Skip to main content

Acupuncture for Symptom Management in Cancer Care: an Update

Current Oncology Reports volume 16, Article number: 418 (2014) Cite this article

Abstract

In a previous systematic review of the worldwide literature of randomized controlled trials (RCTs) involving needle insertion into acupuncture points for symptom management in cancer patients, we identified only one high-quality RCT that was deemed to have a low risk of bias. Medline, Embase, CINAHL, Cochrane (all databases), Scopus, and PubMed were searched from inception through December 2011 with no language limits applied. A total of 41 RCTs met all inclusion criteria and were rated. In the current review, we examined 18 trials published since our last report. The purpose of this update was to emphasize important recent findings and discuss how concerns such as blinding, separating non-specific placebo effects from specific needling effects, determining biologic mechanisms and dosing parameters, evaluating determinants of response such as expectation, controlling for sources of bias, and the lack of standardization in treatment and study methods may affect the interpretation of study results.

This is a preview of subscription content, access via your institution.

Access options

Buy single article

Instant access to the full article PDF.

USD 39.95

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

References

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

  1. Towler P, Molassiotis A, Brearley SG. 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. 2013;21:2913–23.

    Article  CAS  PubMed  Google Scholar 

  2. Garcia MK, McQuade J, Haddad R, Patel S, Lee R, Yang P, et al. Systematic review of acupuncture in cancer care: a synthesis of the evidence. J Clin Oncol. 2013;31:952–60. This is an initial systematic review of acupuncture for symptom management in cancer care upon which the current update is based.

    Article  PubMed Central  PubMed  Google Scholar 

  3. Higgins JPT, Altman DG, Sterne JAC. Chapter 8: assessing risk of bias in included studies. In: Higgins JPT, Green S, editors. Cochrane handbook for systematic reviews of interventions, version 5.1.0. [http://www.cochrane-handbook.org].

  4. Shen J, Wenger N, Glaspy J, Hays RD, Albert PS, Choi C, et al. Electroacupuncture for control of myeloablative chemotherapy-induced emesis: a randomized controlled trial. JAMA. 2000;284:2755–61.

    Article  CAS  PubMed  Google Scholar 

  5. Lu L, Liao M, Zeng J, He J. Quality of reporting and its correlates among randomized controlled trials on acupuncture for cancer pain: application of the CONSORT 2010 Statement and STRICTA. Expert Rev Anticancer Ther. 2013;13:489–98.

    Article  CAS  PubMed  Google Scholar 

  6. Vickers AJ, Cronin AM, Maschino AC, Lewith G, Macpherson H, Foster NE, Sherman KJ, Witt CM, Linde K. Acupuncture for chronic pain: individual patient data meta-analysis. Arch Intern Med. 2012:1-10. This study reports results from an individual patient-level data meta-analysis of 29 trials involving 14,597 patients with non-malignant chronic pain treated with acupuncture.

  7. Crew KD, Capodice JL, Greenlee H, Apollo A, Jacobson JS, Raptis G, et al. Pilot study of acupuncture for the treatment of joint symptoms related to adjuvant aromatase inhibitor therapy in postmenopausal breast cancer patients. J Cancer Survive. 2007;1:283–91.

    Article  Google Scholar 

  8. Henry NL, Jacobson JA, Banerjee M, Hayden J, Smerage JB, Van Poznak C, et al. A prospective study of aromatase inhibitor-associated musculoskeletal symptoms and abnormalities on serial high-resolution wrist ultrasonography. Cancer. 2010;116:4360–7.

    Article  PubMed Central  PubMed  Google Scholar 

  9. Mao JJ, Xie SX, Farrar JT, Stricker CT, Bowman MA, Bruner D, et al. A randomised trial of electro-acupuncture for arthralgia related to aromatase inhibitor use. Eur J Cancer. 2014;50:267–76. This is the largest trial published to date of acupuncture in AI-related joint pain.

    Article  CAS  PubMed  Google Scholar 

  10. Oh B, Kimble B, Costa DS, Davis E, McLean A, Orme K, et al. Acupuncture for treatment of arthralgia secondary to aromatase inhibitor therapy in women with early breast cancer: pilot study. Acupunct Med. 2013;31:264–71.

    Article  CAS  PubMed  Google Scholar 

  11. Bao T, Cai L, Giles JT, Gould J, Tarpinian K, Betts K, et al. A dual-center randomized controlled double blind trial assessing the effect of acupuncture in reducing musculoskeletal symptoms in breast cancer patients taking aromatase inhibitors. Breast Cancer Res Treat. 2013;138:167–74.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  12. Mao JJ, Bruner DW, Stricker C, Farrar JT, Xie SX, Bowman MA, et al. Feasibility trial of electroacupuncture for aromatase inhibitor-related arthralgia in breast cancer survivors. Integr Cancer Ther. 2009;8:123–9.

    Article  PubMed Central  PubMed  Google Scholar 

  13. Bao T, Goloubeva O, Pelser C, Porter N, Primrose J, Hester L, Sadowska M, Lapidus R, Medeiros M, Lao L, Dorsey SG, Badros AZ. A pilot study of acupuncture in treating bortezomib-induced peripheral neuropathy in patients with multiple myeloma. Integr Cancer Ther. 2014;13:396–404.

