The effect of TCM acupuncture on hot flushes among menopausal women (ACUFLASH) study: A study protocol of an ongoing multi-centre randomised controlled clinical trial Randomized, controlled trial of acupuncture for the treatment of hot flashes in breast cancer patients. Functional magnetic resonance imaging (fMRI) changes and saliva production associated with acupuncture at LI-2 acupuncture point: a randomized controlled study Effect of acupuncture compared with placebo-acupuncture at P6 as additional antiemetic prophylaxis in high-dose chemotherapy and autologous peripheral blood stem cell transplantation: a randomized controlled single-blind trial. Acupuncture for the prevention of radiation-induced xerostomia in patients with head and neck cancer. Getting the Grip on Nonspecific Treatment Effects: Emesis in Patients Randomized to Acupuncture or Sham Compared to Patients Receiving Standard Care The effects of P6 acupressure in the prophylaxis of chemotherapy-related nausea and vomiting in breast cancer patients. Acupuncture compared with placebo acupuncture in radiotherapy-induced nausea--a randomized controlled study. Randomized, blinded, sham-controlled trial of acupuncture for the management of aromatase inhibitor-associated joint symptoms in women with early-stage breast cancer. Acupuncture for postchemotherapy fatigue: a phase II study. Clinical research of acupuncture on malignant tumor patients for improving depression and sleep quality. [Effects of warming needle moxibustion on improvement of gastrointestinal and immune function in patients with postoperation of colorectal cancer]. Symptom management with massage and acupuncture in postoperative cancer patients: a randomized controlled trial. Effect of stimulation of the P6 antiemetic point on postoperative nausea and vomiting. Acupuncture for pain and dysfunction after neck dissection: results of a randomized controlled trial. Acupuncture for the treatment of hot flashes in breast cancer patients, a randomized, controlled trial Acupuncture for Hot Flushes in Perimenopausal and Postmenopausal Women: A Randomised, Sham-Controlled Trial The management of cancer-related fatigue after chemotherapy with acupuncture and acupressure: a randomised controlled trial. The acute effects of acupuncture upon autonomic balance in healthy subjects. Pilot study of acupuncture for the treatment of joint symptoms related to adjuvant aromatase inhibitor therapy in postmenopausal breast cancer patients Analgesic effect of auricular acupuncture for cancer pain: a randomized, blinded, controlled trial. The influence of sensory stimulation (acupuncture) on the release of neuropeptides in the saliva of healthy subjects. Acupressure for chemotherapy-induced nausea and vomiting: a randomized clinical trial.
Background After menopause , 10–20 % of all women have nearly intolerable hot flushes . Long term use of hormone replacement therapy involves a health risk , and many women seek alternative strategies to relieve climacteric complaints . Acupuncture is one of the most frequently used complementary therapies in Norway . We design ed a study to evaluate whether Traditional Chinese Medicine acupuncture-care together with self-care is more effective than self-care alone to relieve climacteric complaints . Methods / Design The study is a multi-centre pragmatic r and omised controlled trial with two parallel arms . Participants are postmenopausal women who document ≥7 flushes/24 hours and who are not using hormone replacement therapy or other medication that may influence flushes . According to power calculations 200 women are needed to detect a 50 % reduction in flushes , and altogether 286 women will be recruited to allow for a 30 % dropout rate . The treatment group receives 10 sessions of Traditional Chinese Medicine acupuncture-care and self-care ; the control group will engage in self-care only . A team of experienced Traditional Chinese Medicine acupuncturists give acupuncture treatments . Discussion The study tests acupuncture as a complete treatment package including the therapeutic relationship and expectation . The intervention period lasts for 12 weeks , with follow up at 6 and 12 months . Primary endpoint is change in daily hot flush frequency in the two groups from baseline to 12 weeks ; secondary endpoint is health related quality of life , assessed by the Women 's Health Question naire . We also collect data on Traditional Chinese Medicine diagnoses , and we examine treatment experiences using a qualitative approach . Finally we measure biological variables , to examine potential mechanisms for the effect of acupuncture . The study is funded by The Research Council of Norway PURPOSE To determine the immediate and long-term effects of true acupuncture versus sham acupuncture on hot flash frequency in women with breast cancer . PATIENTS AND METHODS Seventy-two women with breast cancer experiencing three or more hot flashes per day were r and omly assigned to receive either true or sham acupuncture . Interventions were given twice weekly for 4 consecutive weeks . Hot flash frequency was evaluated at baseline , at 6 weeks , and at 6 months after initiation of treatment . Patients initially r and omly assigned to the sham group were crossed over to