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Using Acupuncture to Thrive

Using Acupuncture to Thrive During Chemotherapy

Over the last ten years, it would’ve been much more likely for me to see a patient who had cancer in the past than to see a patient actively seeking to manage the side effects of treatment. Happily, that trend seems to be changing. Patients are taking a much more active role in their care by seeking out alternative therapies, changing their diets, and making significant changes to lifestyle. The goal is no longer to just ‘survive’ treatment; people want to thrive!

In my practice, I use herbs to both potentiate chemotherapy treatment and mitigate its side effects. I use acupuncture to improve my patients’ overall mood, decrease the burden of fear, and optimize energy, digestion and sleep. If this seems too good to be true, it’s not. Read on to learn more about acupuncture’s potent role in managing the side effects of chemotherapy. You may also be interested in my recent blog post: Top 5 herbs for cancer prevention.

Cancer in the U.S.

Cancer is common in the United States, with approximately 1,685,210 new cases reported in 2016 according to the NIH’s National Cancer Institute. The main treatment option for cancer is chemotherapy.

Chemotherapy has proven and well-tested benefits towards the treatment of cancer. However, it comes with a wide range of negative, and often debilitating, side effects. Supportive treatments like acupuncture for chemotherapy can go a long way towards restoring the quality of life and treatment outcomes in these patients.

Acupuncture has been used for over two thousand years to to improve general health and vitality. Recently, researchers have backed up its use for a variety of conditions, including  it’s use in supporting cancer patients receiving chemotherapy.

The Side Effects Of Chemotherapy

Chemotherapy is a large and widespread class of drugs used in the treatment of cancer. It has become the standard treatment for cancer patients around the world.

Despite the usefulness of chemotherapy, there’s is still significant room for improvement. Chemotherapy works by preventing the growth of any and all fast growing cells in the body (such as hair, skin, immune cells and tumours). By doing this, the hope is that the cancerous tumour shrinks enough to be removed surgically before other parts of the body become too sick to continue the treatment. This is why chemotherapy treatment produces so many negative side effects.

Side effects of chemotherapy include:

  • Hair loss
  • Nausea & vomiting
  • Skin conditions
  • Poor immunity
  • Fatigue
  • Appetite suppression

Perhaps the most significant side effect of chemotherapy is its effect on the immune system. Doctors constantly measure white blood cell levels in their patients to assess immune system health.. If levels fall too low, the chemotherapy must be stopped or reduced. This is also a common reason for hospitalization during chemotherapy treatment.  

Moreover, the number and severity of symptoms a patient experiences on chemotherapy can dramatically affect his or her strength, vitality, and well-being.. A person who cannot tolerate treatment is less likely to receive chemotherapy’s full benefits because they may be forced to discontinue treatment. So any treatment that improves a patient’s vitality during treatment deserves serious consideration.

Supporting Chemotherapy With Acupuncture

Acupuncture offers unique support for chemotherapy patients. It reduces many of the key side effects including fatigue, pain, nausea, vomiting, and can even boost immune function. It boosts overall vitality and can be used to make chemotherapy outcomes more positive through a holistic, multifactorial approach.

In recent years, researchers have been studying the effectiveness of this traditional medicine on the side effects of chemotherapy. The vast majority of this research produced positive improvements in the acupuncture group over placebo controls.

What The Research Tells Us

Acupuncture For Nausea & Vomiting

There are a number of drugs doctors can combine with chemotherapy to reduce nausea & vomiting. Most of these drugs use a receptor located in our digestive tract and brain known as 5-HT3 (serotonin) [1, 3, 4]. These drugs are far from perfect as many patients still experience nausea and vomiting while taking these medications. Chemotherapy-induced nausea and vomiting can have a significant impact on quality of life and vitality of chemotherapy patients. It can also aggravate other factors like fatigue due to constant nausea and vomiting.

While there well over 2000 acupuncture points on the body, a typical acupuncturist will rely on about 100-150 points in everyday practice. Of those, there are some truly exceptional points which address nausea and vomiting- the most well-studied being P6. (Pericardium 6) located on the wrist.

