1
|
Li H, Schlaeger JM, Patil CL, Danciu O, Chen Z, Lif N, Gao S, Doorenbos AZ. Feasibility of implementing acupuncture in medically underserved breast cancer survivors (FAB): A protocol. Contemp Clin Trials 2024; 136:107387. [PMID: 37972754 PMCID: PMC10922295 DOI: 10.1016/j.cct.2023.107387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 10/24/2023] [Accepted: 11/04/2023] [Indexed: 11/19/2023]
Abstract
Nearly 94% of breast cancer survivors experience one or more symptoms or side effects during or after endocrine therapy. Joint pain, hot flashes, sleep disturbance, fatigue, depression, and anxiety are the most common concurrent symptoms, some of which can persist for 5 to 10 years. Acupuncture is a holistic modality that addresses multiple symptoms and side effects in a single therapy. Acupuncture has not yet been investigated for its effectiveness in treating the multiple symptoms experienced by breast cancer survivors receiving endocrine therapy. Medically underserved breast cancer survivors typically have limited access to acupuncture. The barriers limiting access to acupuncture need to be removed to enable equal access to breast cancer survivors for this evidence-based treatment. Thus, we developed a randomized controlled trial with a 5-week acupuncture intervention versus usual care for medically underserved breast cancer survivors. Mixed methods (semi-structured interviews, surveys, study notes) will be used to obtain in-depth understanding of barriers and facilitators for eventual implementation of the acupuncture intervention. This study will facilitate the widespread implementation, dissemination, and sustained utilization of acupuncture for symptom management among medically underserved breast cancer survivors receiving endocrine therapy.
Collapse
Affiliation(s)
- Hongjin Li
- University of Illinois, Chicago College of Nursing, Department of Human Development Nursing Science, 845 S. Damen Avenue (M/C 802), Chicago, IL 60612, USA; University of Illinois Cancer Center, 818 South Wolcott Ave, Chicago, IL 60612, USA.
| | - Judith M Schlaeger
- University of Illinois, Chicago College of Nursing, Department of Human Development Nursing Science, 845 S. Damen Avenue (M/C 802), Chicago, IL 60612, USA
| | - Crystal L Patil
- University of Illinois, Chicago College of Nursing, Department of Human Development Nursing Science, 845 S. Damen Avenue (M/C 802), Chicago, IL 60612, USA
| | - Oana Danciu
- University of Illinois, Chicago College of Medicine, Department of Hematology/Oncology, 820 S. Wood Street Suite 172 CSN (M/C 712), Chicago, IL 60612, USA
| | - Zhengjia Chen
- University of Illinois Cancer Center, 818 South Wolcott Ave, Chicago, IL 60612, USA
| | - Natalie Lif
- University of Illinois, Chicago College of Nursing, Department of Human Development Nursing Science, 845 S. Damen Avenue (M/C 802), Chicago, IL 60612, USA
| | - Shuang Gao
- University of Illinois, Chicago College of Medicine, 1853 W Polk St, Chicago, IL 60612, USA
| | - Ardith Z Doorenbos
- University of Illinois Cancer Center, 818 South Wolcott Ave, Chicago, IL 60612, USA; University of Illinois, Chicago College of Nursing, Department of Biobehavioral Nursing Science, 845 S. Damen Avenue (M/C 802), Chicago, IL 60612, USA
| |
Collapse
|
2
|
Jeong YJ, Choi HR, Kim KS, Shin IH, Park SH. Impact of Acupuncture on Hot Flashes in Breast Cancer Patients Receiving Adjuvant Antiestrogen Therapy with Tamoxifen: A Randomized Controlled Trial. JOURNAL OF INTEGRATIVE AND COMPLEMENTARY MEDICINE 2023; 29:241-252. [PMID: 36787483 DOI: 10.1089/jicm.2022.0636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/15/2023]
Abstract
Objectives: The aim of this study was to evaluate the impact of acupuncture on hot flashes in breast cancer patients taking tamoxifen as an adjuvant antiestrogen therapy in Korea. Design: This trial was a randomized, no-treatment-controlled, single-blind, multi-center trial. Participants were randomized 1:1 into the acupuncture group or into the no-treatment control group. Location: This trial was conducted at Daegu Catholic University Hospital and Daegu Haany University Korean Medicine Hospital in Daegu, Republic of Korea. Participants: Patients with moderate to severe symptoms of hot flashes while receiving adjuvant antiestrogen therapy using tamoxifen after surgery for breast cancer were included. Interventions: In the acupuncture group, acupuncture was performed three times a week for 4 consecutive weeks at five predetermined points. The control group received no treatment during the study period. Study Outcome Measures: As a primary outcome, the severity of hot flashes was measured on the visual analogue scale (VAS) and total hot flash score. In addition, the quality of life (QoL) of participants was assessed as a secondary outcome. Results: A total of 30 patients were included in this study, 15 each in the acupuncture group and the control group. The participants in the acupuncture group significantly decreased the severity of hot flashes evaluated with both VAS and total hot flash scores compared with participants in the control group. Also, the acupuncture group showed improved score of a global health status/QoL scale and functional scales assessed with the European Organisation for Research and Treatment of Cancer QoL questionnaire-core questionnaire, compared with those in the control group. This trend was maintained 4 weeks after acupuncture treatment. No adverse events have been reported in this study. Conclusions: Acupuncture was effective and safe in improving hot flashes in Korean breast cancer patients receiving adjuvant antiestrogen therapy with tamoxifen, and it improved the QoL. Clinical Trial Registration: KCT0007829.
