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Breast cancer survivors commonly report experiencing considerable fatigue, which can lead to sleep problems and poor quality of life. Yet, there are no good therapies for these patients. This research study looks at whether self-administered acupressure can help breast cancer survivors with their fatigue. (8/9/16)
Whether self-administered acupressure can improve persistent cancer-related fatigue in breast cancer survivors.
Breast cancer survivors commonly experience fatigue, which can lead to poor sleep and quality of life, yet few treatments are available.
This study suggests that acupressure, which uses firm finger pressure to stimulate the same sensitivity points used in acupuncture, may be used for treating fatigue in breast cancer survivors. However, not all breast cancer survivors who used acupressure benefited from it. More work needs to be done to determine which patients might benefit most from acupressure, and how long patients should use it. Breast cancer survivors experiencing cancer-related fatigue should talk to their health care providers to see if acupressure is an option they might explore, and to find out what other options are available.
The same article was also covered by Fox News
Oncology Nurse Advisor
About one-third of breast cancer survivors report experiencing moderate to severe fatigue after breast cancer treatment. In some cases, this fatigue can last up to 10 years! Finding ways to combat this fatigue is critical, as it affects quality of life. Even though fatigue is a major issue for some breast cancer survivors, few therapeutic options are available.
Suzanna Zick and her colleagues from the University of Michigan published work in the journal JAMA Oncology in July 2016 that examined acupressure as a potential treatment for persistent fatigue in breast cancer survivors.
Can relaxing acupressure or stimulating acupressure help breast cancer survivors with their persistent cancer-related fatigue?
The women in this study were recruited from the Michigan Tumor Registry, with data collected from women who live in Michigan. These women previously had breast cancer between stages 0 to III, completed their cancer treatments 12 months prior to the study, and were currently cancer free. All women in the study scored 4 or higher on the Brief Fatigue Inventory (BFI), which assesses the severity and impact of cancer-related fatigue. Scores on the BFI range from zero (no fatigue) to 10 (as bad [fatigue] as you can image). Women who had a cancer diagnosis other than breast or skin cancer in the past 10 years, an untreated major depressive disorder, another diagnosed condition associated with fatigue, or who had previously done acupressure were not included in the study.
Study participants included 270 women, each randomly assigned to one of three groups:
The women who received the acupressure treatments were taught by a trained acupressure educator to self-administer the therapy. They were assessed to see how well they performed the acupressure (for example, if they could locate the correct acupoints) at their first visit and at weeks 3 and 6.
The majority (about 90%) of women who participated in this study were white non-Hispanics; the majority of the minority women were black women. Because this study did not observe how male breast cancer survivors or people with metastatic breast cancer respond to acupressure, these findings may not be applicable to all breast cancer survivors. Additionally, this study looked only at doing acupressure for 6 weeks and only measured its effects after 10 weeks; researchers do not know how well the effects might hold up beyond 10 weeks. Six women could not complete the study because of bruising or difficulty doing the acupressure. And while the women were assessed to see how well they performed the acupressure, the therapy was self-administered, which means that the women’s techniques may have varied, and that they may have not adhered perfectly to the recommended daily schedule.
Finally, as pointed out in a PLOS blog post by James Coyne, a professor of health psychology, this was a single blind trial, which means that the patients’ health care providers knew which treatment they were getting, which could potentially bias how they were treated by their health care provider. And while the patients technically did not know which treatment they were getting, it would be obvious to the patients if they were getting the control treatment (no acupressure). More work should be done to see which breast cancer survivors are more likely to benefit from acupressure.
The results of this study suggest that acupressure may be a therapeutic option for breast cancer survivors experiencing persistent cancer-related fatigue. According to the study authors, “Self-administered relaxing acupressure could offer an inexpensive, easy-to-learn intervention for improving fatigue, sleep, and quality of life in fatigued breast cancer survivors.” However, more work needs to be done to explore these findings further. These findings have not changed clinical guidelines—acupressure is not guaranteed to improve fatigue for breast cancer survivors. Patients should discuss with their health care providers to see if acupressure would be a good option for them.
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Zick, SM, Sen A, Wyatt GK, et al. “Investigation of 2 Types of Self-administered Acupressure for Persistent Cancer-Related Fatigue in Breast Cancer Survivors, A Randomized Clinical Trial.” JAMA Oncology. Published online first on July 16, 2016.
Coyne, J, “Relaxing vs Stimulating Acupressure for Fatigue Among Breast Cancer Patients: Lessons to be Learned,” PLOS Blogs, July 13, 2016
FORCE Video: Complementary and Integrative Medicine for Symptom Management (presentation from the 2014 Joining FORCEs Against Hereditary Cancer Conference)