About
"CAM-Cancer" is the name of a project entitled "Concerted Action for Complementary and Alternative Medicine Assessment in the Cancer Field" (CAM-Cancer). Originally funded by the European Commission (EC) within the Framework 5 Programme, it is now hosted by the National Information Center for Complementary and Alternative Medicine (NIFAB) at the University of Tromsø, Norway.
Written by Vinjar Fønnebø and the CAM-Cancer Consortium.
Updated February 15, 2011

Acupuncture and acupressure for chemotherapy-associated nausea and vomiting

  • Abstract and key points
  • What is it?
  • Does it work ?
  • Is it safe?
  • Download as PDF
  • Printable version
  • View article in one page

Abstract and key points

  • The Neiguan (P6) point is stimulated either with an acupuncture needle (acupuncture) or by a wristband with a protruding knob or by finger pressure (acupressure).
  • Acupuncture and acupressure of Neiguan (P6) were shown to reduce some aspects of chemotherapy-associated nausea and vomiting when given in conjunction with standard antiemetic treatments.
  • Acupuncture and acupressure appear to be generally safe.

Acupuncture or acupressure stimulation of the P6 point is a popular treatment for nausea and vomiting associated with chemotherapy. Traditional Chinese medicine (TCM) claims that chemotherapy-induced nausea and vomiting are due to the reversal of the gastrointestinal flow of "qi". Stimulation of P6 causes the qi to flow in the right (downward) direction. The antiemetic effect is likely mediated via the central opioid pathway.

Acupuncture and acupressure of Neiguan (P6) have been compared to no treatment or placebo treatment with regard to nausea and vomiting. Studies of acupuncture or acupressure given without concurrent standard anti-emetic treatment have not been performed. Sixteen human clinical trials and one animal trial were identified, one trial involved chemotherapy treatment of rheumatoid arthritis. In addition one meta-analysis and two systematic reviews were considered. Acupuncture and acupressure of Neiguan (P6) were shown to reduce some aspects of chemotherapy-associated nausea and vomiting when given in conjunction with standard antiemetic treatments. That acupuncture and acupressure can fully replace standard approaches to reduce nausea and vomiting in chemotherapy-treated cancer patients is unlikely.

Acupuncture and acupressure appear to be generally safe. It has been shown to cause mild transient adverse effects in about 10% of patients. It does, however, have few serious adverse effects.

What is it ? »

Citation

Vinjar Fønnebø, CAM-Cancer Consortium. Acupuncture/pressure for nausea and vomiting [online document]. http://www.cam-cancer.org/layout/set/print/CAM-Summaries/Mind-body-interventions/Acupuncture-pressure-for-nausea-and-vomiting. February 15, 2011.