true acupuncture starting at week 7 . RESULTS The mean number of hot flashes per day was reduced from 8.7 ( st and ard deviation [ SD ] , 3.9 ) to 6.2 ( SD , 4.2 ) in the true acupuncture group and from 10.0 ( SD , 6.1 ) to 7.6 ( SD , 5.7 ) in the sham group . True acupuncture was associated with 0.8 fewer hot flashes per day than sham at 6 weeks , but the difference did not reach statistical significance ( 95 % CI , -0.7 to 2.4 ; P = .3 ) . When participants in the sham acupuncture group were crossed over to true acupuncture , a further reduction in the frequency of hot flashes was seen . This reduction in hot flash frequency persisted for up to 6 months after the completion of treatment . CONCLUSION Hot flash frequency in breast cancer patients was reduced following acupuncture . However , when compared with sham acupuncture , the reduction by the acupuncture regimen as provided in the current study did not reach statistical significance . We can not exclude the possibility that a longer and more intense acupuncture intervention could produce a larger reduction of these symptoms Background Clinical studies suggest that acupuncture can stimulate  saliva production  and reduce xerostomia ( dry mouth ) . We were interested in exploring the neuronal substrates involved in such responses . Methods In a r and omized , sham acupuncture controlled , subject blinded trial , twenty healthy volunteers received true and sham acupuncture  in r and om order . Cortical regions that were activated or deactivated during the interventions were evaluated by functional magnetic resonance imaging ( fMRI ) . Saliva production was also measured . Results Unilateral manual acupuncture stimulation at LI-2 , a point commonly used in clinical practice to treat xerostomia , was associated with bilateral activation of the insula and adjacent operculum . Sham acupuncture at an adjacent site induced neither activation nor deactivation .  True acupuncture induced more saliva production than sham acupuncture . Conclusion Acupuncture at LI-2 was associated with neuronal activations absent during sham acupuncture stimulation . Neuroimaging signal changes appear correlated to saliva production PURPOSE The purpose is to investigate an additional antiemetic effect to ondansetron with needle acupuncture at P6 compared with nonskin-penetrating placebo acupuncture in patients undergoing high-dose chemotherapy and autologous peripheral blood stem cell transplantation . EXPERIMENTAL DESIGN Eighty patients who were admitted to hospital for high-dose chemotherapy and autologous peripheral blood stem cell transplantation were included into a r and omized placebo-controlled single-blind trial . The patients were r and omized to receive acupuncture ( n = 41 ) or noninvasive placebo acupuncture ( n = 39 ) at the acupuncture point P6 30 min before first application of high-dose chemotherapy and the day after . All patients received 8 mg ondansetron/day i.v . as basic antiemetic prophylaxis . The main outcome measure was the rate of patients who either had at least one episode of vomiting or required any additional antiemetic drugs on the first 2 days of chemotherapy . RESULTS The main outcome measure showed no significant difference ( P = 0.82 ) : 61 % failure in the acupuncture group and 64 % in the placebo acupuncture group ( 95 % confidence interval of 3 % difference : -18.1 and 24.3 % ) . Comparing nausea , episodes of vomiting or retching and number of additionally required antiemetic drugs did not provide any discrepancy with the main result . CONCLUSIONS This study suggests that in combination with ondansetron i.v . , invasive needle acupuncture at P6 compared with nonskin-penetrating placebo acupuncture has no additional effect for the prevention of acute nausea and vomiting in high-dose chemotherapy The aim of this study was to evaluate the effectiveness of  acupuncture  in minimizing the severity of radiation-induced xerostomia in patients with head and neck cancer . A total of 24 consecutive patients receiving > 5000 cGy radiotherapy ( RT ) involving the major salivary gl and s bilaterally were assigned to either the preventive acupuncture group ( PA , n = 12 ) , treated with acupuncture before and during RT , or the control group ( CT , n = 12 ) , treated with RT and not receiving acupuncture . After RT completion , clinical response was assessed in all patients by syalometry , measuring the resting ( RSFR ) and stimulated ( SSFR ) salivary flow rates , and by the visual analogue scale ( VAS ) regarding dry mouth-related symptoms . Statistical analyses were performed with repeated- measures using a mixed-effect modeling procedure and analysis of variance . An alpha level of 0.05 was accepted for statistical significance . Although all patients exhibited some degree of impairment in salivary gl and functioning after RT , significant differences were found between the groups . Patients in the PA group showed improved salivary flow rates ( RSFR , SSFR ; p < 0.001 ) and decreased xerostomia-related symptoms ( VAS , p < 0.05 ) compared with patients in the CT group . Although PA treatment did not prevent the oral sequelae of RT completely , it significantly minimized the severity of radiation-induced xerostomia . The results