Mon Dec 15, 2004
Cancer patients who aren't getting enough pain control from conventional medications may be able to find relief in the ancient Chinese practice of acupuncture. A recent study found that this complementary therapy reduced pain by 36% in people with advanced cancer.
Acupuncture has been used in the United States for many years as a treatment for chronic muscle pain. Only recently, however, has it been tried as a remedy for other types of pain, including cancer pain, said Gary Deng, MD, PhD. Deng is an internist who specializes in integrative (complementary) medicine at Memorial Sloan-Kettering Cancer Center in New York. The center has a large service that provides complementary therapies like acupuncture, massage, reflexology, nutritional and herbal counseling, and music therapy to cancer patients and other community members.
The new findings, published in the Journal of Clinical Oncology (Vol. 21, No. 22: 4120-4126), add to a growing body of evidence that acupuncture can be effective against cancer pain.
Needles in the Ear
The French researchers studied 79 people at a clinic who had been treated unsuccessfully with conventional drugs for cancer-related pain. After rating their pain in a questionnaire, the patients were divided into three groups: one that received acupuncture with needles inserted into valid acupuncture points (points where an electrical signal was detected) on the ear; one that had needles inserted into placebo points on the ear (points not considered legitimate acupuncture points); and one that had steel beads applied to placebo points on the ear with a sticky patch.
The patients were instructed to leave the tiny needles and steel beads in place until they fell out on their own. (Typically, in the US, needles would be removed after 20-40 minutes, and are not usually inserted in the ear.) After 1 month, the patients returned and rated their pain again.
All the participants reported similar levels of pain before the study began. But at the second evaluation, the people who got true acupuncture ? needles in acupuncture points - reported less pain than people in the other two groups. After 2 months, people in the acupuncture group reported a 36% drop in their pain level, while people in the placebo group reported only a 2% decline.Acupuncture Not for Everyone
"For people who have acute pain, or just started having pain, the typical treatment is NSAIDs [non-steroidal anti-inflammatory drugs] or narcotics, and they might respond very well to that," he said. "But for people with intractable pain, when conventional treatment isn't producing results, it's reasonable to try acupuncture from a trained, experienced practitioner," Deng said.
But not all cancer patients are suitable candidates for acupuncture, he warned. People who have a low white blood cell count (neutropenia) or low blood platelets (thrombocytopenia) are at greater risk of infection and bleeding. Likewise, a patient with lymphedema (a swelling of the arms or legs) might have a higher risk of infection if acupuncture is performed on the swollen limb.Experience Counts
Cancer patients who are considering acupuncture should talk with their doctor to make sure it's a safe option for them, Deng said. And finding an experienced acupuncturist is key.
Lily Zhang, MS, who manages the acupuncture program at Memorial Sloan-Kettering, agreed.
"It's important that the acupuncturist should have experience working with patients who have cancer, or at least experience working with patients in the hospital," she said. "The acupuncturist should have a close relationship with the oncologist so if there are any concerns, the acupuncturist can communicate it to the doctor right away."
It's a good idea, Zhang added, for a cancer patient to bring treatment notes to acupuncture therapy, so the acupuncturist can see what type of treatment the patient is receiving and adjust the acupuncture accordingly.