Study: Acupuncture may ease breast cancer treatment side effects
Contents
At a glance | Questions for your doctor |
Study findings | Clinical trials |
Strengths and limitations | Related resources |
What does this mean for me? | |
STUDY AT A GLANCE
What is this study about?
This study looks at past research on acupuncture to manage symptoms (“side effects”) experienced by breast cancer survivors taking hormone therapy. The researchers looked at findings from 26 separate studies on the effectiveness of acupuncture to ease pain, hot flashes, sleep disturbance, fatigue, depression, and neuropathy.
Why is this study important?
Treatment-related symptoms can affect the quality of life for breast cancer patients. Even when drugs successfully control cancer, they can cause pain, fatigue, hot flashes and other symptoms that interfere with daily life. These side effects can affect both physical and mental health and interfere with work and daily activities. People with hormone receptor-positive breast cancer often stay on hormone therapy for up to 10 years—a long time to live with these symptoms. More information can be found in our XRAY review on how breast cancer patients experience hormone therapy.
Some people stop taking their medication as prescribed because of their side effects. In some cases, the drugs used to manage side effects can cause other symptoms and may be costly (more information can be found in our XRAY review on the cost of medication for the treatment of side effects). Many breast cancer survivors benefit from non-medicinal approaches, such as acupuncture, for symptom management. Acupuncture is generally thought to be safe but it can cause mild reactions, including pain, bruising, swelling, skin infection, hematoma, headache or menstrual bleeding. It is important to study whether acupuncture approaches are a safe and effective option for breast cancer patients.
Study findings
This study is a that summarizes the findings of research from the past 47 years on the use of acupuncture to manage breast cancer treatment-related symptoms. The research team searched articles published between 1974 and 2021 for information on this topic.
They identified studies that tested acupuncture or electroacupuncture (including various needle techniques) compared to an untreated control group. The untreated group could have included sham acupuncture (performed without established acupuncture points, stimulation and manipulation or using a non-penetrating technique), usual care, a “wait list" group or participants who received acupuncture after the study group or another approach such as meditation or relaxation. Studies that looked at acupressure or laser acupuncture were not included.
The researchers looked at how well acupuncture treated the side effects that are common among people taking hormone therapy for breast cancer:
- Hot flashes (10 studies)
- Joint pain (5 studies)
- Sleep disturbances (5 studies)
- Fatigue (4 studies)
- Depression (3 studies)
- (3 studies)
- Neuropathy (2 studies)
Researchers identified 26 studies that met the criteria, which together included 2,055 people. The participants had completed chemotherapy and were taking hormonal/endocrine therapy at the time of the study.
Studies differed based on where the acupuncture needles were placed. Seventeen studies used manual acupuncture (acupuncture needles are placed and moved by hand to stimulate a region of the body), while nine studies used electroacupuncture (standard acupuncture in which electricity is relayed by the acupuncture needle to stimulate the body).
- Standard acupuncture places the needle in traditional points in the body.
- Semi-standard acupuncture uses standard acupuncture points and additional points based on the patient’s needs.
- Individualized acupuncture plans all needle point locations based on individual patient needs.
Procedure |
Number of studies in which acupuncture eased symptoms more than in the untreated group |
---|---|
Standardized acupuncture |
5 of 17 (29%) |
Semi-standardized acupuncture |
8 of 8(100%) |
Individualized acupuncture |
1 of 1 (100%)* |
*Study of hot flashes
People receiving semi-standard acupuncture treatments were more likely to benefit than those who received only the standard acupuncture treatment. A single study that looked at individualized acupuncture alone showed favorable results in easing hot flashes but more research is needed to confirm this approach.
The authors analyzed the overall effect by looking at information from 20 of the 26 studies combined. In this analysis, acupuncture was more effective than untreated groups in reducing the intensity of pain, the severity of hot flashes and fatigue. They then looked at the subgroups of untreated participants and found that:
- compared to wait list groups or usual care groups, acupuncture offered more relief for pain intensity, fatigue, depression, hot flash severity and neuropathy.
- when comparing acupuncture to sham acupuncture, the results were less clear. This may be due in part to how the study was designed.
