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Lu W, Posner MR, Wayne P, Rosenthal DS, Haddad RI. Acupuncture for dysphagia after chemoradiation therapy in head and neck cancer: a case series report. Integr Cancer Ther 2010; 9:284-90. [PMID: 20713374 DOI: 10.1177/1534735410378856] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Dysphagia is a common side effect following chemoradiation therapy (CRT) in patients with head and neck cancer (HNC). METHODS In this retrospective case series, 10 patients with HNC were treated with acupuncture for radiation-induced dysphagia and xerostomia. All patients were diagnosed with stage III/IV squamous cell carcinoma. In all, 7 of 10 patients were percutaneous endoscopic gastrostomy (PEG) tube dependent when they began acupuncture. Manual acupuncture and electroacupuncture were used once a week. RESULTS A total of 9 of 10 patients reported various degrees of subjective improvement in swallowing functions, xerostomia, pain, and fatigue levels. Overall, 6 (86%) of 7 PEG tube-dependent patients had their feeding tubes removed after acupuncture, with a median duration of 114 days (range 49 to 368 days) post CRT. One typical case is described in detail. CONCLUSIONS A relatively short PEG tube duration and reduced symptom severity following CRT were observed in these patients. Formal clinical trials are required to determine the causality of the observations.
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Affiliation(s)
- Weidong Lu
- Dana-Farber Cancer Institute, Harvard Medical School, 44 Binney Street, Boston, MA 02115, USA.
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Pfister DG, Cassileth BR, Deng GE, Yeung KS, Lee JS, Garrity D, Cronin A, Lee N, Kraus D, Shaha AR, Shah J, Vickers AJ. Acupuncture for pain and dysfunction after neck dissection: results of a randomized controlled trial. J Clin Oncol 2010; 28:2565-70. [PMID: 20406930 DOI: 10.1200/jco.2009.26.9860] [Citation(s) in RCA: 111] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
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 randomly 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 randomly 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.
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Affiliation(s)
- David G Pfister
- Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, NY, USA.
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Walker EM, Rodriguez AI, Kohn B, Ball RM, Pegg J, Pocock JR, Nunez R, Peterson E, Jakary S, Levine RA. Acupuncture Versus Venlafaxine for the Management of Vasomotor Symptoms in Patients With Hormone Receptor–Positive Breast Cancer: A Randomized Controlled Trial. J Clin Oncol 2010; 28:634-40. [PMID: 20038728 DOI: 10.1200/jco.2009.23.5150] [Citation(s) in RCA: 141] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Purpose Vasomotor symptoms are common adverse effects of antiestrogen hormone treatment in conventional breast cancer care. Hormone replacement therapy is contraindicated in patients with breast cancer. Venlafaxine (Effexor), the therapy of choice for these symptoms, has numerous adverse effects. Recent studies suggest acupuncture may be effective in reducing vasomotor symptoms in menopausal women. This randomized controlled trial tested whether acupuncture reduces vasomotor symptoms and produces fewer adverse effects than venlafaxine. Patients and Methods Fifty patients were randomly assigned to receive 12 weeks of acupuncture (n = 25) or venlafaxine (n = 25) treatment. Health outcomes were measured for up to 1 year post-treatment. Results Both groups exhibited significant decreases in hot flashes, depressive symptoms, and other quality-of-life symptoms, including significant improvements in mental health from pre- to post-treatment. These changes were similar in both groups, indicating that acupuncture was as effective as venlafaxine. By 2 weeks post-treatment, the venlafaxine group experienced significant increases in hot flashes, whereas hot flashes in the acupuncture group remained at low levels. The venlafaxine group experienced 18 incidences of adverse effects (eg, nausea, dry mouth, dizziness, anxiety), whereas the acupuncture group experienced no negative adverse effects. Acupuncture had the additional benefit of increased sex drive in some women, and most reported an improvement in their energy, clarity of thought, and sense of well-being. Conclusion Acupuncture appears to be equivalent to drug therapy in these patients. It is a safe, effective and durable treatment for vasomotor symptoms secondary to long-term antiestrogen hormone use in patients with breast cancer.