suggest that acupuncture focused in a preventive approach can be a useful therapy in the management of patients with head and neck cancer undergoing RT Background It is not known whether or not delivering acupuncture triggers mechanisms cited as placebo and if acupuncture or sham reduces radiotherapy-induced emesis more than st and ard care . Methodology /Principal Findings Cancer patients receiving radiotherapy over abdominal/pelvic regions were r and omized to  verum ( penetrating ) acupuncture ( n = 109 ; 99 provided data ) in the alleged antiemetic acupuncture point PC6 or sham acupuncture  ( n = 106 ; 101 provided data ) performed with a telescopic non-penetrating needle at a sham point 2–3 times/week during the whole radiotherapy period . The acupuncture cohort was compared to a reference  cohort receiving st and ard care ( n = 62 ; 62 provided data ) . The occurrence of emesis in each group was compared after a mean dose of 27 Gray . Nausea and vomiting were experienced during the preceding week by 37 and 8 % in the verum acupuncture group , 38 and 7 % in the sham acupuncture group and 63 and 15 % in the st and ard care group , respectively . The lower occurrence of nausea in the acupuncture cohort ( verum and sham ) compared to patients receiving st and ard care ( 37 % versus 63 % , relative risk ( RR ) 0.6 , 95 % confidence interval ( CI ) 0.5–0.8 ) was also true after adjustment for potential confounding factors for nausea ( RR 0.8 , CI 0.6 to 0.9 ) . Nausea intensity was lower in the acupuncture cohort ( 78 % no nausea , 13 % a little , 8 % moderate , 1 % much ) compared to the st and ard care cohort ( 52 % no nausea , 32 % a little , 15 % moderate , 2 % much ) ( p = 0.002 ) . The acupuncture cohort expected antiemetic effects from their treatment ( 95 % ) . Patients who expected nausea had increased risk for nausea compared to patients who expected low risk for nausea ( RR 1.6 ; Cl 1.2–2.4 ) . Conclusions / Significance Patients treated with verum or sham acupuncture experienced less nausea and vomiting compared to patients receiving st and ard care , possibly through a general care effect or due to the high level of patient expectancy . Trial Registration Clinical Trials.gov BACKGROUND Nausea , and to a lesser extend vomiting , remain significant clinical problems after the administration of chemotherapy , with up to 60 % of patients reporting nausea despite use of antiemetics . Combining antiemetics with other non-pharmacological treatments may prove more effective in decreasing nausea than antiemetics alone . Hence , the aim of the current study was to evaluate the effectiveness of using acupressure in Pericardium 6 ( Neiguan ) acu-point in managing chemotherapy-induced nausea and vomiting . METHODS This was a r and omised controlled trial . Acupressure was applied using wristb and s ( Sea-B and ) which patients in the experimental group had to wear for the 5 days following the chemotherapy administration . Assessment s of nausea , retching and vomiting were obtained from all patients daily for 5 days . Thirty-six patients completed the study from two centres in the UK , with 19 patients allocated to the control arm and 17 to the experimental arm . RESULTS It was found that nausea and retching experience , and nausea , vomiting and retching occurrence and distress were all significantly lower in the experimental group compared to the control group ( P<0.05 ) . The only exception was with the vomiting experience , which was close to significance ( P=0.06 ) . DISCUSSION Results highlight the important role of safe and convenient non-pharmacological complementary therapies , such as acupressure , in the management of the complex symptoms of chemotherapy-related nausea and vomiting BACKGROUND It is not known if verum ( real ) acupuncture is effective for nausea and vomiting ( emesis ) during radiotherapy . PATIENTS AND METHODS We r and omly treated 215 blinded cancer patients with verum : penetrating ' deqi ' creating acupuncture ( n = 109 ) or non-penetrating sham needles ( n = 106 ) two to three times per week . The patients documented emesis daily during the radiotherapy period . Primary end point was the number of patients with at least one episode of nausea . RESULTS In the verum and the sham acupuncture group , 70 % and 62 % experienced nausea at least once during the radiotherapy period ( relative risk 1.1 , 95 % CI 0.9 - 1.4 ) for a mean number of 10.1 and 8.7 days . Twenty five percent and 28 % vomited , and 42 % and 37 % used  antiemetic drugs  at least once , respectively . Ninety-five percent in the verum acupuncture group and 96 % in the sham acupuncture group believed that the treatment had been effective against nausea . In both groups , 67 % experienced positive effects on relaxation , mood , sleep or pain reduction and 89 % wished to receive the treatment again . CONCLUSION Acupuncture creating deqi is not more effective than sham in radiotherapy-induced nausea , but in this study , nearly all patients in both groups experienced that the treatment was effective for nausea PURPOSE Women with breast cancer ( BC ) treated with aromatase inhibitors ( AIs ) may experience joint symptoms that can lead to discontinuation of effective therapy . We examined whether acupuncture improves AI-induced arthralgias in women with early-stage BC . METHODS We conducted a r and omized , controlled , blinded study comparing true acupuncture ( TA ) versus sham acupuncture ( SA ) twice weekly for 6 weeks in postmenopuasal women with BC who had self-reported musculoskeletal pain related to AIs .  