A large-scale meta analysis investigated the effectiveness of acupuncture at the P6 point, for reducing nausea and vomiting induced by cancer therapy. Researchers found that the P6 acupuncture point, as well as point stimulation (using electrical impulses with acupuncture) were both effective at reducing acute vomiting in cancer patients [8].

Another meta analysis involving nearly 2000 people found similar results. 27 out of the 29 groups investigated showed significant improvements in nausea and vomiting symptoms compared to those not receiving acupuncture [9].

The largest meta analysis on the subject, involving 4858 patients, reported that the P6 acupuncture point was able to prevent postoperative nausea and vomiting [10]. Although this study looked at surgically induced nausea and vomiting, the mechanisms involved are very similar to those involved with chemotherapy.  

Acupuncture For Cancer-Related Fatigue

Fatigue is one of the most disruptive side effects of chemotherapy, as well as one of the most common [2]. Nearly 90% of chemotherapy patients, and 80% of radiotherapy patients will experience fatigue as a side effect to their treatment [6, 7]. For some, this doesn’t end after treatment. As many as 40% of patients will continue to experience fatigue for years after treatment has stopped [5].

A randomized controlled trial looked at the effectiveness of acupuncture treatments for 6 weeks on patients suffering from cancer-related fatigue. Researchers reported at the end of the 6 week study that the treatment group had a 36% reduction in pain overall compared to the control group [11]. Another study shed some light on how these benefits were possible. Using 29 patients, researchers found that acupuncture was able to increase our parasympathetic nervous system, which is responsible for our rest & digest processes. It helps us recover from stress, and regulates important processes like digestion, cellular repair, and immune function [14].

Acupuncture For Pain

There are several high-quality research studies looking at the effectiveness of acupuncture for pain. Some of these studies were specific to cancer, others involved more general pain.

A meta analysis investigating the effectiveness of acupuncture on 4 different types of pain found it to be significantly more effective than the sham treatment group. The sham group used acupuncture as treatment, but didn’t use the correct acupuncture spots for treating pain, proving that the placement of the needles is relevant to the outcome [13]. This study included nearly 18,000 patients, various forms of pain, and 2 different placebo types. It’s one of the best studies highlighting the effectiveness of acupuncture for the treatment of pain to date.

Another study more specific to cancer-related pain showed a 36% reduction in pain scores in cancer patients compared to placebo [11]. Auricular (ear) acupuncture was shown to decrease neuropathic pain associated with cancer as well [12].

Acupuncture & The Immune System

Lowered immunity is one of the most significant side effects of chemotherapy, and tends to be the main limiting factor for the continuation of treatment.

Acupuncture is well known in traditional medicine sources for improving the health of the immune system. Scientific research has backed this traditional knowledge up in a series of studies looking at the effects of acupuncture on various immune cells. One study found that patients treated with acupuncture had a significant increase in special immune cells known as T lymphocytes (CD3, CD4 and CD8) [15]. These immune cells serve as the “big guns” of the immune system. They seek and destroy infectious agents and cancerous cells marked by other members of the immune system. This study also highlighted improvements in other immune cells including monocytes, and natural killer cells, both of which play a role in the elimination of cancer.

Acupuncture was also shown to increase neutrophil counts, which are the main immune cells affected by chemotherapy treatment [16, 17]. This makes acupuncture an important consideration for the supportive treatment of patients receiving chemotherapy for producing optimal outcomes and reducing the chances of having to stop or reduce chemotherapy treatment.

Conclusion

Though acupuncture has been around for millenia, its use has recently grown in popularity among patients looking to optimize chemotherapy treatment. Recent scientific research has found acupuncture to be effective for a variety of side effects involved with chemotherapy, and even mechanisms that may produce more positive treatment outcomes from the chemotherapy itself.

Additional Resources

American Cancer Society- Cancer Facts & Figures 2018

NIH National Cancer Institute- What Is Cancer?

