Abstract
Introduction
Fatigue is the most common symptom reported by survivors of cancer. At present the medical community lacks evidence-based options for its management.
Materials and methods
This paper describes the rationale, current evidence, and research in progress as related to the use of acupuncture as a potential option.
Results
Preliminary evidence suggests that clinicians and cancer survivors may find benefit in considering acupuncture as an option for managing fatigue; this is especially appealing since acupuncture appears to be a safe medical technique. We draw upon our research and clinical experience to generate a description of considerations for patient and provider when thinking about acupuncture as an option for the management of fatigue in non-anemic, disease-free breast cancer survivors.
Discussion/conclusions
Research examining its relative effectiveness and potential for integration with other approaches is a logical next step if the results from RCTs are positive.
Implications for cancer survivors
Acupuncture is not routinely considered in mainstream discussions of options for fatigue management. While future research will more clearly determine its relative effectiveness, given the present options available clinicians and breast cancer survivors may find benefit in considering and discussing acupuncture as an approach for managing persistent fatigue.
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References
Lawrence D, Kupelnick B, Miller K, Devine D, Lau J. Evidence report on the occurrence, assessment, and treatment of fatigue in cancer patients. J Natl Cancer Inst Monographs. 2004;32:40–50.
Gall H. The basis of cancer fatigue: where does it come from? Eur J Cancer Care [Suppl]. 1996;5:31–4.
Bower JE, Ganz PA, Desmond KA, Rowland JH, Meyerowitz BE, Belin TR. Fatigue in breast cancer survivors: occurrence, correlates, and impact on quality of life. J Clin Oncol. 2000;18(4):743–53.
Bower JE, Ganz PA, Desmond KA, Bernaards C, Rowland JH, Meyerowitz BE, et al. Fatigue in long-term breast carcinoma survivors: a longitudinal investigation. Cancer. 2006;106(4):751–8.
Andrykowski MA, Curran SL, Lightner R. Off-treatment fatigue in breast cancer survivors: a controlled comparison. J Behav Med. 1998;21(1):1–18.
Groenvold M, Petersen MA, Idler E, Bjorner JB, Fayers PM, Mouridsen HT. Psychological distress and fatigue predicted recurrence and survival in primary breast cancer patients. Breast Cancer Res Treat. 2007;105(2):209–19.
Hanna A, Sledge G, Mayer ML, Hanna N, Einhorn L, Monahan P, et al. A phase II study of methylphenidate for the treatment of fatigue. Support Care Cancer. 2006;14(3):210–5.
National Cancer Institute. Fatigue(PDQÒ). Last Modified May 31, 2007. Accessed at http://www.cancer.gov/cancertopics/pdq/supportivecare/fatigue/HealthProfessional on July 1, 2007.
National Comprehensive Cancer Network (NCCN) practice guidelines in oncology for treatment of cancer related fatigue. Version 1.2007, 01/25/07, © 2007 National Comprehensive Cancer Network, Inc. Accessed on February 5, 2007 from: www.nccn.org.
Patrick DL, Ferketich SL, Frame PS, Harris JJ, Hendricks CB, Levin B, et al. National institutes of health state-of-the-science conference statement: symptom management in cancer: pain, depression, and fatigue, July 15–17, 2002. J Natl Cancer Inst. 2003;95(15):1110–7.
Hui KK, Hui EK, Johnston MF. The potential of a person-centered approach in caring for patients with cancer: A perspective from the UCLA Center for East-West Medicine. Integrative Cancer Therapies. 2006;5(1):56–62.
Zhao CH, Stillman MJ, Rozen TD. Traditional and evidence-based acupuncture in headache management: theory, mechanism, and practice. Headache. 2005;45(6):716–30.
Cheng XN (chief editor). Chinese acupuncture and moxibustion. Beijing: Foreign Languages Press; 1999.
Ma SX. Enhanced nitric oxide concentrations and expression of nitric oxide synthase in acupuncture points/meridians. J Altern Complement Med. 2003;9(2):207–15.