Collapse
Affiliation(s)
- Young Ju Jeong
- Department of Surgery, School of Medicine, Daegu Catholic University, Daegu, Korea
| | - Hye Ryeon Choi
- Department of Surgery, Eulji Medical Center, Seoul, Korea
| | - Kyung-Soon Kim
- Department of Korean Internal Medicine, College of Korean Medicine, Daegu Haany University, Daegu, Korea
| | - Im Hee Shin
- Department of Medical Statistics, School of Medicine, Daegu Catholic University, Daegu, Korea
| | - Sung Hwan Park
- Department of Surgery, School of Medicine, Daegu Catholic University, Daegu, Korea
| |
Collapse
|
3
|
Höxtermann MD, Haller H, Aboudamaah S, Bachemir A, Dobos G, Cramer H, Voiss P. Safety of acupuncture in oncology: A systematic review and meta-analysis of randomized controlled trials. Cancer 2022; 128:2159-2173. [PMID: 35262912 DOI: 10.1002/cncr.34165] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 01/06/2022] [Accepted: 02/09/2022] [Indexed: 12/26/2022]
Abstract
BACKGROUND Acupuncture is frequently used to treat the side effects of cancer treatment, but the safety of this intervention remains uncertain. The current meta-analysis was conducted to assess the safety of acupuncture in oncological patients. METHODS The PubMed, Cochrane Central Register of Controlled Trials, and Scopus databases were searched from their inception to August 7, 2020. Randomized controlled trials in oncological patients comparing invasive acupuncture with sham acupuncture, treatment as usual (TAU), or any other active control were eligible. Two reviewers independently extracted data on study characteristics and adverse events (AEs). Risk of bias was assessed using the Cochrane Risk of Bias Tool. RESULTS Of 4590 screened articles, 65 were included in the analyses. The authors observed that acupuncture was not associated an with increased risk of intervention-related AEs, nonserious AEs, serious AEs, or dropout because of AEs compared with sham acupuncture and an active control. Compared with TAU, acupuncture was not associated with an increased risk of intervention-related AEs, serious AEs, or drop out because of AEs but was associated with an increased risk for nonserious AEs (odds ratio, 3.94; 95% confidence interval, 1.16-13.35; P = .03). However, the increased risk of nonserious AEs compared with TAU was not robust against selection bias. The meta-analyses may have been biased because of the insufficient reporting of AEs in the original randomized controlled trials. CONCLUSIONS The current review indicates that acupuncture is as safe as sham acupuncture and active controls in oncological patients. The authors recommend researchers heed the CONSORT (Consolidated Standards of Reporting Trials) safety and harm extension for reporting to capture the side effects and better investigate the risk profile of acupuncture in oncology. LAY SUMMARY According to this analysis, acupuncture is a safe therapy for the treatment of patients with cancer. Acupuncture seems to be safe compared with sham acupuncture and active controls.