TA included full body/auricular acupuncture and joint-specific point prescriptions , whereas SA involved superficial needle insertion at nonacupoint locations . Outcome measures included the Brief Pain Inventory-Short Form ( BPI-SF ) , Western Ontario and McMaster Universities Osteoarthritis Index ( WOMAC ) , and Modified Score for the Assessment of Chronic Rheumatoid Affections of the H and s ( M-SACRAH ) obtained at baseline and at 3 and 6 weeks . Results Of 51 women enrolled , 43 women were r and omly assigned and 38 were evaluable . Baseline characteristics were comparable between the two groups . Our primary end point was the difference in mean BPI-SF worst pain scores at 6 weeks , which was lower for TA compared with SA ( 3.0 v 5.5 ; P < .001 ) . We also found differences between TA and SA in pain severity ( 2.6 v 4.5 ; P = .003 ) and pain-related interference ( 2.5 v 4.5 ; P = .002 ) at 6 weeks . Similar findings were seen for the WOMAC and M-SACRAH scores . The acupuncture intervention was well-tolerated . CONCLUSION Women with AI-induced arthralgias treated with TA had significant improvement of joint pain and stiffness , which was not seen with SA . Acupuncture is an effective and well-tolerated strategy for managing this common treatment-related side effect PURPOSE To determine whether improvement in postchemotherapy fatigue following acupuncture treatment is substantial enough to warrant a controlled trial . PATIENTS AND METHODS We accrued patients at Memorial Sloan-Kettering Cancer Center who had completed cytotoxic chemotherapy but experienced persisting fatigue . Patients with severe anemia , clinical depression , or Karnofsky performance status score less than 70 were excluded . Thirty-seven patients were registered in two cohorts ; 31 provided follow-up data . Patients received acupuncture either twice per week for 4 weeks ( 25 patients ) or once per week for 6 weeks ( 12 patients ) . The primary end point was change in score on the Brief Fatigue Inventory between baseline and 2 weeks after the final treatment . A baseline Brief Fatigue Inventory score of four or greater was an eligibility requirement for the trial . RESULTS Patients had completed cytotoxic chemotherapy an average of more than 2 years previously .  Baseline fatigue scores were high , with approximately half of the sample scoring in the " severe " range . Mean improvement following  acupuncture  was 31.1 % ( 95 % CI , 20.6 % to 41.5 % ) , meeting our prespecified criterion for declaring acupuncture worthy of further study . Increasing age was associated with poorer response and failure to complete the study . There was no important difference in improvement following once-weekly and twice-weekly treatments . CONCLUSION Acupuncture is worthy of further study in the treatment of postchemotherapy fatigue OBJECTIVE To study the effect of acupuncture on  depression and insomnia of malignant tumor patients . METHODS Eighty cases of cancer related depression and sleep disorders were r and omly divided into 2 groups : treatment 1 group ( acupuncture n = 40 ) and control group ( Fluoxetione n = 40 ) . All patients were assessed by Self-rating Depression Scale ( SDS ) , Hemilton Depression Rating Scale ( HAMD ) and Pittsburgh Sleep Quality Index ( PSQI ) after treatment for 30 days . RESULTS Before treatment the SDS and HAMD scores of the trial group were 64.12 + /- 5.34 and 20.92 + /- 2.38 , those of the control group were 64.24 + /- 4.98 and 20.72 + /- 2.74 , after treatment the SDS and HAMD scores of the trial group were 43.64 + /- 5.28 and 9.88 + /- 1.27 respectively , significantly lower than those of the control group ( 50.76 + /- 5.42 and 13.72 + /- 2.05 respectively , both P < 0.05 ) . Before treatment the PSQI score of the trial group and the control group were 14.48 + /- 1.71 and 13.92 + /- 2.59 , after treatment the PSQI score of the trial group was 7.92 + /- 1.22 after treatment , significantly lower than those of the control group ( 11.44 + /- 1.89 , P < 0.01 ) . CONCLUSION Acupuncture can effectively reduce  malignant-related depression , improve sleep quality , and help to improve the quality of life of cancer patients OBJECTIVE To verify the clinical therapeutic effect of warming needle moxibustion on improvement of the gastrointestinal and immune function in patients with postoperation of colorectal cancer . METHODS One hundred and five patients with postoperation of colorectal cancer were r and omly divided into an acupuncture and moxibustion group , a Chinese medicine group and a routine treatment group , 35 cases in each group . They were all treated with gastrointestinal decompression and fluid replacement after operation . The acupuncture and moxibustion group was also treated with warming needle moxibustion on the 1st day after operation , and Zusanli ( ST 36 ) , Shangjuxu ( ST 37 ) and Xiajuxu ( ST 39 ) etc . were selected , once a day for 10 days , and the Chinese medicine group