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Affiliation(s)
- Eleanor M. Walker
- From the Department of Radiation Oncology, Henry Ford Hospital, Detroit; Center for Integrative Wellness, Henry Ford Health System, Southfield; Center for Integrative Medicine, Henry Ford Health System, Northville; Waterford Center for Integrative Medicine, Waterford; Department of Biostatistics and Research Epidemiology, Henry Ford Health System, Detroit; and Michigan Acupuncture, Novi, MI
| | - Alba I. Rodriguez
- From the Department of Radiation Oncology, Henry Ford Hospital, Detroit; Center for Integrative Wellness, Henry Ford Health System, Southfield; Center for Integrative Medicine, Henry Ford Health System, Northville; Waterford Center for Integrative Medicine, Waterford; Department of Biostatistics and Research Epidemiology, Henry Ford Health System, Detroit; and Michigan Acupuncture, Novi, MI
| | - Beth Kohn
- From the Department of Radiation Oncology, Henry Ford Hospital, Detroit; Center for Integrative Wellness, Henry Ford Health System, Southfield; Center for Integrative Medicine, Henry Ford Health System, Northville; Waterford Center for Integrative Medicine, Waterford; Department of Biostatistics and Research Epidemiology, Henry Ford Health System, Detroit; and Michigan Acupuncture, Novi, MI
| | - Ronald M. Ball
- From the Department of Radiation Oncology, Henry Ford Hospital, Detroit; Center for Integrative Wellness, Henry Ford Health System, Southfield; Center for Integrative Medicine, Henry Ford Health System, Northville; Waterford Center for Integrative Medicine, Waterford; Department of Biostatistics and Research Epidemiology, Henry Ford Health System, Detroit; and Michigan Acupuncture, Novi, MI
| | - Jan Pegg
- From the Department of Radiation Oncology, Henry Ford Hospital, Detroit; Center for Integrative Wellness, Henry Ford Health System, Southfield; Center for Integrative Medicine, Henry Ford Health System, Northville; Waterford Center for Integrative Medicine, Waterford; Department of Biostatistics and Research Epidemiology, Henry Ford Health System, Detroit; and Michigan Acupuncture, Novi, MI
| | - Jeffrey R. Pocock
- From the Department of Radiation Oncology, Henry Ford Hospital, Detroit; Center for Integrative Wellness, Henry Ford Health System, Southfield; Center for Integrative Medicine, Henry Ford Health System, Northville; Waterford Center for Integrative Medicine, Waterford; Department of Biostatistics and Research Epidemiology, Henry Ford Health System, Detroit; and Michigan Acupuncture, Novi, MI
| | - Ramon Nunez
- From the Department of Radiation Oncology, Henry Ford Hospital, Detroit; Center for Integrative Wellness, Henry Ford Health System, Southfield; Center for Integrative Medicine, Henry Ford Health System, Northville; Waterford Center for Integrative Medicine, Waterford; Department of Biostatistics and Research Epidemiology, Henry Ford Health System, Detroit; and Michigan Acupuncture, Novi, MI
| | - Ed Peterson
- From the Department of Radiation Oncology, Henry Ford Hospital, Detroit; Center for Integrative Wellness, Henry Ford Health System, Southfield; Center for Integrative Medicine, Henry Ford Health System, Northville; Waterford Center for Integrative Medicine, Waterford; Department of Biostatistics and Research Epidemiology, Henry Ford Health System, Detroit; and Michigan Acupuncture, Novi, MI
| | - Susan Jakary
- From the Department of Radiation Oncology, Henry Ford Hospital, Detroit; Center for Integrative Wellness, Henry Ford Health System, Southfield; Center for Integrative Medicine, Henry Ford Health System, Northville; Waterford Center for Integrative Medicine, Waterford; Department of Biostatistics and Research Epidemiology, Henry Ford Health System, Detroit; and Michigan Acupuncture, Novi, MI
| | - Robert A. Levine
- From the Department of Radiation Oncology, Henry Ford Hospital, Detroit; Center for Integrative Wellness, Henry Ford Health System, Southfield; Center for Integrative Medicine, Henry Ford Health System, Northville; Waterford Center for Integrative Medicine, Waterford; Department of Biostatistics and Research Epidemiology, Henry Ford Health System, Detroit; and Michigan Acupuncture, Novi, MI
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Wesa KM, Cassileth BR. Is there a role for complementary therapy in the management of leukemia? Expert Rev Anticancer Ther 2009; 9:1241-9. [PMID: 19761428 DOI: 10.1586/era.09.100] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Patients with leukemia often seek additional treatments not prescribed by their oncologist in an effort to improve their cancer treatment outcome or to manage symptoms. Complementary therapies are used in conjunction with traditional cancer treatments to decrease symptoms and side effects associated with cancer or cancer treatment, and to improve patients' overall quality of life. Complementary therapies are distinct from so-called 'alternative' therapies, which are unproven, ineffective and may postpone or interfere with mainstream cancer treatment. Complementary therapies are pleasant, inexpensive, nonpharmacologic and effective. For patients with leukemia, the complementary therapies that are always appropriate include mind-body interventions, such as self-hypnosis, meditation, guided imagery and breath awareness. Massage and reflexology (foot massage) decrease symptoms with effects lasting at least 2 days following treatment. Acupuncture is very beneficial for symptom management without adverse consequences. Physical fitness with regular exercise and healthy dietary habits can significantly decrease side effects of cancer treatments and may prolong survival. Botanical extracts and vitamin supplements may interfere with active cancer treatments, and should be discussed with the oncologist or pharmacist before use.
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Affiliation(s)
- Kathleen M Wesa
- Integrative Medicine Service, Memorial Sloan-Kettering Cancer Center, 1429 First Avenue, NY 10021, USA.
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Lund I, Näslund J, Lundeberg T. Minimal acupuncture is not a valid placebo control in randomised controlled trials of acupuncture: a physiologist's perspective. Chin Med 2009; 4:1. [PMID: 19183454 PMCID: PMC2644695 DOI: 10.1186/1749-8546-4-1] [Citation(s) in RCA: 137] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2008] [Accepted: 01/30/2009] [Indexed: 01/06/2023] Open
Abstract
Placebo-control of acupuncture is used to evaluate and distinguish between the specific effects and the non-specific ones. During 'true' acupuncture treatment in general, the needles are inserted into acupoints and stimulated until deqi is evoked. In contrast, during placebo acupuncture, the needles are inserted into non-acupoints and/or superficially (so-called minimal acupuncture). A sham acupuncture needle with a blunt tip may be used in placebo acupuncture. Both minimal acupuncture and the placebo acupuncture with the sham acupuncture needle touching the skin would evoke activity in cutaneous afferent nerves. This afferent nerve activity has pronounced effects on the functional connectivity in the brain resulting in a 'limbic touch response'. Clinical studies showed that both acupuncture and minimal acupuncture procedures induced significant alleviation of migraine and that both procedures were equally effective. In other conditions such as low back pain and knee osteoarthritis, acupuncture was found to be more potent than minimal acupuncture and conventional non-acupuncture treatment. It is probable that the responses to 'true' acupuncture and minimal acupuncture are dependent on the aetiology of the pain. Furthermore, patients and healthy individuals may have different responses. In this paper, we argue that minimal acupuncture is not valid as an inert placebo-control despite its conceptual brilliance.
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Affiliation(s)
- Iréne Lund
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden.
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