Collapse
Affiliation(s)
- Melanie D Höxtermann
- Evangelical Clinics Essen-Mitte, Department of Internal and Integrative Medicine, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany
| | - Heidemarie Haller
- Evangelical Clinics Essen-Mitte, Department of Internal and Integrative Medicine, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany
| | - Shaimaa Aboudamaah
- Evangelical Clinics Essen-Mitte, Department of Internal and Integrative Medicine, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany
| | - Armin Bachemir
- Evangelical Clinics Essen-Mitte, Department of Internal and Integrative Medicine, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany
| | - Gustav Dobos
- Evangelical Clinics Essen-Mitte, Department of Internal and Integrative Medicine, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany
| | - Holger Cramer
- Evangelical Clinics Essen-Mitte, Department of Internal and Integrative Medicine, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany
| | - Petra Voiss
- Evangelical Clinics Essen-Mitte, Department of Internal and Integrative Medicine, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany
| |
Collapse
|
4
|
Li H, Schlaeger JM, Jang MK, Lin Y, Park C, Liu T, Sun M, Doorenbos AZ. Acupuncture Improves Multiple Treatment-Related Symptoms in Breast Cancer Survivors: A Systematic Review and Meta-Analysis. J Altern Complement Med 2021; 27:1084-1097. [PMID: 34449251 DOI: 10.1089/acm.2021.0133] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Introduction: Acupuncture has demonstrated effectiveness for symptom management among breast cancer survivors. This meta-analysis aims to evaluate the effect of acupuncture on treatment-related symptoms among breast cancer survivors. Methods: The authors searched PubMed, CINAHL, and EMBASE for relevant randomized clinical trials (RCTs) of acupuncture for managing treatment-related symptoms published in English through June 2021. They appraised the quality of each article using the Cochrane Collaboration Risk of Bias Criteria. The primary outcomes were pain, hot flashes, sleep disturbance, fatigue, depression, lymphedema, and neuropathy as individual symptoms. They also evaluated adverse events reported in acupuncture studies. Results: Of 26 selected trials (2055 patients), 20 (1709 patients) were included in the meta-analysis. Acupuncture was more effective than control groups in improving pain intensity [standardized mean difference (SMD) = -0.60, 95% confidence intervals (CI) -1.06 to -0.15], fatigue [SMD = -0.62, 95% CI -1.03 to -0.20], and hot flash severity [SMD = -0.52, 95% CI -0.82 to -0.22]. The subgroup analysis indicated that acupuncture showed trends but not significant effects on all the treatment-related symptoms compared with the sham acupuncture groups. Compared with waitlist control and usual care groups, the acupuncture groups showed significant reductions in pain intensity, fatigue, depression, hot flash severity, and neuropathy. No serious adverse events were reported related to acupuncture intervention. Mild adverse events (i.e., bruising, pain, swelling, skin infection, hematoma, headache, menstrual bleeding) were reported in 11 studies. Conclusion: This systematic review and meta-analysis suggest that acupuncture significantly reduces multiple treatment-related symptoms compared with the usual care or waitlist control group among breast cancer survivors. The safety of acupuncture was inadequately reported in the included studies. Based on the available data, acupuncture seems to be generally a safe treatment with some mild adverse events. These findings provide evidence-based recommendations for incorporating acupuncture into clinical breast cancer symptom management. Due to the high risk of bias and blinding issues in some RCTs, more rigorous trials are needed to confirm the efficacy of acupuncture in reducing multiple treatment-related symptoms among breast cancer survivors.
Collapse
Affiliation(s)
- Hongjin Li
- Department of Human Development Nursing Science, College of Nursing, University of Illinois Chicago, Chicago, IL, USA.,Department of Cancer Prevention and Control, University of Illinois Cancer Center, Chicago, IL, USA
| | - Judith M Schlaeger
- Department of Human Development Nursing Science, College of Nursing, University of Illinois Chicago, Chicago, IL, USA
| | - Min Kyeong Jang
- Department of Cancer Prevention and Control, University of Illinois Cancer Center, Chicago, IL, USA.,Department of Biobehavioral Nursing Science, College of Nursing, University of Illinois Chicago, Chicago, IL, USA
| | - Yufen Lin
- School of Nursing, Emory University, Atlanta, GA, USA
| | - Chang Park
- Department of Population Health Nursing Science, College of Nursing, University of Illinois Chicago, Chicago, IL, USA
| | - Tingting Liu
- Eleanor Mann School of Nursing, University of Arkansas, Little Rock, AR, USA
| | - Min Sun
- Department of Hematology and Oncology, Hillman Cancer Center, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Ardith Z Doorenbos
- Department of Cancer Prevention and Control, University of Illinois Cancer Center, Chicago, IL, USA.,Department of Biobehavioral Nursing Science, College of Nursing, University of Illinois Chicago, Chicago, IL, USA
| |
Collapse
|
5
|
Zhang Y, Sun Y, Li D, Liu X, Fang C, Yang C, Luo T, Lu H, Li H, Zhang H, Liang Q, Wu J, Huang L, Xu R, Ren L, Chen Q. Acupuncture for Breast Cancer: A Systematic Review and Meta-Analysis of Patient-Reported Outcomes. Front Oncol 2021; 11:646315. [PMID: 34178633 PMCID: PMC8222976 DOI: 10.3389/fonc.2021.646315] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2020] [Accepted: 05/17/2021] [Indexed: 12/29/2022] Open
Abstract
