Treatment of Hot Flushes in Breast Cancer Patients with Acupuncture

Tukmachi, Emad S

doi:10.1136/aim.18.1.22

Cited by 27 publications

(24 citation statements)

References 32 publications

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“…Acupuncture has been used for the natural climacteric, [38][39][40][41][42] for patients having tamoxifen treatment for breast cancer, [42][43][44][45][46][47] and for patients with prostate cancer. Education and practice with superficial acupuncture.…”

Section: Introductionmentioning

confidence: 99%

Acupuncture and Self Acupuncture for Long Term Treatment of Vasomotor Symptoms in Cancer Patients - Audit and Treatment Algorithm

Filshie

Bolton²,

Browne

et al. 2005

Acupunct Med

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Introduction Since hormone replacement therapy given for long periods is now recognised to produce serious side effects, patients with troublesome vasomotor symptoms are increasingly using non-hormonal treatment including acupuncture. Several randomised controlled trials have shown that acupuncture reduces menopausal symptoms in patients experiencing the normal climacteric. It may have this effect by raising serotonin levels which alter the temperature set point in the hypothalamus. Va somotor symptoms can be extreme in breast cancer patients and patients with prostate cancer who are undergoing anticancer therapy. The safety of some herbal medicines and phytoestrogens has been questioned, as they could potentially interfere adversely with the bioavailability of tumouricidal drugs. Aprevious study reports short term benefit from acupuncture, and the aim of this report is to describe our approach to long term treatment. Acupuncture approach After piloting several approaches, six weekly treatments were given initially at LI4, TE5, LR3 and SP6 and two upper sternal points, but avoiding any limb with existing lymphoedema or prone to developing it. If there were no contraindications, patients were given clear instructions on how to perform self acupuncture using either semi-permanent needles or conventional needling at SP6, weekly for up to six years, for long term maintenance. Audit methods and results Aretrospective audit of electronic records was carried out by a doctor not involved in treatment. Atotal of 194 patients were treated, predominantly with breast and prostate cancer. One hundred and eighty two patients were female. The number of pre-treatment hot flushes per day was estimated by the patient: in the 159 cases providing adequate records, the mean was 16 flushes per day. Following treatment, 114 (79%) gained a 50% or greater reduction in hot flushes and 30 (21%) a less than 50% reduction. Treatment was abandoned in those who responded poorly or not at all. The duration of treatment varied from one month to over six years with a mean duration of nine months. Seventeen patients (9%) experienced minor side effects over the six year period, mostly minor rashes; one patient described leg swelling but this was likely to be due to a concurrent fracture. Conclusion Acupuncture including self acupuncture is associated with long term relief of vasomotor symptoms in cancer patients. Treatment is safe and costs appear to be low. An algorithm is presented to guide clinical use. We recommend the use of self acupuncture with needles at SP6 in preference to semipermanent needles in the first instance, but poor responders use indwelling studs if they fail to respond adequately to self acupuncture with regular needles. Point location may be of less importance than the overall 'dose', and an appropriate minimum dose may be required to initiate the effect.

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Section: Introductionmentioning

confidence: 99%

Acupuncture and Self Acupuncture for Long Term Treatment of Vasomotor Symptoms in Cancer Patients - Audit and Treatment Algorithm

Filshie

Bolton²,

Browne

et al. 2005

Acupunct Med

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“…In this context, acupuncture to a particular area has produced both local and distant effects, according to traditional terminology. [12][13][14][15][16][17][18][19][20][21][22] Another study demonstrated that acupuncture was effective in the treatment of patients with pain and limited ROM, when given within 14 days of breast cancer surgery with node axillary dissection. 18 In that study, however, additional acupuncture meridian points were used according to health conditions of the patients before and after surgery.…”

Section: Discussionmentioning

confidence: 99%

“…The degree of lymphoedema was classified as 1 to 3, according to skin characteristics and limb consistency through palpation and visual inspection. 14 The absence of alterations was classified as 0 (zero).…”

Section: Evaluationsmentioning

confidence: 99%

“…[11][12][13][14][15][16] In a previous study including 24 patients diagnosed with gynaecological malignancies undergoing intrapelvic lymph node dissection, it was observed that acupuncture combined with moxibustion treatment was associated with prevention of lower limb lymphoedema and reduction where it had already occurred. 17 Another study demonstrated that acupuncture alone had a positive effect on pain reduction and limitation of shoulder ROM shortly after breast cancer surgery.…”

Section: Introductionmentioning

confidence: 99%

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Acupuncture in the Rehabilitation of Women after Breast Cancer Surgery – a Case Series

