Florida, Minnesota, and Arizona Mayo Clinic researchers find systematic review evidence indicating that acupuncture is safe and effective for the alleviation of pain due to cancer. Acupressure and laser acupuncture were excluded from the study; however, filiform acupuncture needling, electroacupuncture, auricular acupuncture, percutaneous electrical nerve stimulation (PENS), and scalp acupuncture were included. The researchers note that the exclusion of acupressure and laser acupuncture from the investigation reduces heterogeneity and improves the quality of the results.
The researchers note, “The evidence suggests that acupuncture is effective and safe in managing cancer pain in palliative settings.” [1] However, the Mayo Clinic and Jinan University researchers add that additional studies are necessary to confirm the results.
They research team notes, “Our review addresses the unmet need for acupuncture in palliative care treatment.” [2] They explain that the lack of access to and usage of palliative care arises, in part, due to a fundamental misunderstanding of pain management. One salient point made by the team is that palliative care is misconstrued as end-of-life care. The conflation of palliative care with end-of-life care causes delays and late medical referrals. The researchers estimate that approximately 10% of patients requiring palliative care actually receive it.
This is a groundbreaking study because it focuses on acupuncture administered in a palliative care setting. The researchers note that there are numerous studies (including meta-analyses) finding acupuncture effective for cancer pain relief. However, none have specifically singled out the palliative care medical setting as the only place where delivery of care is received.
This investigation solely examined acupuncture as a palliative care measure, specifically for pain relief only. They note that other investigations have included other symptoms including nausea, depression, adverse affects associated with chemotherapy and radiation therapy, and fatigue. This targeted approach of to the investigation is meant to address the specific needs for pain management.
The researchers note that a multidisciplinary approach to pain management for cancer patients is required because of the “multifactorial and complex nature of cancer pain.” [3] They add that many cancer patients, including those receiving opioids, report inadequate pain relief. In addition, many patients experience adverse effects associated with analgesic medication intake and consequently are unable to take them. As a result, the research team indicates that interdisciplinary care is a necessary component of pain management.
The researchers note, “Acupuncture has long been used for the treatment of pain, and substantial evidence supports acupuncture is effective in pain management.” [4–6] They add that acupuncture is often used for alleviating cancer pain but is also used to address medication side effects and reduce medication dosage levels. In addition, they note that scientific evidence indicates that acupuncture alleviates chemotherapy and radiotherapy induced nausea, emesis, dry mouth, and leucopenia.
The research team consisted of Mayo Clinic researchers from three US states (Florida, Minnesota, Arizona) and an additional researcher from Jinan University (Guangzhou, China). The investigation team presents an overall message that, based on current positive patient outcomes achieved through the use of acupuncture, additional acupuncture research is warranted to confirm the findings of the study.
References:
1. Yang, Juan, Dietlind L. Wahner-Roedler, Xuan Zhou, Lesley A. Johnson, Alex Do, Deirdre R. Pachman, Tony Y. Chon, Manisha Salinas, Denise Millstine, and Brent A. Bauer. "Acupuncture for palliative cancer pain management: systematic review." BMJ Supportive & Palliative Care.
Author Affiliations:
Mayo Clinic: Jacksonville, Florida; Rochester, Minnesota; Scottsdale, Arizona. School of Traditional Chinese Medicine, Jinan University (Guangzhou, China).
2. Ibid.
3. Ibid.
4. Vickers AJ, Cronin AM, Maschino AC, et al. Acupuncture for chronic pain: individual patient data meta-analysis. Arch Intern Med 2012;172:1444–53.
5. Cho Y-H, Kim C-K, Heo K-H, et al. Acupuncture for acute postoperative pain after back surgery: a systematic review and meta-analysis of randomized controlled trials. Pain Pract 2015;15:279–91.
6. Murakami M, Fox L, Dijkers MP. Ear acupuncture for immediate pain Relief-A systematic review and meta-analysis of randomized controlled trials. Pain Med 2017;18:551–64.