Abstract The present systematic review and meta-analysis was undertaken to evaluate the effects of acupuncture in women with breast cancer (BC), focusing on patient-reported outcomes (PROs). Methods A comprehensive literature search was carried out for randomized controlled trials (RCTs) reporting PROs in BC patients with treatment-related symptoms after undergoing acupuncture for at least four weeks. Literature screening, data extraction, and risk bias assessment were independently carried out by two researchers. Results Out of the 2, 524 identified studies, 29 studies representing 33 articles were included in this meta-analysis. At the end of treatment (EOT), the acupuncture patients’ quality of life (QoL) was measured by the QLQ-C30 QoL subscale, the Functional Assessment of Cancer Therapy-Endocrine Symptoms (FACT-ES), the Functional Assessment of Cancer Therapy–General/Breast (FACT-G/B), and the Menopause-Specific Quality of Life Questionnaire (MENQOL), which depicted a significant improvement. The use of acupuncture in BC patients lead to a considerable reduction in the scores of all subscales of the Brief Pain Inventory-Short Form (BPI-SF) and Visual Analog Scale (VAS) measuring pain. Moreover, patients treated with acupuncture were more likely to experience improvements in hot flashes scores, fatigue, sleep disturbance, and anxiety compared to those in the control group, while the improvements in depression were comparable across both groups. Long-term follow-up results were similar to the EOT results. Conclusions Current evidence suggests that acupuncture might improve BC treatment-related symptoms measured with PROs including QoL, pain, fatigue, hot flashes, sleep disturbance and anxiety. However, a number of included studies report limited amounts of certain subgroup settings, thus more rigorous, well-designed and larger RCTs are needed to confirm our results.
Collapse
Affiliation(s)
- Yuzhu Zhang
- Breast Clinic Center, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China.,Breast Clinic Center, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China.,National Resource Center for Chinese Materia Medica, China Academy of Chinese Medical Sciences, Beijing, China
| | - Yang Sun
- Breast Clinic Center, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China.,Breast Clinic Center, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Dongmei Li
- Breast Department, Zhuhai Hospital of Guangdong Province Hospital of Chinese Medicine, Zhuhai, China
| | - Xiaoyuan Liu
- Breast Clinic Center, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China.,Breast Clinic Center, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Chen Fang
- Breast Clinic Center, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China.,Breast Clinic Center, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Chunmin Yang
- Breast Clinic Center, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China.,Breast Clinic Center, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Tianyu Luo
- Breast Clinic Center, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China.,Breast Clinic Center, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Hai Lu
- Breast Clinic Center, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China.,Breast Clinic Center, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Huachao Li
- Breast Clinic Center, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China.,Breast Clinic Center, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Hongyan Zhang
- Breast Clinic Center, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China.,Breast Clinic Center, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Qianyi Liang
- Breast Clinic Center, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China.,Breast Clinic Center, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Jiahua Wu
- Breast Clinic Center, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China.,Breast Clinic Center, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Limei Huang
- Breast Clinic Center, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China.,Breast Clinic Center, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Rui Xu
- Breast Clinic Center, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China.,Breast Clinic Center, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Liping Ren
- Breast Clinic Center, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China.,Breast Clinic Center, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Qianjun Chen
- Breast Clinic Center, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China.,Breast Clinic Center, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| |
Collapse
|
6
|
Hutton B, Hersi M, Cheng W, Pratt M, Barbeau P, Mazzarello S, Ahmadzai N, Skidmore B, Morgan SC, Bordeleau L, Ginex PK, Sadeghirad B, Morgan RL, Cole KM, Clemons M. Comparing Interventions for Management of Hot Flashes in Patients With Breast and Prostate Cancer: A Systematic Review With Meta-Analyses. Oncol Nurs Forum 2021; 47:E86-E106. [PMID: 32555553 DOI: 10.1188/20.onf.e86-e106] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
PROBLEM IDENTIFICATION Hot flashes are common and bothersome in patients with breast and prostate cancer and can adversely affect patients' quality of life. LITERATURE SEARCH Databases were searched for randomized controlled trials (RCTs) evaluating the effects of one or more interventions for hot flashes in patients with a history of breast or prostate cancer. DATA EVALUATION Outcomes of interest included changes in hot flash severity, hot flash frequency, quality of life, and harms. Pairwise meta-analyses and network meta-analyses were performed where feasible, with narrative synthesis used where required. SYNTHESIS 40 RCTs were included. Findings from network meta-analysis for hot flash frequency suggested that several therapies may offer benefits compared to no treatment, but little data suggested differences between active therapies. Findings from network meta-analysis for hot flash score were similar. IMPLICATIONS FOR RESEARCH Although many interventions may offer improvements for hot flashes versus no treatment, minimal data suggest important differences between therapies. SUPPLEMENTARY MATERIALS CAN BE FOUND BY VISITING HTTPS //bit.ly/2WGzi30.