Vickers AJ, Straus DJ, Fearon B, Cassileth BR. Acupuncture for postchemotherapy fatigue: a phase II study. J Clin Oncol. 2004;22(9):1731–5.
Harris RE, Tian X, Williams DA, Tian TX, Cupps TR, Petzke F, et al. Treatment of fibromyalgia with formula acupuncture: investigation of needle placement, needle stimulation, and treatment frequency. J Altern Complement Med. 2005;11(4):663–71.
Assefi NP, Sherman KJ, Jacobsen C, Goldberg J, Smith WR, Buchwald D. A randomized clinical trial of acupuncture compared with sham acupuncture in fibromyalgia. Ann Intern Med. 2005;143(1):10–9.
Hays RD, Brodsky M, Johnston MF, Spritzer KL, Hui KK. Evaluating the statistical significance of health-related quality-of-life change in individual patients. Eval Health Prof. 2005;28(2):160–71.
Macpherson H, Scullion A, Thomas KJ, Walters S. Patient reports of adverse events associated with acupuncture treatment: a prospective national survey. Qual Saf Health Care. 2004;13(5):349–55.
White A. A cumulative review of the range and incidence of significant adverse events associated with acupuncture. Acupunct Med. 2004;22(3):122–33.
Deng G. Principal investigator, memorial sloan-kettering cancer center. Acupuncture for the treatment of chronic post-chemotherapy fatigue: a randomized, phase III trial. ClinicalTrials.gov identifier NCT00200096. http://clinicaltrials.gov/ct/show/NCT00200096?order=2.
Hui K-K. Principal investigator, UCLA Center for East-West Medicine. Improving fatigue: a pilot study of acupuncture and patient education for breast cancer survivors. Susan G. Komen Breast Cancer Foundation.
Carlson LE, Speca M, Patel KD, Goodey E. Mindfulness-based stress reduction in relation to quality of life, mood, symptoms of stress, and immune parameters in breast and prostate cancer outpatients. Psychosom Med. 2003;65:571–81.
Speca M, Carlson LE, Goodey E, Angen M. A randomized, wait-list controlled clinical trial: the effect of a mindfulness meditation-based stress reduction program on mood and symptoms of stress in cancer outpatients. Psychosom Med. 2000;62:613–622.
Gielissen MF, Verhagen S, Witjes F, Bleijenberg G. Effects of cognitive behavior therapy in severely fatigued disease-free cancer patients compared with patients waiting for cognitive behavior therapy: a randomized controlled trial. J Clin Oncol. 2006;24(30):4882–7.
Stanton AL, Ganz PA, Kwan L, Meyerowitz BE, Bower JE, Krupnick JL, et al. Outcomes from the moving beyond cancer psychoeducational, randomized, controlled trial with breast cancer patients. J Clin Oncol. 2005;23(25):6009–18.
McNeely ML, Campbell KL, Rowe BH, Klassen TP, Mackey JR, Courneya KS. Effects of exercise on breast cancer patients and survivors: a systematic review and meta-analysis. CMAJ. 2006;175(1):34–41.
Courneya KS, Mackey JR, Bell GJ, Jones LW, Field CJ, Fairey AS. Randomized controlled trial of exercise training in postmenopausal breast cancer survivors: cardiopulmonary and quality of life outcomes. J Clin Oncol. 2003;21(9):1660–8.
Pinto BM, Frierson GM, Rabin C, Trunzo JJ, Marcus BH. Home-based physical activity intervention for breast cancer patients. J Clin Oncol. 2005;23(15):3577–87.
Leonard BE, McCartan D, White J, King DJ. Methylphenidate: a review of its neuropharmacological, neuropsychological and adverse clinical effects. Hum Psychopharmacol. 2004;19(3):151–80.
Hansten P, Horn J. Hansten and Horn’s drug interaction analysis and management. St. Louis, MO: Wolters Kluwer Health, Inc.; 2006.
O’Connor A, Llewellyn-Thomas HA, Flood AB. Modifying unwarranted variations in health care: shared decision making using patient decision aids: a review of the evidence base for shared decision making. Health Aff 63–72, October 2004.
