Acupuncture in Oncology

April 14 2021

Acupuncture in Oncology

Written by Angela Ehret, Acupuncturist, Advocate Aurora Health (AAH), Aurora Cancer Care Integrative Therapies

Acupuncture has been integrated into many hospital systems across the United States and is a common practice worldwide.Acupuncture is a modality of TCM (Traditional Chinese Medicine) that dates 2500-3000 years ago. While research on how acupuncture works is underway, studies show more than 72% of CAM (complementary and alternative medicine) users do not inform their medical providers that they are using therapies like acupuncture, herbs, homeopathic remedies, supplements, and more. ^1,2

Acupuncture has been used in Oncology settings at Advocate Aurora Health for over 5 years and is located in 13 of 19 Cancer Clinics throughout eastern Wisconsin.³ Acupuncture is one of many modalities at AHH; Our Integrative Medicine Department also includes massage therapy, aromatherapy, reiki, tai chi, cranial sacral therapy, & health coaching.

The practice of acupuncture in oncology is used to alleviate side effects from chemotherapy and radiation (C&R). Patients often experience C&R side effects such as fatigue, nausea/ vomiting, hot flashes, pain,⁴ compromised immune system, dry mouth, insomnia, stress, peripheral neuropathy,^5,6 and lymphedema⁷. Although these are common side effects of C&R, acupuncture is not limited to treat only these symptoms, it is also used for preventative care and wellness.

Acupuncture:Is an evidence-based medical practice in which fine needles are inserted into specific points in the body to induce a self-healing mechanism. TCM also includes herbal therapies, exercises, nutrition, moxibustion, breathing techniques, and meditation. Beside insertion of needles what else happens in acupuncture?TCM modalities are used for balancing qi, yin, and yang.Qi (pronounced Chee) in TCM, explains life's vital force within us.When qi does not flow smoothly illness will present itself.Acupuncture moves qi and brings balance to the body’s organ functions and other systems. Yin and yang make up substances in the body like, fluids, humor, & cellular energy.^8,9

Acupuncture brought to the States.

One of the lesser known and first encounters of acupuncture being brought to the states was in the early 1970’s, when the Black Panthers and Young Lords, two civil rights groups, provided acupuncture treatments in their community. The groups used acupuncture to help with: stress, drug addiction (detox), & to provide a low cost/free community health care program during economic inequality.At that time the New York the Lincoln Detox Center was established.There they use a protocol known as NADA (National Acupuncture Detoxification Association). NADA is an auricular style of acupuncture in which needles are inserted in the ear to release hormones in the brain. The patient experiences less pain and stress as well as promote better sleep.The main use for the NADA protocol is for drug dependency, like nicotine.Today NADA is the main acupuncture protocol for smoking cessation. ^10,11

After members of the Black Panthers travelled to China to learn acupuncture, President Richard Nixon also travelled to China in 1972. Nixon travelled to build relations with China and explore how to bring down the cost of health care in the U.S.During the trip Nixon’s physician, Major General Walter R Tkach, of the U.S Airforce, wrote an article in Reader’s Digest “I Watched Acupuncture Work”. ¹²

In 1971 Dr. Samuel Rosen, a New York surgeon, witnessed acupuncture being used in China as anesthesia. Acupuncture has been used for procedures that patients may need to be conscious or that do not want the side effects from anesthesia.Medical procedures such as tonsillectomy, cesarean sections, appendectomies, dental work and open-heart surgery have been done with acupuncture anesthesia. Since these events, many physicians have travelled to China and witnessed the same operations. They were intrigued that the acupuncture needles were not local and distal to the surgical sites with no Western anatomical correlation. ¹²

Acupuncture in Oncology

Practitioners of TCM can incorporate different modalities to have a best care practice for patients and provide a mind-body approach treatment for the patient.This approach can relate to the Biopsychosocial model, which includes the physical, psychological, and social aspect of a disorder.^13,14  For many, side effects from chemotherapy make it difficult to tolerate. With 85% of patients experiencing cancer related pain during diagnosis, treatment, or survivorship.¹⁵

At AAH integrative therapies such as acupuncture and massage are offered to reducing side effects of C&R and improving patient outcomes.Patients report less pain, better sleep, increase in physical activity and more joy in life (or quality of life).³ Integrative therapies give the patient tools to help feel in control or impowered with their care.Patients develop a more senseful appreciation for self-care.