with Simo Decoction oral solution , three times daily for 10 days . The gastrointestinal function , peripheral blood components and changes of T lymphocyte and NK cells in postoperative patients were observed . RESULTS The time of the first bowel sound , exhaust and defecation in the acupuncture and moxibustion group were all shorter than those in the Chinese medicine group and the routine treatment group ( P<0.05 , P<0.01 ) . On the 10th day after operation , the percentages distribution of lymphocyte and neutrophil in the acupuncture and moxibustion group were better than those in the Chinese medicine group and the routine treatment group ( all P<0.05 ) . The acupuncture and moxibustion group was also superior to the Chinese medicine group and the routine treatment group in improving the subgroup of T lymphocyte , NK cells and the digestive system symptoms ( all P<0.05 ) . CONCLUSION Warming needle moxibustion has a good therapeutic effect on gastrointestinal function and can regulate bidirectionally peripheral blood lymphocyte and neutrophile granulocyte and improve the T lymphocyte subgroup and NK cells so as to promote the recovery of immune function in patients with colorectal cancer after operation The level of evidence for the use of acupuncture and massage for the management of perioperative symptoms in cancer patients is encouraging but inconclusive . We conducted a r and omized , controlled trial assessing the effect of massage and acupuncture added to usual care vs. usual care alone in postoperative cancer patients . Cancer patients undergoing surgery were r and omly assigned to receive either massage and acupuncture on postoperative Days 1 and 2 in addition to usual care , or usual care alone , and were followed over three days . Patients ' pain , nausea , vomiting , and mood were assessed at four time points . Data on health care utilization were collected . Analyses were done by mixed-effects regression analyses for repeated measures . One hundred fifty of 180 consecutively approached cancer patients were eligible and consented before surgery . Twelve patients rescheduled or declined after surgery , and 138 patients were r and omly assigned in a 2:1 scheme to receive massage and acupuncture ( n=93 ) or to receive usual care only ( n=45 ) . Participants in the intervention group experienced a decrease of 1.4 points on a 0 - 10 pain scale , compared to 0.6 in the control group ( P=0.038 ) , and a decrease in depressive mood of 0.4 ( on a scale of 1 - 5 ) compared to + /-0 in the control group ( P=0.003 ) . Providing massage and acupuncture in addition to usual care result ed in decreased pain and depressive mood among postoperative cancer patients when compared with usual care alone . These findings merit independent confirmation using larger sample sizes and attention control The antiemetic action of stimulation of the P6 ( Neiguan ) acupuncture ( ACP ) point has been studied in women , premedicated with nalbuphine 10 mg , undergoing minor gynaecological operations under methohexitone-nitrous oxide-oxygen anaesthesia . Invasive ACP -- manual or electrical at 10 Hz -- applied for 5 min at the time of administration of the premedication markedly reduced the incidence of vomiting and nausea in the first 6 h after operation , compared with untreated controls . This did not occur with stimulation of a " dummy " ACP point outside the recognized ACP meridians . Non-invasive methods ( stimulation via a conducting stud or by pressure ) were equally as effective as invasive ACP  during the early postoperative period . However , both these non-invasive approaches were less effective than invasive ACP in the 1 - 6 h postoperative period , although each was as effective as two st and ard antiemetics ( cyclizine  50 mg , metoclopramide 10 mg ) . In view of the total absence of any side effects in more than 500 ACP procedures , the clinical applications of this finding are worthy of further study PURPOSE To determine whether acupuncture reduces pain and dysfunction in patients with cancer with a history of neck dissection . The secondary objective is to determine whether acupuncture relieves dry mouth in this population . PATIENTS AND METHODS Patients at a tertiary cancer center with chronic pain or dysfunction attributed to neck dissection were r and omly assigned to weekly acupuncture versus usual care ( eg , physical therapy , analgesia , and /or anti-inflammatory drugs , per patient preference or physician recommendation ) for 4 weeks . The Constant-Murley score , a composite measure of pain , function , and activities of daily living , was the primary outcome measure . Xerostomia , a secondary end point , was assessed using the Xerostomia Inventory . RESULTS Fifty-eight evaluable patients were accrued and r and omly assigned from 2004 to 2007 ( 28 and 30 patients on acupuncture and control arms , respectively ) . Constant-Murley scores improved more in the acupuncture group ( adjusted difference between groups = 11.2 ; 95 % CI , 3.0 to 19.3 ; P = .008 ) . Acupuncture produced greater improvement in reported xerostomia ( adjusted difference in Xerostomia Inventory = -5.8 ; 95 % CI , -0.9 to -10.7 ; P = .02 ) . CONCLUSION Significant reductions in pain , dysfunction , and xerostomia were observed in patients receiving acupuncture versus usual care . Although further study is needed , these data support the potential role of acupuncture in addressing post-neck dissection pain and dysfunction , as well as xerostomia Acupuncture has been used to treat the problem of hot flashes in healthy postmenopausal women . The object of this study was to investigate the efficacy of acupuncture in women with breast cancer suffering from hot flashes as a result of anti-oestrogen medication .  