- acupuncture was more effective than the diet supplement diosmin in managing .
Acupuncture should always be performed by a licensed healthcare provider using sterile, disposable needles. Side effects of acupuncture are usually mild and may include:
- soreness
- minor bleeding or bruising at the site where the needles were inserted
- swelling
- hematoma (a bad bruise)
- headache
- menstrual bleeding
- skin infection
Strengths and limitations
Strengths
- This study attempts to summarize all of the research on a topic of high interest to people with breast cancer.
- The authors looked at results for several common symptoms experienced by people taking hormone therapy.
- The research team used a thorough approach to evaluate the studies.
- Multiple researchers were involved in selecting studies to be included, which may decrease bias.
Limitations
- Little information is provided on the safety of acupuncture, although findings from prior research indicate that acupuncture is safe. Ten studies in this review did not report adverse events.
- Only 5 of 17 studies that used a standardized acupuncture approach showed improvement with acupuncture, weakening the article’s conclusion.
- Some of the studies included in the review had small sample sizes.
- The authors encourage more research on the topic due to biases in 14 studies.
- The studies of acupuncture versus sham acupuncture cannot be conducted as double-blind research.
- This study only focused on the side effects of hormone therapy, not other treatment side effects, and does not offer any specific insight into treatment for cancers linked to genetic mutations.
Context
Acupuncture is a technique used in Traditional Chinese Medicine, an Eastern approach to medicine that considers the whole body. Acupuncture is increasingly used in the United States for many purposes and is considered safe and effective for the relief of certain symptoms. More than 60 percent of National Cancer Institute-designated cancer centers offer acupuncture. A 2019 study published in Integrative Medicine Research found that acupuncture improves overall health.
People with breast cancer often stay in treatment for many years. This is especially common among people with hormone receptor-positive breast cancer who may receive endocrine therapy for five to 10 years. Side effects can interfere with daily life, affecting mood and physical wellness.
Conclusions
This study adds to the research on acupuncture of managing side effects from breast cancer treatment. Overall, acupuncture was found to be beneficial compared to usual care or wait list control, especially for severe hot flashes and joint pain. A benefit was also seen for fatigue, depression and neuropathy. Based on these results, the authors recommend incorporating acupuncture into clinical practice. Double-blind control trials are needed to fully assess the impact of acupuncture.
What does this mean for me?
If you are experiencing side effects from hormone therapy, acupuncture may provide some relief, especially for hot flashes, joint pain, fatigue, depression or neuropathy. The studies showed that acupuncture may ease the intensity of the pain and hot flashes, although it does not eliminate them. Acupuncture is more effective for than diosmin, a diet supplement derived from citrus fruits. (Diosmin is sometimes used for vein inflammation however there is limited evidence of effectiveness.) Overall, semi-standard acupuncture treatments are more likely to be effective than standard acupuncture treatments. A semi-standard approach incorporates acupuncture points based on the needs of the individual in addition to a standard set of acupuncture points. Acupuncture is generally safe but it can cause mild reactions, including pain, bruising, swelling, skin infection, hematoma, headache or menstrual bleeding.
Reference
Li H, Schlaeger JM, Jang MK, et al. Acupuncture Improves Multiple Treatment-Related Symptoms in Breast Cancer Survivors: A Systematic Review and . Journal of Alternative and Complementary Medicine 2021 Dec;27(12):1084-1097. Published online August 27, 2021.
Disclosure: FORCE receives funding from industry sponsors, including companies that manufacture cancer drugs, tests and devices. All XRAYS articles are written independently of any sponsor and are reviewed by members of our Scientific Advisory Board prior to publication to assure scientific integrity.
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posted 9/28/22
This article is relevant for:
People considering acupuncture for managing breast cancer treatment symptoms.
This article is also relevant for:
people with breast cancer
men with breast cancer
people newly diagnosed with cancer
people with metastatic or advanced cancer
Be part of XRAY:
- Could acupuncture help ease the symptoms I am experiencing from hormone therapy, such as pain, fatigue, hot flashes, depression or neuropathy?