Kirshbaum MN. A review of the benefits of whole body exercise during and after treatment for breast cancer. J Clin Nurs. 2007;16(1):104–21.
Weiger WA, Smith M, Boon H, Richardson MA, Kaptchuk TJ, Eisenberg DM. Advising patients who seek complementary and alternative medical therapies for cancer. Ann Intern Med. 2002;137(11):889–903.
Fox R. Informed choice in screening programs: do leaflets help? A critical literature review. J Publ Health. Advance Access Published October 23, 2006.
IOM (Institute of Medicine). Complementary and Alternative Medicine (CAM) in the United States. Washington, DC: National Academy Press; 2005.
IOM (Institute of Medicine). Crossing the quality chasm: a new health system for the 21st Century. Washington, DC: National Academy Press; 2001.
IOM (Institute of Medicine). From cancer patient to cancer survivor: lost in transition. Washington, DC: National Academy Press; 2006.
Cohen MH, Hrbek A, Davis RB, Schachter SC, Kemper KJ, Boyer EW, et al. Emerging credentialing practices, malpractice liability policies, and guidelines governing complementary and alternative medical practices and dietary supplement recommendations: a descriptive study of 19 integrative health care centers in the United States. Arch Intern Med. 2005;165(3):289–95. Erratum in: Arch Intern Med. 2005 Apr 11;165(7):730. Kemper, Kathi J [added]; Boyer, Edward W [added].
Frosch D, Kaplan R. Shared decision making in clinical medicine: past research and future directions. Am J Prev Med. 1999;17:285–94.
Kaplan R, Frosch D. Decision-making in medicine and health care. Annu Rev Clin Psychol. 2005;1:525–56.
Tagliaferri M, Cohen I, Tripathy D. Complementary and alternative medicine in early-stage breast cancer. Sem Oncol. 2001;28(1):121–34.
Bower JE. Cancer-related fatigue: links with inflammation in cancer patients and survivors. Brain Behav Immun. 2007;21(7):863–71.
Bender CM, Ergyn FS, Rosenzweig MQ, Cohen SM, Sereika SM. Symptom clusters in breast cancer across 3 phases of the disease. Cancer Nurs. 2005;28(3):219–25.
Walling A. Therapeutic modulation of the psychoneuroimmune system by medical acupuncture creates enhanced feelings of well-being. J Am Acad Nurse Pract. 2006;18(4):135–43.
Cho ZH, Hwang SC, Wong EK, Son YD, Kang CK, Park TS. Neural substrates, experimental evidences and functional hypothesis of acupuncture mechanisms. Acta Neurol Scand. 2006;113(6):370–7.
Markes M, Brockow T, Resch KL. Exercise for women receiving adjuvant therapy for breast cancer. Cochrane Database Syst Rev 2006;(4):CD005001.
Yang JS. Acupuncture and moxibustion. Beijing: Ren Min Wei Sheng Press; 1997.
Henderson JW, Donatelle RJ. Complementary and alternative medicine use by women after completion of allopathic treatment for breast cancer. Altern Ther Health Med. 2004;10(1):52–7.
Molassiotis A, Sylt P, Diggins H. The management of cancer-related fatigue after chemotheraphy with acupuncture and acupressure: a randomized controlled trial. Complement Ther Med. (in press).
Acknowledgements
This research was supported by funds from the California Breast Cancer Research Program of the University of California, Grant Number 10FB-0049 (Johnston, Hui). Authors also gratefully acknowledge support from the Susan G. Komen Breast Cancer Foundation, Award Number POP0504401 (Hui, Johnston), the Gerald Oppenheimer Family Foundation (Hui), and the Annenberg Foundation (Hui). We thank Dominick Frosch for introducing us to the field of informed decision-making and very helpful comments on an earlier draft of this paper.
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Johnston, M.F., Xiao, B. & Hui, KK. Acupuncture and fatigue: Current basis for shared communication between breast cancer survivors and providers. J Cancer Surviv 1, 306–312 (2007). https://doi.org/10.1007/s11764-007-0035-9
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DOI: https://doi.org/10.1007/s11764-007-0035-9