In a prospect i ve , controlled trial , 59 women suffering from hot flashes following breast cancer surgery and adjuvant oestrogen-antagonist treatment ( Tamoxifen )  were r and omized to either 10 weeks of traditional Chinese acupuncture or sham acupuncture ( SA ) .  Mean number of hot flashes at day and night were recorded prior to treatment , during the treatment period as well as during the 12 weeks following treatment . A vali date d health score ( Kupperman index ) was conducted at baseline , at the end of the treatment period and at 12 weeks following treatment . During the treatment period mean number of hot flashes at day and night was significantly reduced by 50 and almost 60 % , respectively from baseline in the acupuncture group , and was further reduced by 30 % both at day and night during the next 12 weeks . In the sham acupuncture group a significant reduction of 25 % in hot flashes at day was seen during treatment , but was reversed during the following 12 weeks . No reduction was seen in hot flashes at night . Kupperman index was reduced by 44 % from baseline to the end of the treatment period in the acupuncture group , and largely maintained 12 weeks after treatment ended . No corresponding changes were seen in the sham acupuncture group . Acupuncture seems to provide effective relief from hot flashes both day and night in women operated for breast cancer , treated with Tamoxifen . This treatment effect seems to coincide with a general health improvement measured with the vali date d Kupperman index Objectives To determine the effect of acupuncture in treating hot flushes in perimenopausal or postmenopausal women . Methods The study was a r and omised single-blind sham-controlled clinical trial . Perimenopausal or postmenopausal women with moderate or severe hot flushes were r and omised to receive real or sham acupuncture . Both groups underwent a 4-week run-in period before the treatment . The real acupuncture group received 11 acupuncture treatments for 7 weeks , and the control group underwent sham acupuncture on non-acupuncture points during the same period . Both groups were followed for 8 weeks after the end of treatment period . Changes from baseline in the hot flush scores at week 7 , measured by multiplying the hot flush frequency and severity , were the primary outcome . Hot flush frequency , severity and menopause-related symptoms measured with the Menopause Rating Scale Question naire were regarded as secondary outcomes . Results 54 participants were r and omised into the  real acupuncture group ( n=27 ) and the sham acupuncture group ( n=27 ) . The mean change in hot flush scores was −6.4±5.2 in the real acupuncture group and −5.6±9.2 in the sham group at week 7 from values at the start of the acupuncture treatment ( 10.0±8.1 vs 11.7±12.6 ) , respectively ( p=0.0810 ) . No serious adverse events were observed during the whole study period . Conclusions Compared to sham acupuncture , acupuncture failed to show significantly different effects on the hot flush scores but showed partial benefits on the hot flush severity . Further consideration is needed to develop appropriate strategies for distinguishing non-specific effects from observed overall effectiveness of acupuncture for hot flushes . Whether acupuncture has point-specific effects for hot flushes should be also considered in design ing future research es BACKGROUND Cancer-related fatigue after chemotherapy is a difficult symptom to manage in practice and the most disruptive symptom in patients ' lives . Acupuncture is a popular complementary therapy among cancer patients and some evidence exists that it could potentially alleviate fatigue by stimulating ' energy ' points in the body . Hence , this study was carried out to assess the effects of acupuncture and acupressure in managing cancer-related fatigue and the feasibility of running a r and omised trial with these two complementary therapies in preparation for a large trial . METHODS This study was a r and omised controlled trial . Forty-seven patients with cancer who experienced moderate to severe fatigue were r and omised either to an acupuncture group ( n=15 ) , an acupressure group ( n=16 ) or a sham acupressure group ( n=16 ) . The acupuncture group received six 20-min sessions over 2 weeks , while the patients in the two acupressure groups were taught to massage/press the points and did so daily thereafter for 2 weeks on their own . Patients completed the Multidimensional Fatigue Inventory before r and omisation , at the end of the 2-week intervention and again about 2 weeks after the end of the intervention . RESULTS Significant improvements were found with regards to General fatigue ( P<0.001 ) , Physical fatigue ( P=0.016 ) , Activity ( p=0.004 ) and