there are limited treatment options, using current peer-reviewed guidelines and clinical reasoning. Much of the primary research reported in reviews is innovative and indicates potential benefit for people with cancer-related symptoms. The complexity of acupuncture as an intervention needs to be acknowledged in future research designs and when reviewing research findings. An iterative approach using adequate interventions, appropriate outcome measures and adherence to reporting standards is required to evaluate the efficacy of acupuncture in cancer supportive and palliative care.

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Acknowledgments

P. Towler was supported in undertaking this review by a scholarship from the Cancer Experiences Collaborative, which was funded by the National Cancer Research Institute. We appreciate and acknowledge the contribution of Dr J. Brine, subject librarian for Health and Medicine, Lancaster University, in undertaking the electronic searches.

Conflict of interest

No relevant financial conflict of interest reported for all authors.

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Correspondence to S. G. Brearley.

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Towler, P., Molassiotis, A. & Brearley, S.G. What is the evidence for the use of acupuncture as an intervention for symptom management in cancer supportive and palliative care: an integrative overview of reviews. Support Care Cancer 21, 2913–2923 (2013). https://doi.org/10.1007/s00520-013-1882-8

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  • DOI: https://doi.org/10.1007/s00520-013-1882-8

Keywords

  • Acupuncture
  • Cancer
  • Symptom management
  • Complex intervention