Collapse
|
7
|
Franzoi MA, Agostinetto E, Perachino M, Del Mastro L, de Azambuja E, Vaz-Luis I, Partridge AH, Lambertini M. Evidence-based approaches for the management of side-effects of adjuvant endocrine therapy in patients with breast cancer. Lancet Oncol 2021; 22:e303-e313. [PMID: 33891888 DOI: 10.1016/s1470-2045(20)30666-5] [Citation(s) in RCA: 114] [Impact Index Per Article: 38.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 10/13/2020] [Accepted: 10/22/2020] [Indexed: 12/13/2022]
Abstract
The growing availability of more effective therapies has contributed to an increased survival of patients with breast cancer. In hormone receptor-positive early disease, increased survival is strongly correlated with the use of adjuvant endocrine therapy, but this therapy can cause side-effects that have major consequences in terms of treatment adherence and patients' quality of life. In premenopausal breast cancer survivors, these side-effects might be even more prominent due to the abrupt suppression of oestrogen associated with the most intense endocrine therapies. An important ambition of cancer care in the 21st century is to recover pre-cancer quality of life and emotional and social functions, which is only possible through the mitigation of the side-effects of anticancer treatments. This Review presents a comprehensive summary of the efficacy and safety data of the available interventions (hormonal and non-hormonal pharmacological strategies, non-pharmacological approaches, and complementary and alternative medicine) to control selected side-effects associated with adjuvant endocrine therapy (hot flashes, sexual dysfunction, weight gain, musculoskeletal symptoms, and fatigue), providing updated, evidence-based approaches for their management.
Collapse
Affiliation(s)
- Maria Alice Franzoi
- Academic Trials Promoting Team, Jules Bordet Institute and Université Libre de Bruxelles, Brussels, Belgium
| | - Elisa Agostinetto
- Academic Trials Promoting Team, Jules Bordet Institute and Université Libre de Bruxelles, Brussels, Belgium; Medical Oncology and Hematology Unit, IRCCS Istituto Clinico Humanitas-Humanitas Cancer Center, Humanitas Research Hospital, Milan, Italy
| | - Marta Perachino
- Department of Medical Oncology, UOC Clinica di Oncologia Medica, IRCCS Policlinico San Martino Hospital, University of Genoa, Genoa, Italy; Department of Internal Medicine and Medical Specialties, School of Medicine, University of Genoa, Genoa, Italy
| | - Lucia Del Mastro
- Department of Internal Medicine and Medical Specialties, School of Medicine, University of Genoa, Genoa, Italy; Breast Unit, IRCCS Policlinico San Martino Hospital, Genoa, Italy
| | - Evandro de Azambuja
- Academic Trials Promoting Team, Jules Bordet Institute and Université Libre de Bruxelles, Brussels, Belgium
| | - Ines Vaz-Luis
- Unit 981-Molecular Predictors and New Targets In Oncology, Department of Medical Oncology, INSERM and Institut Gustave Roussy, Paris, France
| | - Ann H Partridge
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Matteo Lambertini
- Department of Medical Oncology, UOC Clinica di Oncologia Medica, IRCCS Policlinico San Martino Hospital, University of Genoa, Genoa, Italy; Department of Internal Medicine and Medical Specialties, School of Medicine, University of Genoa, Genoa, Italy.