Motivation ( P=0.024 ) . At the end of the intervention , there was a 36 % improvement in fatigue levels in the acupuncture group , while the acupressure group improved by 19 % and the sham acupressure by 0.6 % . Improvements were observed even 2 weeks after treatments , although they were lower ( 22 % , 15 % , 7 % , respectively ) . Acupuncture was a more effective method than acupressure or sham acupressure . Subjects needed a longer treatment period to have more sustained results . The trial was method ologically feasible . CONCLUSION Acupuncture shows great potential in the management of cancer-related fatigue . As a r and omised trial with acupuncture is feasible and preliminary data shows significant improvements , it should be tested further using a large sample and a multicentre design Restoration of the sympathovagal ( S/V ) balance , involving a lowering of sympathetic and /or an augmentation of vagal modulation or a combination of both is associated with improvements in cardiovascular morbidity and mortality . To determine whether acupuncture exerts a favorable influence upon resting blood pressure and sympathovagal balance , a single-blind cross-over investigation was used to study the acute effects of acupuncture on S/V balance in normal healthy subjects . The ANOVA revealed a significant lowering of the sympathovagal balance ( LF : HF ) during rest for the acupuncture treatment from pre ( 4 + /- 2 nu ) to post ( 2.2 + /- 1.8 nu)(p < 0.05 ) . No such change was seen during sham treatment . The ANOVA revealed significant differences in systolic blood pressures during rest ( 114 + /- 4 vs. 108 + /- 3 mmHg ) for the acupuncture treatment ( p < 0.05 ) . No significance was found during the sham treatment . The ANOVA failed to reveal any significant improvements in sympathovagal balance during the sustained isometric contraction . The clinical significance of these findings appears to suggest that acupuncture treatment might be beneficial in lowering blood pressure at rest . Furthermore , the lowering of the blood pressure might be in part due to a lowering of the sympathovagal balance . These findings are of importance since acupuncture treatments are non-pharmacological and have no known detrimental side-effects . This investigation employed healthy volunteers , yet acupuncture has been found to have more potent effects in animal models of hypertension and or in the presence of an autonomic imbalance Introduction Aromatase inhibitors ( AIs ) have become the st and ard of care for the adjuvant treatment of postmenopausal , hormone-sensitive breast cancer . However , patients receiving AIs  may experience joint symptoms , which may lead to early discontinuation of this effective therapy . We hypothesize that acupuncture is a safe and effective treatment for AI-induced arthralgias . Methods Postmenopausal women with early-stage breast cancer who had self-reported musculoskeletal pain related to adjuvant AI therapy were r and omized in a crossover study to receive acupuncture twice weekly for 6 weeks followed by observation or vice-versa . The intervention included full body and auricular acupuncture , and a joint-specific point prescription . Outcome measures included the Brief Pain Inventory-Short Form ( BPI-SF ) , Western Ontario and McMaster Universities Osteoarthritis ( WOMAC ) index , the Functional Assessment of Cancer Therapy-General ( FACT-G ) quality of life measure , and serum levels of inflammatory markers , IL-1β and TNF-α . Results Twenty-one women were enrolled and two discontinued early . From baseline to the end of treatment , patients reported improvement in the mean BPI-SF worst pain scores ( 5.3 to 3.3 , p = 0.01 ) , pain severity ( 3.7 to 2.5 , p = 0.02 ) , and pain-related functional interference ( 3.1 to 1.7 , p = 0.02 ) , as well as the WOMAC function subscale and FACT-G physical well-being ( p = 0.02 and 0.04 , respectively ) . No adverse events were reported . Discussion / conclusions In this pilot study , acupuncture reduced AI-related joint symptoms and improved functional ability and was well-tolerated . Implication s for cancer survivorsMusculoskeletal side effects are common among breast cancer survivors on adjuvant AI therapy , therefore , effective treatments are needed for symptom relief and to improve adherence to these life-saving medications PURPOSE During the last 30 years , auricular acupuncture has been used as complementary treatment of cancer pain when analgesic drugs do not suffice . The purpose of this study is to examine the efficacy of auricular acupuncture in decreasing pain intensity in cancer patients . PATIENTS AND METHODS Ninety patients were r and omly divided in three groups ; one group received two courses of auricular acupuncture at points where an electrodermal signal had been detected , and two placebo groups received auricular acupuncture at points with no electrodermal signal ( placebo points ) and one with auricular seeds fixed at placebo points .  