- Do you offer acupuncture at this clinic, cancer center or hospital? If not, where do you reccommend I go to receive treatment?
- Will my insurance cover the cost of acupuncture?
The following studies are looking at management of side effects:
Multiple cancers
- NCT03581357: Mobile Mindfulness Meditation to Improve Neuropathy in Cancer Survivors. The studies a mobile app for cancer-related neuropathy in people with breast, colorectal, endometrial, pancreatic, and other cancers, who have finished treatment and are experiencing neuropathy.
- NCT02296450: Quality of Life (QoL) Assessment in Cancer Patients and Survivors With Dermatologic Conditions Using Dermatologic QoL Instruments. This large study is designed to see how skin conditions that are related to different kinds of cancer or cancer treatments affect a patient's overall well-being.
- NCT04262180: Physical Activity Promotion for Breast and Endometrial Cancer Survivors. This study is looking at whether messaging and coaching can increase activity level and how moderate-to-vigorous activity improves symptoms and quality-of-life in women diagnosed with breast or endometrial cancer.
- EnergyPoints: A Mobile App Guiding Use of Acupressure for Cancer-related Fatigue and Sleep Disturbances. This study is looking at the use of acupressure to manage cancer-related fatigue and sleep disturbances.
Breast cancer
- NCT04621721: Physical Activity at Home for Relief from Neuropathy Caused by Taxanes in People with Breast Cancer. This study will look at the effects of gain and balance training and resistance exercise (using bands) on gait, balance, and lower extremity muscle strength after a 16-week home-based exercise program compared to educational materials without an exercise program.
- NCT04586530: Telehealth and Memory Study (TAMS). The overall purpose of this trial is to confirm the effectiveness of Memory and Attention Adaptation Training (a cognitive-behavioral therapy) as a treatment for chemotherapy-related dysfunction among breast cancer survivors.
- NCT02290834: Chemotherapy-induced and brain changes in older adults with breast cancer. The study will investigate abilities and brain images before and after chemotherapy to identify people at risk for side effects and to better understand the effects of treatment on brain structure and function.
- NCT04906200: Web-Based Symptom Monitoring and Self-Management Portal for Adolescent and Young Adult Breast Cancer Survivors. This compares a web-based patient-reported symptom-monitoring and self-management portal to standard therapy in young breast cancer survivors.
- NCT04049695: Improving Cognition After Cancer (ICAN). This study will test whether physical activity can improve cognition in breast cancer survivors and help the development of physical activity guidelines for cognition in breast cancer survivors.
- NCT04086875: A Text-based Tool to Improve Adherence to Hormone Therapy in Patients With Hormone Positive Breast Cancer. This trial studies how well text messaging works to improve adherence to hormone therapy in people with breast cancer.
- NCT04837820: The Effect of Acupuncture on Cancer-Related Difficulties. This study will test whether acupuncture can improve thinking and insomnia in breast cancer survivors. This study will also look at insomnia's link to difficulties.
- NCT03996265: Bupropion in Reducing Cancer Related Fatigue in I-III Breast Cancer Survivors. This will study how well the drug bupropion (welbutrin) reduces cancer-related fatigue in I-III breast cancer survivors.
- NCT02831582: Omega-3 Supplementation to Prevent Aromatase Inhibitor-Induced in Patients With I-III Breast Cancer. This study looks at omega-3 fatty acid supplementation to prevent aromatase inhibitor-induced side effects in patients with I-III breast cancer.
- NCT03879629: TrAstuzumab Cardiomyopathy Therapeutic Intervention With Carvedilol (TACTIC). Breast cancer patients receiving Herceptin or other HER2-directed therapy are at risk of heart damage. This study is looking at whether beta-blocker drugs could help prevent this from happening.
- NCT01802346: Low Calorie Diet to Reduce Side Effects and Increase Response to Chemo in People With Breast or Cancer. This studies a low calorie diet to reduce side effects and increase response to chemotherapy in patients with breast or cancer.
Colorectal cancer
- NCT04763174: An mHealth Symptom Management Intervention for Colorectal Cancer Patients (mCOPE). The study will look at a mobile health tool to meet the multiple symptom needs and stage-of-life challenges faced by colorectal cancer survivors.