Acupuncture suitable treatments

Recognized by WHO, NIH & JAMA

Treatable conditions ^16,17,18,19

Adverse reactions to Chemotherapy/ Radiation	Induction of labor	Nausea/ vomiting	Raynaud syndrome	Stiff neck
Allergic Rhinitis	Insomnia	Neck pain	Retention of urine	Stroke
Bell’s palsy	Knee pain	Obesity	Rheumatoid Arthritis	TMJ dysfunction
Diabetes Mellitus	Leukopenia	Osteoarthritis	Schizophrenia	Tennis elbow
Headache	Low Back pain	Polycystic Ovarian syndrome	Spine pain	Tobacco dependence
Hypertension	Male sexual dysfunction	Postoperative pain	Sprain	Ulcerative colitis

Physician testimonial: ‘I would like to offer my support and gratitude for the availability of Acupuncture services as provided under the care of Angela Ehret through Aurora Cancer Care at Aurora Medical Center - Summit.Acupuncture offers an evidence-based, effective supportive care modality for our patients as they navigate symptoms of pain, anxiety, nausea, and gastrointestinal toxicity associated with therapy for their illness. I regularly receive glowingly positive feedback from my patients who have initiated acupuncture under the care of Angela for treatment of these symptoms.Patients particularly report marked improvement in their neuropathy symptoms, for which limited pharmacologic treatment options are conventionally available. The comprehensive quality of our patient care at Aurora Cancer Care would wane without the support of Angela Ehret and acupuncture services, and I am very grateful to have this program available to better serve our patients.’ - Dr. Seigel, Oncologist at Aurora Cancer Clinic, Summit, WI.

Patient testimonial: ‘I started acupuncture after chemotherapy for stage 4 Non-Hodgkin's B-cell lymphoma.Acupuncture helps my peripheral neuropathy, pain, stress, and immune system. I feel I have a tool in my ongoing heath concerns.I look forward to each treatment. ’- Yvonne M.

Figure 1. Model used to locate acupuncture points. ²⁰

References

1. Institute of Medicine (US) Committee on the Use of Complementary and Alternative Medicine by the American Public.Washington (DC): National Academies Press (US); 2005.
2. Eisenberg DM, Kessler RC, Foster C, Norlock FE, Calkins DR, Delbanco TL. Unconventional medicine in the United States. Prevalence, costs, and patterns of use. N Engl J Med. 1993;328(4):246–252. [PubMed]
3. Fink J, Burns J, Perez Moreno AC, Kram JJF, Armstrong M, Chopp S, Maul SJ, Conway N. A Quality Brief of an Oncological Multisite Massage and Acupuncture Therapy Program to Improve Cancer-Related Outcomes. J Altern Complement Med. 2020 Sep;26(9):820-824. doi: 10.1089/acm.2019.0371. PMID: 32924553.
4. Alimi D, Rubino C, Pickard-Leandri E. (2003). Analgesic effect of auricular acupuncture for cancer pain: a randomized, blinded, controlled trial. J Clin Oncol.
5. Tsai-Ju Chien , Chia-Yu Liu , Ching-Ju Fang , Chun-Yu Kuo :The Efficacy of Acupuncture in Chemotherapy-Induced Peripheral Neuropathy: Systematic Review and Meta-Analysis. (2017) PubMed article # 31833790
6. Schroder S, Liepert J, Remppis A. Acupuncture treatment improves nerve conduction in peripheral neuropathy. Eur J Neurol. (2007)
7. Tsai-Ju Chien , Chia-Yu Liu , Ching-Ju Fang: The Effect of Acupuncture in Breast Cancer-Related Lymphoedema (BCRL): A Systematic Review and Meta-Analysis. Pubmed. Integr. Cancer Ther. 2019 Jan-Dec
8. Edward S. Yang, Pei-Wen Li, Bernd Nilius & Geng Li, Pflügers Archiv - European Journal of Physiology volume 462, Article number: 645 (2011)
9. Lixing Lao, Ling Xu, Shifen Xu: Integrative Pediatric Oncology pp 125-135| Traditional Chinese Medicine. (2012)
10. Mitchell ER. Fighting Drug Abuse with Acupuncture. Berkeley, CA: Pacific View Press; 1995. [Google Scholar]
11. Elizabeth B Stuyt and Claudia A Voyles; The National Acupuncture Detoxification Association protocol, auricular acupuncture to support patients with substance abuse and behavioral health disorders: current perspectives. NIH. (2016)
12. Dominic P. Lu, DDS, Lic and Gabriel P. Lu, MD, MA, PhD: An Historical Review and Perspective on the Impact of Acupuncture on U.S. Medicine and Society, NIH, (2013) Med Acupuncture. Oct; 25(5): 311–316.
13. Bruns D, Disorbio JM. Chronic pain and biopsychosocial disorders. Pract Pain Manag. 2005;5(7):2-9. 5.
14. Gallagher RM. Biopsychosocial pain medicine and mind-brain-body science. Phys Med Rehabil Clin N Am. 2004;15:855-82.
15. Lu W, Rosenthal D. Acupuncture for cancer pain and related symptoms, Curr pain headache Rep 2013;17:1-8.
16. Acupuncture: Review and Analysis of Reports on Controlled Clinical Trials, WHO Health Systems Library,
17. Diehl DL, Kaplan G, Coulter I, Glik D, Hurwitz EL. Use of acupuncture by American physicians. J Altern Complement Med 1997; 3: 119–26.
18. Marwick C. Acceptance of some acupuncture applications. JAMA 1997; 278: 1725–7.
19. WHO. Acupuncture: Review and Analysis of Reports on Controlled Clinical Trials. 2003.
20. https://cdn.pixabay.com/photo/2016/03/26/05/22/aiguille-1280088_960_720.jpg