Acupuncture for hot flushes, vasomotor symptoms, breathlessness, xerostomia, chemotherapy-induced leucopenia and for alleviating the adverse effects of conventional breast cancer therapies
Does it work ?
In oncology, acupuncture is almost exclusively used for supportive and palliative care. Several systematic reviews 2-6 have become available addressing specific cancer symptoms such as hot flushes, nausea or xerostemia (Table 1). For chemotherapy-induced leucopenia, and for alleviating the adverse effects of conventional breast cancer therapies, the evidence is unclear 2,5. For hot flushes and xerostomia the evidence fails to be positive 3-6. (The evidence for acupuncture in pain and nausea in cancer patients is described in two other CAM-Cancer summaries at www.cam-cancer.org)
In addition, there is evidence from systematic reviews not specifically focused on acupuncture. A Cochrane review of non-pharmacological interventions for breathlessness in advanced stages of malignant and non-malignant diseases included 5 RCTs of acupuncture/acupressure 7. Collectively they resulted in low strength evidence suggesting that acupuncture/acupressure might be effective for alleviating this problem.
A recent RCT suggested that acupuncture is as effective as drug treatment for vasomotor symptoms in breast cancer patients 8. This finding requires independent replication.
| First author Year (Ref) | Condition | No. primary studies | Quality of primary studies | Meta-analysis | Conclusion (quote) | Quality of SR | Result + / - |
| Chao 2009 2 | Therapy related adverse effects in breast cancer patients | 26 | Mostly poor | No | ... no conclusive remarks can be made. | Good | + / - |
| Lee 2009 3 | Hot flushes in prostate cancer patients | 6 | Mostly poor | Yes | The evidence is not convincing. | Good | - |
| Lee 2009 4 | Hot flushes in breast cancer | 6 | Mostly good | Yes | The evidence is not convincing. | Good | - |
| Lu 2007 5 | Chemotherapy induced leucopenia | 11 | Poor | ? | ... studies may lead to false positive estimation ... | Poor | + / - |
| Jedel 2005 6 | Xerostomia | 3 | Mostly poor | No | ... there is no evidence for the efficacy of acupuncture. | Good | - |
+ Overall positive
- Fails to show effectiveness
+ / - Undecided
Citation
Edzard Ernst, CAM-Cancer Consortium. Acupuncture for other cancer-related complaints [online document]. http://www.cam-cancer.org/CAM-Summaries/Mind-body-interventions/Acupuncture-for-other-cancer-related-complaints. March 6, 2011.Document history
First published in March 2011, authored by Edzard Ernst.
References
- Zhao ZQ. Neural mechanism underlying acupuncture analgesia. Prog Neurobiol 2008; 84(4):355-375.
- Chao L-F, Zhang AL, Liu H-E, Cheng M-H, Lam H-B, Lo SK. The efficacy of acupoint stimulation for the management of therapy-related adverse events in patients with breast cancer. A systematic review. Breast Cancer Res Treat 2009; 118:255-267.
- Lee MS, Kim K-H, Shin B-C, Choi S-M, Ernst E. Acupuncture for treating hot flushes in men with prostate cancer: a systematic review. Support Care Cancer 2009; 17(7):763-70.
- Lee MS, Kim KH, Choi S-M, Ernst E. Acupuncture for treating hot flashes in breast cancer patients: a systematic review. Breast Cancer Res Treat 2008; 115(3):497-503.
- Lu W, Hu D, an-Clower E, Doherty-Gilman A, Legedza AT, Lee H et al. Acupuncture for chemotherapy-induced leukopenia: exploratory meta-analysis of randomized controlled trials. J Soc Integrative Oncol 2007; 5(1):1-10.
- Jedel E. Acupuncture in xerostomia - a systematic review. J Oral Rehabil 2005; 32(6):392-396.
- Bausewein C, Booth S, Gysels M, Higginson IJ. Non-pharmacological interventions for breathlessness in advanced stages of malignant and non-malignant diseases. Cochrane Database of System Reviews 2008; Issue 2. Art. No.: CD005623. DOI: 10.1002/14651858.CD005623.pub2.
- Walker EM, Rodriguez AI, Kohn B, Ball RM, Pegg J, Pocock JR et al. Acupuncture versus venlafaxine for the management of vasomotor symptoms in patients with hormone receptor-positive breast cancer: a randomized controlled trial. J Clin Oncol 2010; 28(4):634-40.
- White A, Hayhoe S, Ernst E. Survey of Adverse Events Following Acupuncture. Acupunct Med. 1997; 15:67-70.
- White A. A cumulative review of the range and incidence of significant adverse events associated with acupuncture. Acupunct Med. 2004; 22(3):122-123.
- Ernst E. Deaths after acupuncture: A systematic review. Int J Risk Safety 2010; 22(3):131-136.
- Filshie J, White A. Medical Acupuncture. A Western Scientific Approach. Churchill Livingstone, Edinburgh. 1998.
- Ernst E, Pittler MH, Wider B, Boddy K. The desktop guide to complementary and alternative medicine. Edinburgh; 2nd edition. Edinburgh: Mosby/Elsevier. 2006.
The present documentation has been compiled by the CAM-CANCER Project with all due care and expert knowledge. However, the CAM-CANCER Project provides no assurance, guarantee or promise with regard to the correctness, accuracy, up-to-date status or completeness of the information it contains. This information is designed for health professionals. Readers are strongly advised to discuss the information with their physician. Accordingly, the CAM-CANCER Project shall not be liable for damage or loss caused because anyone relies on the information.