Endometrial cancer
- NCT04713618: Changes in Pelvic Health, Sexual Function, and Quality of Life in Women With Pelvic Cancer Undergoing Radiation Therapy. This study looks at changes in physical measures and patient-reported outcomes of sexual function, intimacy and quality of life.
- NCT04298827: Gyn Onc Prehab Study. This study will compare physical therapy, nutritional counseling and behavioral therapy with physical therapy alone as part of a prehabilitation program. Return of function after surgery, quality of life, patient satisfaction and compliance will be measured.
Ovarian cancer
- NCT04533763: Living WELL: A Web-Based Program for Ovarian Cancer Survivors. This studies a group-based and web-delivered tool for ovarian cancer survivors in increasing quality of life and decreasing stress, depressive mood, anxiety, and fatigue across a 12-month period.
- NCT05047926: Prehabilitation for Advanced Ovarian Cancer Patients. Prehabilitation may improve peri-operative outcomes in patients undergoing cancer surgery. This study will look at structured activity for women undergoing chemotherapy to improve their physical state prior to surgical intervention and thus improve outcomes.
cancer
- NCT03971591: Men Moving Forward: A Lifestyle Program for African-American Cancer Survivors (MMF). This study will look at Men Moving Forward (MMF), a community-based lifestyle intervention that supports adherence to nutrition and physical activity guidelines to promote improved body composition and lessen the side effects of treatment.
- NCT05155501: Pelvic Fascia spARing Radical Prostatectomy TrIAL (PARTIAL). This clinical trial is studying whether pelvic fascia-sparing radical prostatectomy has similar cancer control and sexual function outcomes; and significantly better urinary function, less penile deformity and inguinal hernia risks as compared to radical prostatectomy.
- NCT01802346: Low Calorie Diet to Reduce Side Effects and Increase Response to Chemo in People With Breast or Cancer. This studies a low calorie diet to reduce side effects and increase response to chemotherapy in patients with breast or cancer.
Updated: 02/15/2023
The following are studies on menopause and menopause management for survivors and previvors:
- NCT03815929: , Therapy and Cardiovascular Disease Risk in Young Women. Researchers are trying to assess the best dose of for decreasing heart disease in women whose ovaries have been removed before age 46.
- NCT05042362: A Study to Learn More About How Well Elinzanetant Works and How Safe it is for the Treatment of Hot Flashes Caused by Hormonal Changes Over 26 Weeks in Women Who Have Been Through the Menopause (OASIS-1). The study treatment elinzanetant was developed to treat symptoms caused by hormonal changes. Researchers will study how well 26 weeks of elinzanetant works compared to a in women who have been through menopause and have hot flashes.
- NCT04251052: A Study to Compare Two Surgical Procedures in Women with Mutations to Assess Reduced Risk of Ovarian Cancer (SOROCk). Women ages 35–50 with a mutation and at risk for ovarian cancer are eligible. SOROCk will determine if removal of the alone can reduce the risk of ovarian cancer as much as removing the ovaries and .
- NCT04439370: Autonomic Regulation of Blood Pressure in Premature and Early Menopausal Women. This study will look at the effects of early menopause on blood pressure.
- NCT03572153: A Mind-Body Intervention for Hot Flash Management. The main goal of this study is to test whether self-administered hypnosis can be used to reduce hot flashes more than self-administered white noise hypnosis over 6 weeks of home practice.
- NCT05086705: EMBr Wave for the Reduction of Hot Flashes in Women With a History of Breast Cancer. This trial studies how well a personal heating and cooling device worn on the wrist (called EMBr Wave) may help reduce hot flash severity in women with a history of breast cancer.
- NCT04821141: Phase IIB Trial of Bazedoxifene Plus Conjugated Estrogens. Women at increased risk for breast cancer who experience hot flashes will receive bazedoxifene plus conjugated estrogens (similar to the drug Duavee) for 6 months or a control (no drug). Researchers will measure breast density with and needle biopsy that looks at biomarkers.
Updated: 03/09/2023