Document history

References

  1. Hu S, Stritzel R, Chandler A, Stern RM. P6 acupressure reduces symptoms of vection-induced motion sickness. Aviat.Space.Environ.Med. 1995;66:631-4.
  2. Shiotani A, Tatewaki M, Hoshino E, Takahashi T. Effects of electroacupuncture on gastric myoelectric activity in healthy humans. Neurogastroenterol Motil 2004;16:293-8.
  3. Al-Sadi M, Newman B, Julious SA. Acupuncture in the prevention of postoperative nausea and vomiting. Anaesthesia 1997;52:658–61.
  4. Ezzo J, Vickers A, Richardson MA, Allen C, Dibble SL, Issell B et al. Acupuncture-point stimulation for chemotherapy-induced nausea and vomiting. J Clin Oncol 2005;23:7188-98.
  5. Lee J, Dodd M, Dibble S. Abrams D. Review of acupressure studies for chemotherapy-induced nausea and vomiting control. J Pain Symptom Manage 2008;36:529-44.
  6. Chao LF, Zhang AL, Liu HE, Cheng HM et al. 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.
  7. Shen JN, 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.
  8. Streitberger K, Friedrich-Rust M, Bardenheuer H, Unnebrink K, Windeler J, Goldschmidt H et al. Effect of acupuncture compared with placebo-acupuncture at P6 as additional antiemetic prophylaxis in high-dose chemotherapy and autologous peripheral blood stem cell transplantation: A randomized controlled single-blind trial. Clinical Cancer Research 2003;9:2538-44.
  9. Dundee JW, Ghaly RG, Fitzpatrick KT, Abram WP, Lynch GA. Acupuncture prophylaxis of cancer chemotherapy-induced sickness. J.R.Soc.Med. 1989;82:268-71.
  10. Josefson A, Kreuter M. Acupuncture to reduce nausea during chemotherapy treatment of rheumatic diseases. Rheumatology 2003;42:1149-54.
  11. Reindl TK, Geilen W, Hartmann R, Wiebelitz KR, Kan G, Wilhelm I et al. Acupuncture against chemotherapy-induced nausea and vomiting in pediatric oncology. Interim results of a multicenter crossover study. Support Care Cancer 2006;14:172-6.
  12. Gottschling S, Reindl TK, Meyer S, Berrang J, Henze G, Graeber S et al. Acupuncture to alleviate chemotherapy-induced nausea and vomiting in pediatric oncology – A randomized multicenter crossover pilot trial. Klin Pädiatr 2008;220:365-70.
  13. Roscoe JA, Morrow GR, Bushunow P, Tian L, Matteson S. Acustimulation wristbands for the relief of chemotherapy-induced nausea. Altern Ther Health Med 2002;8(4):56-7,59-63.
  14. Roscoe JA, Matteson SE, Morrow GR, Hickok JT, Bushunow P, Griggs J et al. Acustimulation wrist bands are not effective for the control of chemotherapy-induced nausea in women with breast cancer. J Pain Symptom Manage 2005;29:376-84.
  15. Dibble SL, Luce J, Cooper BA, Israel J, Cohen M, Nussey B et al. Acupressure for chemotherapy-induced nausea and vomiting: A randomized clinical trial. Oncology Nursing Forum 2007;34:813-20.
  16. Treish I, Shord S, Valgus J, Harvey D, Nagy J, Stegal J et al. Randomized double-blind study of the Reliefband as an adjunct to standard antiemetics in patients receiving moderately-high to highly emetogenic chemotherapy. Supportive Care in Cancer 2003;11:516-21.
  17. Jones E, Isom S, Kemper KJ, McLean TW. Acupressure for chemotherapy-associated nausea and vomiting in children. Journ Soc Integr Oncol 2008; 6(4): 141-145.
  18. Roscoe JA, Morrow GR, Hickok JT, Bushunow P, Pierce HI, Flynn PJ et al. The efficacy of acupressure and acustimulation wrist bands for the relief of chemotherapy-induced nausea and vomiting - A University of Rochester Cancer Center Community Clinical Oncology Program Multicenter Study. J Pain Symptom Manage 2003;26:731-42.
  19. Shin YH, Kim TI, Shin MS, Juan HS. Effect of acupressure on nausea and vomiting during chemotherapy cycle for Korean postoperative stomach cancer patients. Cancer Nursing 2004;27:267-74.
  20. Dibble SL, Chapman J, Mack KA, Shih AS. Acupressure for nausea: results of a pilot study. Oncology Nursing.Forum 2000;27:41-7.
  21. Molassiotis A, Helin AM, Dabbour R, Hummerston S. The effects of P6 acupressure in the prophylaxis of chemotherapy-related nausea and vomiting in breast cancer patients. Complementary Therapies in Medicine 2007;15:3-12.
  22. Melchart D, Ihbe-Heffinger A, Leps B, von Schilling C, Linde K. Acupuncture and acupressure for the prevention of chemotherapy-induced nausea – a randomised cross-over pilot study. Support Care Cancer 2006;14:878-82.
  23. Lao L, Zhang G, Wong RH, Carter AK, Wynn RL, Berman BM. The effect of electroacupuncture as an adjunct on cyclophosphamide-induced emesis in ferrets. Pharmacology, Biochemistry and Behavior 2003;74:691-9.
  24. Lin X, Liang J, Ren J, Mu F, Ming Z, Chen JDZ. Electrical stimulation of acupuncture points enhances gastric myoelectrical activity in humans. Am J Gastroenterol 1997;92:1527-30.
  25. Miller KE, Muth ER. Efficacy of acupressure and acustimulation bands for the prevention of motion sickness. Aviat.Space.Environ.Med. 2004;75:227-34.
  26. Zou D, Chen WH, Iwakiri K, Rigda R, Tippett M, Holloway RH. Inhibition of transient lower esophageal sphincter relaxations by electrical point stimulation. Am J Physiol Gastrointest Liver Physiol 2005;289:G197-G201.
  27. Yoo S-S, The, E-K, Blinder RA, Jolesz FA. Modulation of cerebellar activities by acupuncture stimulation: evidence from fMRI study. NeuroImage 2004;22:932-40.
  28. Tatewaki M, Strickland C, Fukuda H, Tsuchida D, Hoshino E, Pappas TN et al. Effects of acupuncture on vasopressin-induced emesis in conscious dogs. American Journal of Physiology-Regulatory Integrative and Comparative Physiology 2005;288:R401-R408.
  29. Norheim AJ, Fønnebø V. Acupuncture adverse effects are more than occasional case reports. Compl Ther Med 1996;4:14-20.
  30. Yamashita H, Tsukayama H, Tanno Y, Nishijo K. Adverse events in acupuncture and moxibustion treatment: a six-year survey at a national clinic in Japan. J Alt Compl Ther 1999;5:229-36.
  31. Ernst E, White AW. Prospective studies of safety in acupuncture: a systematic review. Am J Med 2001;110:481-5.
Legal notice
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.