  14. Garcia MK, Cohen L, Guo Y, Zhou Y, You B, Chiang J, et al. Electroacupuncture for thalidomide/bortezomib-induced peripheral neuropathy in multiple myeloma: a feasibility study. J Hematol Oncol. 2014;7:41.

    Article  PubMed Central  PubMed  Google Scholar 

  15. Rostock M, Jaroslawski K, Guethlin C, Ludtke R, Schroder S, Bartsch HH. Chemotherapy-induced peripheral neuropathy in cancer patients: a four-arm randomized trial on the effectiveness of electroacupuncture. Evid Based Complement Alternat Med. 2013;2013:349653.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  16. Zeng Y, Luo T, Finnegan-John J, Cheng AS. Meta-analysis of randomized controlled trials of acupuncture for cancer-related fatigue. Integr Cancer Ther. 2013;13:193–200.

    Article  PubMed  Google Scholar 

  17. Posadzki P, Moon TW, Choi TY, Park TY, Lee MS, Ernst E. Acupuncture for cancer-related fatigue: a systematic review of randomized clinical trials. Support Care Cancer. 2013;21:2067–73.

    Article  PubMed  Google Scholar 

  18. Molassiotis A, Bardy J, Finnegan-John J, Mackereth P, Ryder DW, Filshie J, et al. Acupuncture for cancer-related fatigue in patients with breast cancer: a pragmatic randomized controlled trial. J Clin Oncol. 2012;30:4470–6.

    Article  PubMed  Google Scholar 

  19. Molassiotis A, Bardy J, Finnegan-John J, Mackereth P, Ryder WD, Filshie J, et al. A randomized, controlled trial of acupuncture self-needling as maintenance therapy for cancer-related fatigue after therapist-delivered acupuncture. Ann Oncol. 2013;24:1645–52.

    Article  CAS  PubMed  Google Scholar 

  20. Deng G, Chan Y, Sjoberg D, Vickers A, Yeung KS, Kris M, et al. Acupuncture for the treatment of post-chemotherapy chronic fatigue: a randomized, blinded, sham-controlled trial. Support Care Cancer. 2013;21:1735–41.

    Article  PubMed Central  PubMed  Google Scholar 

  21. Mao JJ, Farrar JT, Bruner D, Zee J, Bowman M, Seluzicki C, DeMichele A, Xie SX. Electroacupuncture for fatigue, sleep, and psychological distress in breast cancer patients with aromatase inhibitor-related arthralgia: a randomized trial. Cancer. 2014. doi:10.1002/cncr.28917.

  22. Smith C, Carmady B, Thornton C, Perz J, Ussher JM. The effect of acupuncture on post-cancer fatigue and well-being for women recovering from breast cancer: a pilot randomised controlled trial. Acupunct Med. 2013;31:9–15.

    Article  PubMed  Google Scholar 

  23. Frisk JW, Hammar ML, Ingvar M, Spetz Holm AC. How long do the effects of acupuncture on hot flashes persist in cancer patients? Support Care Cancer. 2014;22:1409–15.

    Article  PubMed  Google Scholar 

  24. Nedstrand E, Wijma K, Wyon Y, Hammar M. Vasomotor symptoms decrease in women with breast cancer randomized to treatment with applied relaxation or electro-acupuncture: a preliminary study. Climacteric. 2005;8:243–50.

    Article  CAS  PubMed  Google Scholar 

  25. Frisk J, Carlhall S, Kallstrom AC, Lindh-Astrand L, Malmstrom A, Hammar M. Long-term follow-up of acupuncture and hormone therapy on hot flushes in women with breast cancer: a prospective, randomized, controlled multicenter trial. Climacteric. 2008;11:166–74.

    Article  CAS  PubMed  Google Scholar 

  26. Frisk J, Spetz AC, Hjertberg H, Petersson B, Hammar M. Two modes of acupuncture as a treatment for hot flushes in men with prostate cancer–a prospective multicenter study with long-term follow-up. Eur Urol. 2009;55:156–63.

    Article  PubMed  Google Scholar 

  27. Deng G, Vickers A, Yeung S, D'Andrea GM, Xiao H, Heerdt AS, et al. Randomized, controlled trial of acupuncture for the treatment of hot flashes in breast cancer patients. J Clin Oncol. 2007;25:5584–90.

    Article  PubMed  Google Scholar 

  28. Liljegren A, Gunnarsson P, Landgren BM, Robeus N, Johansson H, Rotstein S. Reducing vasomotor symptoms with acupuncture in breast cancer patients treated with adjuvant tamoxifen: a randomized controlled trial. Breast Cancer Res Treat. 2012;135:791–8.

    Article  CAS  PubMed  Google Scholar 

  29. Hervik J, Mjaland O. Acupuncture for the treatment of hot flashes in breast cancer patients, a randomized, controlled trial. Breast Cancer Res Treat. 2009;116:311–6.

