Important to know: Chronic health conditions should be addressed under direct medical supervision of your GP or consultant, and acupuncture would be an adjunct or complement to usual care.

Acupuncture is often used alongside the conventional medical care as an adjunct for wellbeing and symptomatic issues, where appropriate. In many settings, oncology caregivers arrange or recommend complementary approaches to support patients overall wellbeing alongside their care. The role of this, in partnership with the GP, consultant and caregivers is to complement the conventional treatments in a supportive role.

Cancer Research UK has information on their own website about acupuncture and its potential use in supporting oncology patients with chemotherapy induced nausea, where they recommend using a British Acupuncture Council Member; Macmillan Cancer Support also has its own dedicated page on acupuncture (links to both are in Resources section below). Acupuncture’s role here is focussed on symptomatic issues and side effects of the conventional oncology treatment.

Interpreting the research:

When reading health research, it is important to know that Systematic Reviews or Meta Analyses of a large number of high-quality research studies are the very best way to be able to say to what extent a given treatment can address a condition, symptom, or set of symptoms.  The next best level of evidence is the individual Randomised Controlled Study (RCT) which uses a systematic technique to compare two or more groups of patients receiving different treatments (or a treatment against a “control”, or no treatment).  In acupuncture trials, the nature of the control group is of particular interest as it is hard to blind a patient to whether they are having a needle inserted or not, and even more challenging to blind the researcher/team to this.

The means and quality of how research is carried out varies considerably from country to country, and in terms of how an intervention is compared to another intervention (or a control).  Of note is the fact that “sham” acupuncture (where needles are placed in apparently inert locations rather than traditional acupuncture points) is not really an inert process as it has physiological effects, so that comparing sham and “true acupuncture” may therefore not give a clear picture alone; but and form a part of a research body where acupuncture versus no treatment, vs conventional treatment or vs a different approach/modality also form part of the evidence base.

The n= figure (where quoted in research) tells you how many people were participants in the study, and usually the larger a study (when it is of good quality and design), the more likely it is to be reliable and applicable to larger populations. When (statistical) “significance” is discussed in view of studies it has a very particular meaning – it is the confidence in the data (using statistical tests) that tells us how likely a result could have just come about by chance. The lower the possibility of a chance result, the more likely it is due to the intervention in the experiment. When you are reading a trial/study, the “p” is the number telling us of significance, and this must be under 5% (or p less than 0.05) to mean we can say it is a (statistically) “significant” result.

The Research:

As per systematic reviews of the research (Garcia et al, 2013, 41 RCT studies), acupuncture is commonly employed used in this field, aiming to support the patient alongside their conventional treatment and in line with the oncology team, and has been researched as far as symptoms such as fatigue, pain, hot flushes, emotional issues, chemotherapy induced nausea and vomiting (Zhang et al, 2014); radiation-induced xerostomia; and weakness, are concerned, these symptoms may be being caused by the disease itself, or the treatment being received. The evidence is positive for nausea prevention in acupuncture, but Garcia et al (2013) were not able to draw such compelling conclusions for the other symptoms, warranting further research.

A Systematic review and meta-analysis of randomized controlled trials (Höxtermann & al, 2022) shows that acupuncture is safe to use for oncology patients as an adjunct to routine treatment.

Per Rademacher, (2021). “Acupuncture, a form of traditional Chinese medicine, has been accepted into the arena of integrative oncology therapies used to ease symptom burden throughout oncology care. Research supports the safe use of acupuncture for disease and treatment-related symptoms including pain, fatigue, depression, chemotherapy-induced peripheral neuropathy, and nausea/vomiting. The body of knowledge in oncology acupuncture is significant; yet, additional evidence is warranted. Specific acupuncture research in hematopoietic cell transplantation recipients is necessary to address the unique experiences of this population.”

Ben-Ayre et al (2023: n=99) conducted a randomised controlled trial that examined the impact of integrative therapies on pain and anxiety among patients undergoing gynaecological oncology (cancer) surgery; addition of intraoperative acupuncture significantly reduced severe pain, compared with the control group and the group that received preoperative touch/relaxation only.  The combination of preoperative touch/relaxation and intraoperative acupuncture also improved the patients’ scores in the Measure Yourself Concerns and Wellbeing (MYCAW) questionnaire.

Shih et al (2023) carried out a systematic review and meta-analysis of the effectiveness of acupuncture in relieving chemotherapy-induced bone marrow suppression due to chemotherapy.  Looking at 25 RCT’s (n=1713), they examined outcome measures of G-CSF (a type of protein that helps the body make more blood cells, particularly white blood cells); of white and red blood cell counts, neutrophils and natural killer cells counts.  The results showed that acupuncture significantly increased the levels of G-CSF, WBC, RBC, NEU, ANC, Hb, PLT, and NK cells compared with control groups. The levels of PLT and NK cells also increased cumulatively over time.  They suggested a role alongside conventional medicine for acupuncture in this area.

Resources:

British Acupuncture Council evidence based factsheet about Cancer Care including specific research, trials and mechanisms of action for acupuncture in this condition.

Cancer Research UK (2021): Acupuncture

Macmillan Cancer Care (2021): Acupuncture

References:

Ben‐Arye, E., Segev, Y., Galil, G., Marom, I., Gressel, O., Stein, N., Hirsh, I., Samuels, N., Schmidt, M., Schiff, E. and Lurie, I., 2023. Acupuncture during gynecological oncology surgery: A randomized controlled trial assessing the impact of integrative therapies on perioperative pain and anxiety. Cancer, 129(6), pp.908-919.

Garcia, M.K., McQuade, J., Haddad, R., Patel, S., Lee, R., Yang, P., Palmer, J.L. and Cohen, L., 2013. Systematic review of acupuncture in cancer care: a synthesis of the evidence. Journal of Clinical Oncology, 31(7), p.952.

Höxtermann & al, 2022. Cancer Volume 128, Issue 11 p. 2159-2173

Rademacher, A., 2021. Complementary Medicine: Acupuncture. In Blood and Marrow Transplant Handbook (pp. 747-757). Springer, Cham.

Shih, Y.W., Wang, M.H., Monsen, K.A., Chang, C.W., Rias, Y.A. and Tsai, H.T., 2023. Effectiveness of Acupuncture for Relieving Chemotherapy-Induced Bone Marrow Suppression: A Systematic Review with a Meta-analysis and Trial Sequential Analysis. Journal of Integrative and Complementary Medicine.

Zhang, X., Jin, H.F., Fan, Y.H., Lu, B., Meng, L.N. and Chen, J.D., 2014. Effects and mechanisms of transcutaneous electroacupuncture on chemotherapy-induced nausea and vomiting. Evidence-Based Complementary and Alternative Medicine, 2014.