NIH National Cancer Institute- Cancer Statistics

References

  1. Campora, E., Giudici, S., Merlini, L., Rubagotti, A., & Rosso, R. (1994). Ondansetron and dexamethasone versus standard combination antiemetic therapy. A randomized trial for the prevention of acute and delayed emesis induced by cyclophosphamide-doxorubicin chemotherapy and maintenance of antiemetic effect at subsequent courses. American journal of clinical oncology, 17(6), 522-526.
  2. Curt, G. A., Breitbart, W., Cella, D., Groopman, J. E., Horning, S. J., Itri, L. M., … & Vogelzang, N. J. (2000). Impact of cancer-related fatigue on the lives of patients: new findings from the Fatigue Coalition. The oncologist, 5(5), 353-360.
  3. Hesketh, P. J. (1999). Defining the emetogenicity of cancer chemotherapy regimens: relevance to clinical practice. The Oncologist, 4(3), 191-196.
  4. Ioannidis, J. P., Hesketh, P. J., & Lau, J. (2000). Contribution of dexamethasone to control of chemotherapy-induced nausea and vomiting: a meta-analysis of randomized evidence. Journal of Clinical Oncology, 18(19), 3409-3422.
  5. Servaes, P., Verhagen, S., & Bleijenberg, G. (2002). Determinants of chronic fatigue in disease-free breast cancer patients: a cross-sectional study. Annals of oncology, 13(4), 589-598.
  6. Molassiotis, A., & Chan, C. W. H. (2001). Fatigue patterns in Chinese patients receiving chemotherapy. European Journal of Oncology Nursing, 5(1), 60-67.
  7. Molassiotis, A., & Chan, C. W. H. (2004). Fatigue patterns in Chinese patients receiving radiotherapy. European Journal of Oncology Nursing, 8(4), 334-340.
  8. Ezzo, J. M., Richardson, M. A., Vickers, A., Allen, C., Dibble, S. L., Issell, B. F., … & Shen, J. (2006). Acupuncture-point stimulation for chemotherapy-induced nausea or vomiting. Cochrane Database Syst Rev, 2.
  9. Vickers, A. J. (1996). Can acupuncture have specific effects on health? A systematic review of acupuncture antiemesis trials. Journal of the Royal Society of Medicine, 89(6), 303.
  10. Lee, A., & Fan, L. T. (2009). Stimulation of the wrist acupuncture point P6 for preventing postoperative nausea and vomiting. Cochrane Database Syst Rev, 2.
  11. Molassiotis, A., Sylt, P., & Diggins, H. (2007). The management of cancer-related fatigue after chemotherapy with acupuncture and acupressure: a randomised controlled trial. Complementary therapies in medicine, 15(4), 228-237.
  12. Alimi, D., Rubino, C., Pichard-Léandri, E., Fermand-Brulé, S., Dubreuil-Lemaire, M. L., & Hill, C. (2003). Analgesic effect of auricular acupuncture for cancer pain: a randomized, blinded, controlled trial. Journal of clinical oncology, 21(22), 4120-4126.
  13. Vickers, A. J., Cronin, A. M., Maschino, A. C., Lewith, G., MacPherson, H., Foster, N. E., … & Acupuncture Trialists’ Collaboration. (2012). Acupuncture for chronic pain: individual patient data meta-analysis. Archives of internal medicine, 172(19), 1444-1453.
  14. Li, Z., Wang, C., Mak, A. F., & Chow, D. H. (2005). Effects of acupuncture on heart rate variability in normal subjects under fatigue and non-fatigue state. European journal of applied physiology, 94(5-6), 633-640.
  15. Petti, F. I. L. O. M. E. N. A., Bangrazi, A. L. F. I. O., Liguori, A. L. D. O., Reale, G. A. B. R. I. E. L. L. A., & Ippoliti, F. L. O. R. A. (1998). Effects of acupuncture on immune response related to opioid-like peptides. Journal of traditional Chinese medicine= Chung i tsa chih ying wen pan, 18(1), 55-63.
  16. Karst, M., Scheinichen, D., Rueckert, T., Wagner, T., Wiese, B., Piepenbrock, S., & Fink, M. (2003). Effect of acupuncture on the neutrophil respiratory burst: a placebo-controlled single-blinded study. Complementary therapies in medicine, 11(1), 4-10.
  17. Lustberg, M. B. (2012). Management of neutropenia in cancer patients. Clinical advances in hematology & oncology: H&O, 10(12), 825.

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