Patients had to be in pain , attaining a visual analog score ( VAS ) of 30 mm or more after having received analgesic treatment adapted to both intensity and type of pain , for at least 1 month of therapy . Treatment efficacy was based on the absolute decrease in pain intensity measured 2 months after r and omization using the VAS . RESULTS The main outcome was pain assessed at 2 months , with the assessment at 1 month carried over to 2 months for the eight patients who interrupted treatment after 1 month . For three patients , no data were available because they withdrew from the study during the first month . Pain intensity decreased by 36 % at 2 months from baseline in the group receiving acupuncture ; there was little change for patients receiving placebo ( 2 % ) . The difference between groups was statistically significant ( P < .0001 ) . CONCLUSION The observed reduction in pain intensity measured on the VAS represents a clear benefit from auricular acupuncture for these cancer patients who are in pain , despite stable analgesic treatment In recent studies we have shown that xerostomia ( dry mouth ) can be treated successfully with sensory stimulation ( acupuncture ) . The increase of saliva secretion lasted often for at least one year . Some neuropeptides have been found to influence the secretion of saliva . The aim of this study was to investigate the mechanisms behind the effect of acupuncture on salivary secretion by measuring the release of neuropeptides in saliva under the influence of sensory stimulation . VIP-like immunoreactivity ( VIP-LI ) , NPY-LI , SP-LI , CGRP-LI and NKA-LI were analysed in the saliva of eight healthy subjects .  Manual acupuncture and acupuncture with low-frequency electrical stimulation ( 2 Hz ) were used . The saliva was collected during 20 minutes before the start of acupuncture stimulation , then during 20 minutes while the needles were in situ and then for another 20 minutes after the needles were removed . Four different saliva sampling techniques were used : whole resting saliva , whole saliva stimulated by paraffin-chewing , whole saliva stimulated by citric acid ( 1 % ) , and parotid saliva , also stimulated with citric acid ( 1 % ) . The results showed significant increases in the release of CGRP , NPY and VIP both during and after acupuncture stimulation , especially in connection with electro-acupuncture . SP showed only few increases , mainly in connection with electro-acupuncture , whereas NKA generally was unaffected by the acupuncture stimulation . The sensory stimulation-induced increase in the release of CGRP , NPY and VIP in the saliva could be an indication of their role in the improvement of salivary flow rates in xerostomic patients who had been treated with acupuncture PURPOSE / OBJECTIVES To compare differences in the chemotherapy-induced nausea and vomiting ( CINV ) among three groups of women ( acupressure , placebo acupressure , and usual care ) undergoing chemo-therapy for breast cancer . DESIGN A multicenter , longitudinal , r and omized clinical trial throughout one cycle of chemotherapy . SETTING Ten community clinical oncology programs associated with the M.D. And erson Cancer Center and nine independent sites located throughout the United States . SAMPLE 160 women who were beginning their second or third cycle of chemotherapy for breast cancer treatment and had moderate nausea intensity scores with their previous cycles . METHODS Subjects were r and omized to one of three groups : acupressure to P6 point ( active ) , acupressure to SI3 point ( placebo ) , or usual care only . Subjects in the acupressure group were taught to apply an acupressure wrist device by research assistants who were unaware of the active acupressure point . All subjects completed a daily log for 21 days containing measures of nausea and vomiting and recording methods ( including antiemetics and acupressure )  used to control these symptoms . MAIN RESEARCH VARIABLES Acute and delayed nausea and vomiting . RESULTS No significant differences existed in the demographic , disease , or treatment variables among the treatment groups . No significant differences were found in acute nausea or emesis by treatment group . With delayed nausea and vomiting , the acupressure group had a statistically significant reduction in the amount of vomiting and the intensity of nausea over time when compared with the placebo and usual-care groups . No significant differences were found between the placebo and usual-care groups in delayed nausea or vomiting . CONCLUSIONS Acupressure at the P6 point is a value-added technique in addition to pharmaceutical management for women undergoing treatment for breast cancer to reduce the amount and intensity of delayed CINV . IMPLICATION S FOR NURSING Acupressure is a safe and effective tool for managing delayed CINV and should be offered to women undergoing chemotherapy for breast cancer
Oncology acupuncture has become a new and promising field of research because more and more cancer patients have sought non-pharmacological alternatives for symptom management .
While different mechanisms have been proposed to explain its efficacy , including theories of the neural system , endocrine cytokine or immunological regulation , its eventual role has become that of alleviating the side effects induced by chemotherapy or radiotherapy .
In this paper , we have review ed the related articles focusing on acupuncture mechanisms and applications in cancer care to provide a quick sketch of acupuncture in cancer care .