Acupuncture alleviates cancer pain and reduces opioid use. Researchers conducted a meta-analysis of 14 randomized controlled trials and conclude that acupuncture reduces pain levels for patients with cancer. [1] In addition, the research indicates that opioid use may decrease significantly as a result of acupuncture analgesic treatments. The research was published in JAMA Oncology and includes contributions from Memorial Sloan Kettering Cancer Center (New York), RMIT University (Australia), and Guangdong University (Guangzhou) researchers.
The investigators determined that true acupuncture produces significantly greater pain reduction than sham controls. The review sorted for quality clinical trials from 17 RCTs (randomized controlled trials), including 1,111 patients. A total of 14 RCTs (including 920 patients) were admitted as quality evidence to the investigation. A total of 7 studies were conducted in China, 6 in the USA, and 1 each in Korea, France, Brazil, and Australia.
The investigators note that pain is a common reason for cancer patients to seek emergency medical services and that hospital admission is also common for cancer patients visiting emergency departments. They add that hospitals need to include acupuncture services to address this demand based on the “growing evidence of the efficacy of acupuncture.” [2]
The investigators cite evidence from Memorial Sloan Kettering Cancer Center (New York, NY), Harvard T. H. Chan School of Public Health (Boston, Massachusetts), and China Academy of Chinese Medical Sciences (Beijing, China) researchers demonstrating that most national cancer centers in the USA provide acupuncture. [3] However, the investigators note that there are significant barriers to access. They cite acupuncture’s exclusion from many insurance plans in the USA as a major obstacle for patients seeking acupuncture as an alternative or supplementary analgesic therapy.
One issue is that insurance coverage varies greatly and is largely governed on a state-by-state basis. Acupuncture services are included on the federal level within the Medicare and Medicaid system; however, this only applies to patients suffering from chronic lower back pain unrelated to surgery and the total number of annual visits are limited. For some patients, the Veterans Health Administration covers acupuncture treatments and battlefield acupuncture is a service provided by the US military. Notably, the American Pain Association and the American College of Physicians both recommend acupuncture as a nonpharmacologic treatment option. [4]
Greater inclusion of acupuncture services by licensed acupuncturists into healthcare systems for patients receiving cancer therapies alleviates suffering from severe pain and nausea. Chemotherapy patients benefit significantly from acupuncture’s often immediate and lasting ability to relieve nausea and vomiting. [5] The scope of cancer research examining traditional Chinese medicine is diverse. For example, University of Texas MD Anderson Cancer Center (Houston) and Fudan University Cancer Center (Shanghai) researchers conclude that acupuncture reduces the frequency and severity of dry mouth for head and neck cancer patients receiving radiation therapy. [6]
Research indicates that many cancer clinics provide nonpharmacologic analgesic options to meet the needs of their patients. Acupuncture’s role is expanding in this environment to alleviate suffering and provide treatment options.
References:
1. He, Yihan, Xinfeng Guo, Brian H. May, Anthony Lin Zhang, Yihong Liu, Chuanjian Lu, Jun J. Mao, Charlie Changli Xue, and Haibo Zhang. "Clinical Evidence for Association of Acupuncture and Acupressure With Improved Cancer Pain: A Systematic Review and Meta-Analysis." JAMA oncology (2019).
2. Ibid.
3. Yun, Hyeongjun, Lingyun Sun, and Jun J. Mao. "Growth of integrative medicine at leading cancer centers between 2009 and 2016: a systematic analysis of NCI-designated comprehensive cancer center websites." JNCI Monographs 2017, no. 52 (2017).
4. cms.gov/medicare-coverage-database/details/nca-decision-memo.aspx?NCAId=295&fbclid=IwAR0I9VUcwwqdd0Swm_bdB25gcGfmBtK9k4PjNBZkKy6tMgLONgKsq2_pQUE, Decision Memo for Acupuncture for Chronic Low Back Pain (CAG-00452N), Centers for Medicare & Medicaid Services, 1-24-2020.
5. Xing JY, Li X, & Ren XM. (2013). Therapeutic observation of abdominal acupuncture in preventing nausea and vomiting caused by Cisplatin-based chemotherapy. Shanghai J Acu-mox. 32(12):1046-1048.
6.Garcia, M.K., Meng, Z., Rosenthal, D.I., Shen, Y., Chambers, M., Yang, P., Wei, Q., Hu, C., Wu, C., Bei, W. and Prinsloo, S., 2019. Effect of True and Sham Acupuncture on Radiation-Induced Xerostomia Among Patients With Head and Neck Cancer: A Randomized Clinical Trial. JAMA Network Open, 2(12), pp.e1916910-e1916910.