| |
Collapse
|
8
|
Sheng RY, Yan Y, Linh Dang H. Acupuncture for hot flashes: A literature review of randomized controlled trials conducted in the last 10 years. WORLD JOURNAL OF TRADITIONAL CHINESE MEDICINE 2021. [DOI: 10.4103/wjtcm.wjtcm_27_21] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
|
9
|
Jang S, Ko Y, Sasaki Y, Park S, Jo J, Kang NH, Yoo ES, Park NC, Cho SH, Jang H, Jang BH, Hwang DS, Ko SG. Acupuncture as an adjuvant therapy for management of treatment-related symptoms in breast cancer patients: Systematic review and meta-analysis (PRISMA-compliant). Medicine (Baltimore) 2020; 99:e21820. [PMID: 33327222 PMCID: PMC7738093 DOI: 10.1097/md.0000000000021820] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Although randomized controlled trials have revealed the considerable effectiveness of acupuncture in breast cancer patients, there have been no studies exploring current acupuncture research trends for treatment induced various symptoms in breast cancer patients. This review evaluated the effectiveness of acupuncture for treatment-induced symptoms in breast cancer patients. METHODS We performed a systematic review and meta-analysis of the literature regarding acupuncture to treat symptoms associated with breast cancer therapies. The following databases were searched for relevant RCTs published before June 2018: MEDLINE, EMBASE, the Cochrane Library, AMED, CINAHL, OASIS, CNKI, and CiNii. RESULTS Among the 19,483 records identified, 835 articles remained after screening titles and abstracts. A total of 19 RCTs were included in this qualitative synthesis. Among the studies, 8 explored climacteric symptoms, 4 explored pain, 2 explored lymphedemas, 2 explored nausea and vomiting and 3 investigated miscellaneous symptoms.explored miscellaneous symptoms due to cancer treatments. Most of the studies reported that acupuncture can alleviate various symptoms of breast cancer treatment. However, there is a lack of evidence as to whether accupuncture can alleviate chemotherapy associated side effects CONCLUSIONS:: Acupuncture may alleviate the treatment-related symptoms of breast cancer; however, further studies are necessary to obtain conclusive evidence of the effectiveness of acupuncture in treating breast cancer. REGISTRATION NUMBER CRD42018087813.
Collapse
Affiliation(s)
- Soobin Jang
- Clinical Research Division, Korea Institute of Oriental Medicine; 1672 Yuseong-daero, Yuseong-gu, Daejeon
| | - Youme Ko
- Department of Preventive Medicine, College of Korean Medicine, Kyung Hee University; 26, Kyungheedae-ro, Hoegi-dong, Dongdaemun-gu, Seoul
| | - Yui Sasaki
- Department of Preventive Medicine, College of Korean Medicine, Kyung Hee University; 26, Kyungheedae-ro, Hoegi-dong, Dongdaemun-gu, Seoul
| | - Sunju Park
- Department of Preventive Medicine, College of Korean Medicine, Daejeon University; 62 Daehak-ro, Dong-gu, Daejeon
| | - Junyoung Jo
- Department of Korean Obstetrics and Gynecology, Conmaul Hospital of Korean Medicine, 110 Seochojungang-ro, Seocho-dong, Seocho-gu, Seoul
| | - Na-Hoon Kang
- Department of Clinical Korean Medicine, Graduate School, Kyung-Hee University, 26, Kyungheedae-ro, Hoegi-dong, Dongdaemun-gu, Seoul
| | - Eun-Sil Yoo
- Department of Clinical Korean Medicine, Graduate School, Kyung-Hee University, 26, Kyungheedae-ro, Hoegi-dong, Dongdaemun-gu, Seoul
| | - Nam-Chun Park
- Department of Clinical Korean Medicine, Graduate School, Kyung-Hee University, 26, Kyungheedae-ro, Hoegi-dong, Dongdaemun-gu, Seoul
| | - Seong hee Cho
- Department of Obstetrics and Gynecology, College of Korean Medicine, Dong-Shin University, 185, Geonjae-ro, Naju-si, Jeollanam-do
| | - Heejea Jang
- Women Cancer Center, Soram Korean medicine Hospital, 154–11, Samsung-dong, 06154, Gangnam-gu, Seoul, Republic of Korea
| | - Bo-Hyoung Jang
- Department of Preventive Medicine, College of Korean Medicine, Kyung Hee University; 26, Kyungheedae-ro, Hoegi-dong, Dongdaemun-gu, Seoul
| | - Deok-Sang Hwang
- Department of Preventive Medicine, College of Korean Medicine, Daejeon University; 62 Daehak-ro, Dong-gu, Daejeon
| | - Seong-Gyu Ko
- Department of Preventive Medicine, College of Korean Medicine, Kyung Hee University; 26, Kyungheedae-ro, Hoegi-dong, Dongdaemun-gu, Seoul
| |
Collapse
|
10
|