Alem

Gurgel

2008

Acupunct Med

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Objective To evaluate the effect of acupuncture on rehabilitation of motor function, reduction in lymphoedema and improvement in perceived heaviness and tightness in the arms of women who had undergone breast cancer surgery. Subjects and Methods Twenty nine women who had had mastectomy or segmentectomy with axillary dissection, presenting with lymphoedema and/or a decrease in movement amplitude of the upper limb ipsilateral to surgery were studied. The patients underwent 24 acupuncture sessions once a week from February to December 2004. The movement amplitude of shoulder flexion and abduction and circumferential measurements of the arm, forearm and wrist were evaluated before and after one, three and six months of treatment. Statistical analysis was performed by Friedman's test. Results Significant improvements in range of movement of shoulder flexion and abduction (P<0.001), degree of lymphoedema (P=0.016), and sense of heaviness and tightening (P<0.001) in the affected limb after six months of therapy were observed. For circumferential measurements of the arm, forearm and wrist, no significant improvement between the different periods of treatment was observed. Conclusions Acupuncture in rehabilitation after breast cancer surgery was shown to be associated with improvements in movement amplitude of the shoulder, symptoms of heaviness and tightness in the arm, and the degree of lymphoedema. However, controlled trials should be performed to ascertain whether the results were due to the natural history of the complaint or the acupuncture treatment. KeywordsBreast cancer, lymphoedema, range of movement, acupuncture. IntroductionBreast cancer has been considered the second most frequent female cancer and is the major cause of death due to cancer among Brazilian women.

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“…Three prospective uncontrolled cohort studies have been completed, one in men who had undergone castration for prostate cancer, and two in women who were taking tamoxifen for breast cancer. All demonstrated a reduction in vasomotor symptoms [309][310][311] . Prolonged stimulation using semi-permanent studs or needles, especially at SP6 appears to be associated with more long-term relief of symptoms 270 .…”

Section: Acupuncturementioning

confidence: 99%

Chinese Medicine and Biomodulation in Cancer Patients—Part Two

Sagar

Wong

2008

Current Oncology

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Traditional Chinese Medicine (TCM) is a whole system containing therapeutic interventions that individually induce biomodulation at the physiologic, chemical, and molecular levels. The theory of TCM proposes a synergy between specific interventions selected as part of a care plan based on TCM diagnostic theory. Combining TCM with the modern practice of oncology seems, in conjunction with biomedical interventions (surgery, radiotherapy, chemotherapy, and pharmaceuticals), to have potential advantages through the synergy of biomodulation. Biomodulation approaches are broadly categorized as modification of tumour response and reduction of adverse effects; modulation of immunity; prevention of cancer progression; and enhancement of symptom control. Although the database of preclinical studies is rapidly expanding, good-quality clinical trials are notably scarce.Laboratory studies suggest that some herbs increase the effectiveness of conventional chemotherapy without increasing toxicity. A healthy immune system is necessary for control of malignant disease, and the immune suppression associated with cancer contributes to its progression. Many Chinese herbs contain glycoproteins and polysaccharides (among them, constituents of Coriolus versicolor, Ganoderma lucidum, Grifola frondosa, Astragalus membranaceus, Panax ginseng, and various other medicinal mushrooms) that can modulate metastatic potential and the innate immune system. Phytochemicals such as specific polysaccharides have been shown to boost the innate immune system, especially through interaction with Tolllike receptors in mucosa-associated lymphoid tissue. This intervention can potentially improve the effectiveness of new anticancer vaccines. An increase in virusassociated cancers presents a major public health problem that requires novel therapeutic strategies. A number of herbal therapies have both antiviral activity and the ability to promote immunity, possibly inhibiting the initiation and promotion of virus-associated cancers.The mechanisms learned from basic science should be applied to clinical trials both of specific interventions and of whole-system care plans that safely combine the TCM approach with the conventional biomedical model. In Western medicine, the combination of TCM herbs with drug therapies is controversial, given lack of knowledge concerning whether a drug is favourably enhanced or whether adverse effects occur. Using initial data from the preclinical studies, future clinical research needs to evaluate the combinations, some of which are showing favourable synergy.

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Treatment of Hot Flushes in Breast Cancer Patients with Acupuncture

Cited by 27 publications

References 32 publications

Acupuncture and Self Acupuncture for Long Term Treatment of Vasomotor Symptoms in Cancer Patients - Audit and Treatment Algorithm

Acupuncture and Self Acupuncture for Long Term Treatment of Vasomotor Symptoms in Cancer Patients - Audit and Treatment Algorithm

Acupuncture in the Rehabilitation of Women after Breast Cancer Surgery – a Case Series

Chinese Medicine and Biomodulation in Cancer Patients—Part Two

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