The National Cancer Institute's Conference on Acupuncture for Symptom Management in Oncology

State of the Science, Evidence, and Research Gaps

Published in: NCI Monographs, Volume 2017, Issue 52 (November 2017), lgx005. doi: 10.1093/jncimonographs/lgx005

Posted on RAND.org on December 15, 2017

by Farah Z. Zia, Oluwadamilola Olaku, Ting Bao, Ann Berger, Gary Deng, Arthur Arthur Yin Fan, Mary K. Garcia, Patricia M. Herman, Ted J. Kaptchuk, Elena J. Ladas, Helene M. Langevin, Lixing Lao, Weidong Lu, Vitaly Napadow, Richard C. Niemtzow, Andrew J. Vickers, Xin Shelly Wang, Claudia Witt, Jun J. Mao

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Research Question

  1. What evidence for using acupuncture to treat cancer symptoms was presented at the symposium?

The Division of Cancer Treatment and Diagnosis, Office of Cancer Complementary and Alternative Medicine, at the National Cancer Institute (NCI) held a symposium on "Acupuncture for Cancer Symptom Management" on June 16 and 17, 2016. Invited speakers included 19 scientists and scholars with expertise in acupuncture and cancer research from the United States, Europe, and China. The conference reviewed the NCI's grant funding on acupuncture, analyzed the needs of cancer patients, reviewed safety issues, and assessed both the current scientific evidence and research gaps of acupuncture in oncology care. Researchers and stakeholders presented and discussed basic mechanisms of acupuncture; clinical evidence for specific symptoms; and methodological challenges such as placebo effects, novel biostatistical methods, patient-reported outcomes, and comparative effectiveness research. This paper, resulting from the conference, summarizes both the current state of the science and clinical evidence of oncology acupuncture, identifies key scientific gaps, and makes recommendations for future research to increase understanding of both the mechanisms and effects of acupuncture for cancer symptom management.

Key Findings

  • Use of acupuncture in conjunction with pharmaceutical treatment can be more effective for treating cancer-related pain than pharmacotherapy alone.
  • Acupuncture relieves pain in cancer patients with aromatase inhibitor-associated arthralgia, but its effects on chemotherapy-induced peripheral neuropathy are mixed, suggesting that more information is needed on the timing, dosing, and mode of acupuncture for that type of pain.
  • A short course of acupuncture appears to reduce fatigue for most patients, but prolonged acupuncture does not appear to have additional benefit for fatigue.
  • Evidence of acupuncture's effect on hot flashes is too limited to recommend for or against its use to treat this symptom.
  • Although the use of acupuncture to treat chemotherapy-induced nausea and vomiting is widely accepted, its effectiveness should be evaluated against new anti-emetic guidelines.
  • Clinical trials are studying the effects of acupuncture on the prevention and treatment of radiation-induced xerostomia.
  • The evidence base on effectiveness of acupuncture in children with cancer is limited, and more research needs to be done to understand appropriate needle size, treatment duration and frequency, and individualizing therapy.
  • The symposium identified ten key areas on which to focus to accelerate understanding of and build the evidence base for the use of acupuncture to treat cancer symptoms.

Recommendation

As the evidence base grows for the use of acupuncture to treat cancer symptoms, knowledge needs to be conferred into action: clinical pathways that integrate acupuncture with conventional treatment need to be developed; community acupuncturists, primary care providers, oncologists, and patients need to be educated on acupuncture in oncology settings; and health care insurance coverage needs to be made available to make acupuncture available for oncology patients across socioeconomic strata.

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