Yuanqing P, Yong T, Haiqian L, Gen C, Shen X, Dong J, Qi C, Miaomiao Q. Acupuncture for Hormone Therapy-Related Side Effects in Breast Cancer Patients: A GRADE-Assessed Systematic Review and Updated Meta-Analysis. Integr Cancer Ther 2020; 19:1534735420940394. [PMID: 32718258 PMCID: PMC7388099 DOI: 10.1177/1534735420940394] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Purpose: To determine the efficacy of acupuncture on the management of hormone therapy-related side effects in breast cancer patients. Methods: Randomized controlled trials of acupuncture versus a control or placebo in breast cancer patients that examined reductions in therapy-related side effects were retrieved from PubMed, EMBASE, Web of Science, and the Cochrane Library through April 2020. Data on patient symptoms (hot flashes, fatigue, pain, stiffness, and gastrointestinal symptoms), physical capacity, cytokines, and general psychosomatic well-being were analyzed. We evaluated and analyzed the quality of all included studies with the 5.2 Cochrane Handbook standards using Stata software (version 10.0) and Revman software (version 5.2), respectively. We assessed the risk of bias using the Cochrane Risk of Bias tool and evaluated the quality of evidence using the GRADE (Grading of Recommendations, Assessment, Development, and Evaluations) approach. Results: The pooled results suggested that acupuncture led to moderate improvements in hot flashes, fatigue, and stiffness. No significant differences were observed in pain, gastrointestinal symptoms, Kupperman index scores, Overall quality of life, tumor necrosis factor levels, and interleukin levels. Conclusions: Evidence for outcome indicators of symptom management were downgraded by the GRADE system for inconsistency, indirectness, and imprecision in the included RCTs. Nonetheless, acupuncture is a moderately appropriate alternative therapy for hormone therapy-related side effects in breast cancer patients. However, it still lacks large-sample, multicenter, prospective RCTs. Future research should focus on standardizing comparison groups and treatment methods, be at least single-blinded, assess biologic mechanisms, have adequate statistical power, and involve multiple acupuncturists.
Collapse
Affiliation(s)
- Pan Yuanqing
- Guilin Medical University, Campbell China Network, Guilin, China
| | - Tang Yong
- The Affiliated Tumor Hospital of Tianjin Medical University, Tianjin, China
| | - Liang Haiqian
- Characteristic Medical Center of Chinese people's Armed Police Force, Tianjin, China
| | - Chen Gen
- Guilin Medical University, Campbell China Network, Guilin, China
| | | | - Jin Dong
- Tianjin Pingjin Hospital, Tianjin, China
| | - Cui Qi
- The First Affiliated Hospital of Lanzhou University, Gansu, China
| | | |
Collapse
|
11
|
Kaplan M, Ginex PK, Michaud LB, Fernández-Ortega P, Leibelt J, Mahon S, Rapoport BL, Robinson V, Maloney C, Moriarty KA, Vrabel M, Morgan RL. ONS Guidelines™ for Cancer Treatment-Related Hot Flashes in Women With Breast Cancer and Men With Prostate Cancer. Oncol Nurs Forum 2020; 47:374-399. [PMID: 32555554 DOI: 10.1188/20.onf.374-399] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE Hot flashes are a common and troublesome side effect of surgery or endocrine therapy. They may lead to physical and psychological distress and negatively affect quality of life. This clinical practice guideline presents evidence-based recommendations for pharmacologic, behavioral, and natural health product interventions for treatment-related hot flashes in patients with breast or prostate cancer. METHODOLOGIC APPROACH An interprofessional panel of healthcare professionals with patient representation prioritized clinical questions and patient outcomes for the management of hot flashes. Systematic reviews of the literature were conducted. The GRADE (Grading of Recommendations Assessment, Development, and Evaluation) approach was used to assess the evidence and make recommendations. FINDINGS The panel agreed on 14 pharmacologic, behavioral, and natural health recommendations. IMPLICATIONS FOR NURSING Conditional recommendations include the use of antidepressants rather than no treatment, physical activity rather than no treatment, and the avoidance of gabapentin and dietary supplements in the treatment of hot flashes. SUPPLEMENTARY MATERIAL CAN BE FOUND AT HTTPS //onf.ons.org/ons-guidelines-hot-flashes-supplementary-material.
