Acupuncture as Palliative Therapy for Physical Symptoms and Quality of Life for Advanced Cancer Patients

Abstract

Background. Acupuncture is underutilized as an adjunct cancer therapy. The main study objectives were to determine the feasibility of administering acupuncture as palliative therapy to patients with advanced ovarian or breast cancer and to assess the effect on symptoms and quality of life (QOL). Methods. This study was a pilot, single-armed prospective clinical trial for patients with advanced cancer to receive 12 acupuncture sessions over 8 weeks with follow-up at weeks 9 and 12. Ambulatory patients with advanced ovarian or breast cancer were enrolled to receive treatments at an outpatient academic oncology center. Symptom severity was measured before and after each acupuncture session. A composite QOL assessment tool, consisting of validated instruments, was completed at 5 time points. Results. Forty patients enrolled in the study. Twenty-eight patients (70%; 95% confidence interval [CI] = 53%-83%) completed 4 weeks of treatment, and 26 patients (65%; 95% CI = 48%-79%) completed 8 weeks. Eight patients (20%) withdrew before receiving acupuncture, and 6 patients (15%) discontinued treatment early because of disease progression or scheduling demands. Among all 32 assessed patients, there was self-reported improvement immediately post-treatment in anxiety, fatigue, pain, and depression and significant improvement over time for patients with anxiety (P = .001) and depression (P = .02). Among patients experiencing baseline symptoms, there was improvement in anxiety (P = .001), fatigue (P = .0002), pain (P = .0002), and depression (P = .003). QOL measures of pain severity and interference, physical and psychological distress, life satisfaction, and mood states showed improved scores during treatment, with sustained benefit at 12 weeks. Conclusions. This pilot study demonstrates that an 8-week outpatient acupuncture course is feasible for advanced cancer patients and produces a measurable benefit that should be evaluated in controlled trials.

The Potential Role for Acupuncture in Treating Symptoms in Patients with Lung Cancer: An Observational Longitudinal Study

“…A clinically important improvement (2 points on the esas) clear. Several studies of varying methodologic rigour suggest that acupuncture can potentially help manage cancer symptoms such as pain, lack of appetite, nausea, emotional distress, depression, and anxiety [13][14][15][16][17][18][19] . However, no study has focused exclusively on lung cancer patients, despite that cancer being one of the commonest in men and women alike 20,21 .…”

“…However, the use of acupuncture has not yet been accepted as a standard of care in adjunctive medical treatment. The general applicability of the results from acupuncture studies to date are limited because of the use of different acupuncture techniques (for example, electrical or manual), controls (with or without comparison groups), outcome measures, needle protocols, and duration of treatment 13,15,16,27 . Most importantly from our perspective, no earlier acupuncture trials have focused specifically on lung cancer patients, despite the large numbers of patients diagnosed with lung cancer and their evident need for control of frequent, severe, and debilitating symptoms 28,29 .…”

“…Acupuncture is known to trigger electrophysiologic changes in various areas of the nervous system, including the autonomic nervous system, the pituitary gland, the hypothalamus, and other parts of the brain, causing the release of neurotransmitters, neuropeptides, and other hormones that can affect a range of bodily functions 36,37 . The proposal is that, through this biologic response, acupuncture can modulate blood pressure and body temperature, enhance immunity, decrease inflammation, and subsequently improve cancer-and treatment-related symptoms 13,30,31,38 .…”

Acupuncture in the Treatment of Cancer-Related Psychological Symptoms

“…Dean-Clower et al 15 performed a pilot single-armed prospective trial designed to evaluate quality of life in 40 advanced ovarian and breast cancer patients, using the Profile of Mood States-Short Form as secondary outcome measure. Results demonstrated a significant decrease in severity score for anxiety and depression, and these were sustained at 12 weeks.…”

Effects of acupuncture on the gene expression profile of lung tissue from normal rats

“…The National Institutes of Health (NIH) recommended acupuncture as an adjunctive treatment in comprehensive management programs, such as those for addiction, stroke rehabilitation and asthma (3,4). In recent years, acupuncture has also emerged as an alternative and satisfactory treatment for symptom management in cancer (5), functional gastrointestinal disorders (6) and rheumatic conditions (7).…”