    Article  PubMed  Google Scholar 

  30. Bokmand S, Flyger H. Acupuncture relieves menopausal discomfort in breast cancer patients: a prospective, double blinded, randomized study. Breast. 2013;22:320–3.

    Article  PubMed  Google Scholar 

  31. Guo J, Wang LP, Liu CZ, Zhang J, Wang GL, Yi JH, et al. Efficacy of acupuncture for primary insomnia: a randomized controlled clinical trial. Evid Based Complement Alternat Med. 2013;2013:163850.

    PubMed Central  PubMed  Google Scholar 

  32. Huo ZJ, Guo J, Li D. Effects of acupuncture with meridian acupoints and three Anmian acupoints on insomnia and related depression and anxiety state. Chin J Integr Med. 2013;19:187–91.

    Article  PubMed  Google Scholar 

  33. Bao T, Cai L, Snyder C, Betts K, Tarpinian K, Gould J, et al. Patient-reported outcomes in women with breast cancer enrolled in a dual-center, double-blind, randomized controlled trial assessing the effect of acupuncture in reducing aromatase inhibitor-induced musculoskeletal symptoms. Cancer. 2014;120:381–9.

    Article  PubMed  Google Scholar 

  34. Cassileth BR, Van Zee KJ, Yeung KS, Coleton MI, Cohen S, Chan YH, et al. Acupuncture in the treatment of upper-limb lymphedema: results of a pilot study. Cancer. 2013;119:2455–61.

    Article  PubMed Central  PubMed  Google Scholar 

  35. Meng Z, Garcia MK, Hu C, Chiang J, Chambers M, Rosenthal DI, et al. Sham-controlled, randomised, feasibility trial of acupuncture for prevention of radiation-induced xerostomia among patients with nasopharyngeal carcinoma. Eur J Cancer. 2012;48:1692–9.

    Article  PubMed  Google Scholar 

  36. Braga FP, Lemos Junior CA, Alves FA, Migliari DA. Acupuncture for the prevention of radiation-induced xerostomia in patients with head and neck cancer. Braz Oral Res. 2012;25:180–5.

    Article  Google Scholar 

  37. Simcock R, Fallowfield L, Monson K, Solis-Trapala I, Parlour L, Langridge C, et al. ARIX: a randomised trial of acupuncture v oral care sessions in patients with chronic xerostomia following treatment of head and neck cancer. Ann Oncol. 2013;24:776–83.

    Article  CAS  PubMed  Google Scholar 

  38. Meng Z, Garcia MK, Hu C, Chiang J, Chambers M, Rosenthal DI, et al. Randomized controlled trial of acupuncture for prevention of radiation-induced xerostomia among patients with nasopharyngeal carcinoma. Cancer. 2012;118:3337–44.

    Article  PubMed Central  PubMed  Google Scholar 

  39. Ng SS, Leung WW, Mak TW, Hon SS, Li JC, Wong CY, et al. Electroacupuncture reduces duration of postoperative ileus after laparoscopic surgery for colorectal cancer. Gastroenterology. 2013;144:307–313.e1. This is the largest study published to date evaluating the use of electro-acupuncture for reducing post-operative ileus and length of hospital stay after laparoscopic surgery for colorectal cancer.

  40. Kaptchuk TJ, Kelley JM, Conboy LA, Davis RB, Kerr CE, Jacobson EE, et al. Components of placebo effect: randomised controlled trial in patients with irritable bowel syndrome. BMJ. 2008;336:999–1003.

    Article  PubMed Central  PubMed  Google Scholar 

  41. Ezzo JM, Richardson MA, Vickers A, Allen C, Dibble SL, Issell BF, Lao L, Pearl M, Ramirez G, Roscoe J, Shen J, Shivnan JC, Streitberger K, Treish I, Zhang G. Acupuncture-point stimulation for chemotherapy-induced nausea or vomiting. Cochrane Database Syst Rev. 2006:CD002285.

Download references

Compliance with Ethics Guidelines

Conflict of Interest

M. Kay Garcia, Jennifer McQuade, Richard Lee, Robin Haddad, Michael Spano, and Lorenzo Cohen declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Author information

Authors and Affiliations

  1. Department of General Oncology, Integrative Medicine Program, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 0462, Houston, TX, 77030, USA

    M. Kay Garcia, Jennifer McQuade, Richard Lee, Robin Haddad, Michael Spano & Lorenzo Cohen

Authors
  1. M. Kay Garcia
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jennifer McQuade
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Richard Lee
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Robin Haddad
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Michael Spano
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Lorenzo Cohen
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to M. Kay Garcia.

Additional information

This article is part of the Topical Collection on Integrative Care

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Garcia, M.K., McQuade, J., Lee, R. et al. Acupuncture for Symptom Management in Cancer Care: an Update. Curr Oncol Rep 16, 418 (2014). https://doi.org/10.1007/s11912-014-0418-9

Download citation

  • Published:

  • DOI: https://doi.org/10.1007/s11912-014-0418-9

Keywords

  • Acupuncture
  • Cancer
  • Integrative medicine
  • Complementary medicine
  • Symptom management
  • Pain
  • Fatigue
  • Peripheral neuropathy
  • Lymphedema
  • Hot flashes