Acupuncture for hot flushes, vasomotor symptoms, breathlessness, xerostomia, chemotherapy-induced leucopenia and for alleviating the adverse effects of conventional breast cancer therapies

1.1. Scientific name

The term “acupuncture” is derived from Latin and means ‘piercing with a sharp instrument’.

1.2. Ingredients

Acupuncture is usually performed with fine needles but many variations exist. “Acupoints” might, for instance, be stimulated by electrical currents with or without needles (electro-acupuncture), by pressure (acupressure), by heat (moxibustion) or laser light (laser-acupuncture).

1.3. Application and dosage

Acupuncture is applied to the body surface. The dosage depends on the condition treated. Sometimes only one acupoint is stimulated; more commonly several needles are applied. Sometimes acupoints along meridians are needled; on other occasions, the targets might be trigger points unrelated to meridians. Sometimes only specific areas of the body, e.g. the ear (ear-acupuncture) are treated; more commonly several areas are needled during one session. Sometimes needles or studs are left for days or weeks; more commonly they are removed after a ~30min session. Sometimes the needles are “stimulated” by manual manipulation; at other times they are left unstimulated. Sometimes treatments are repeated regularly, e.g. twice weekly; at other times a treatment can comprise of just one single session.

1.4. History/providers

The history of acupuncture goes back to ancient China and its Taoist philosophy. In TCM, the life energy “Qi” flowing through the body in meridians and the balance of Yin and Yang are thought to determine human health. Illness is seen as an imbalance of these energies and acupuncture is one means of re-balancing any imbalance. Therefore, acupuncture is understood by TCM practitioners as a treatment for most human conditions and symptoms. TCM acupuncturists also diagnose according to principles and techniques unique to TCM, e.g. employing pulse- and tongue-diagnoses to define chi imbalances and blockages. By contrast, most Western acupuncturists diagnose in line with modern medicine and employ acupuncture with a view of affecting neurophysiological mechanisms.

Acupuncture became popular outside Asia after the US president Richard Nixon visited China. Subsequently scientific investigations into this area began first in the US and subsequently across the globe.

1.5. Claims of efficacy

In TCM, acupuncture is understood as a therapy for most human illnesses (see above). By contrast, the modern concepts of acupuncture predict that it is efficacious only for a limited range of conditions including pain.

1.6. Mechanisms of action

The concepts of TCM acupuncture postulating energies, meridians etc are not supported by scientific evidence. Neurophysiological theories to explain acupuncture’s modes of action have been developed, e.g. gate-control mechanism, and effects on neurotransmitters like endorphins 1.

1.7. Alleged indications

According to TCM concepts, acupuncture is a therapy for all symptoms and diseases. Modern concepts are centred around the management of pain and conditions likely to be influenced through effects on neurotransmitters 1.

1.8. Prevalence of use

In many countries, acupuncture is currently one of the most popular and most accepted forms of CAM. Many oncology centres across the world routinely offer acupuncture as one of several therapeutic options for symptom management. Exact prevalence figures vary from country to country and from setting to setting.

1.9. Legal issues

In most countries, acupuncture is administered by both medically-trained and statutorily regulated professionals (e.g. doctors, physiotherapists, nurses, midwives) and by non-medically-trained and often unregulated acupuncturists.

1.10. Cost and expenditures

One session lasting about ½ hour would currently cost between €50 and €90. One series of treatments would normally comprise 5-20 sessions, but often long-term therapy is advised.