Collapse
|
12
|
Liu J, Nie G, Li Y, Wen Z, Lu L, Xie L, Cao D, Lai Y, Yang H. Nonhormonal Hot Flash Management for Breast Cancer Survivors: A Systematic Review and Network Meta-Analysis. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2020; 2020:4243175. [PMID: 32419803 PMCID: PMC7204350 DOI: 10.1155/2020/4243175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Revised: 02/26/2020] [Accepted: 02/28/2020] [Indexed: 11/22/2022]
Abstract
MATERIALS AND METHODS We conducted a systematic literature search in PubMed, Cochrane Central Register of Controlled Trials, Embase, Chinese Biomedicine Database (CBM), China National Knowledge Infrastructure (CNKI), Wan Fang, and VIP up to May 2018. Randomized controlled trials (RCTs) reporting nonhormonal hot flash treatments for breast cancer survivors were included. Primary outcome measurements were hot flash frequency and hot flash score of posttreatment. The methodological quality of each study was assessed with Cochrane's risk of bias tool. RESULTS 16 RCTs involving 2,349 participants were included. The nonhormonal therapies used in the included studies were classified as follows: lifestyle changes, mind-body techniques, dietary/supplements, SSRIs/SNRIs, other medications, and other therapies. Pairwise meta-analysis showed that the general effect of nonhormonal management was statistically more effective than no treatment/placebo/sham in reducing hot flash frequency (SMD = -0.60, 95% CI [-1.13, -0.06]; P=0.03)) and hot flash score (SMD = -0.38, 95% CI [-0.68, -0.08]). For hot flash frequency, results from the NMA showed that there was no statistically significant difference between any two of the nonhormonal treatments. Another NMA result indicated that acupuncture (other therapies) was 16.05 points more effective in reducing hot flash scores than no treatment/waitlist (SMD = -16.05, 95% CI [-30.2, -1.99]). These results were statistically significant. Acupuncture was also ranked the optimal nonhormonal therapy for both hot flash frequency and hot flash score. The safety analysis showed that there were few related adverse events during acupuncture and that drug related adverse reactions could have also occurred in studies using drug interventions. CONCLUSIONS This network meta-analysis comparing nonhormonal treatments suggested that acupuncture might be more effective in improving hot flashes for breast cancer survivors. A pronounced placebo response was found during hot flash treatments. The evidence of safety for nonhormonal therapies was also insufficient. Therefore, at present, we cannot make confirmative recommendations of nonhormonal hot flash management for breast cancer survivors. This study is registered with PROSPERO (CRD42018082008).
Collapse
Affiliation(s)
- Jian Liu
- Department of Gynecology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Dade Road, Yuexiu District, Guangzhou 510120, Guangdong, China
| | - Guangning Nie
- Department of Gynecology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Dade Road, Yuexiu District, Guangzhou 510120, Guangdong, China
| | - Yang Li
- Department of Gynecology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Dade Road, Yuexiu District, Guangzhou 510120, Guangdong, China
| | - Zehuai Wen
- Key Unit of Methodology in Clinical Research, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Liming Lu
- Clinical Research Center, South China Research Center for Acupuncture and Moxibustion, Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Li Xie
- The Second Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Dongdong Cao
- Department of Chinese Medicine, Affiliated Hospital of Guilin Medical University, Guilin, Guangxi, China
| | - Yafang Lai
- Department of Gynecology, Foshan Hospital of Traditional Chinese Medicine, Guangzhou, Guangdong, China
| | - Hongyan Yang
- Department of Gynecology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Dade Road, Yuexiu District, Guangzhou 510120, Guangdong, China
- Guangdong Provincial Key Laboratory of Clinical Research on Traditional Chinese Medicine Syndrome, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| |
Collapse
|
13
|
Chien TJ, Liu CY, Fang CJ, Kuo CY. The maintenance effect of acupuncture on breast cancer-related menopause symptoms: a systematic review. Climacteric 2019; 23:130-139. [PMID: 31612733 DOI: 10.1080/13697137.2019.1664460] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Background: Acupuncture has been used for many breast cancer treatment-related problems, but how long the effect lasts is unknown. This meta-analysis aims to evaluate how long the effect of acupuncture on breast cancer-related hot flushes and menopause symptoms lasts.Methods: The research design followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Statement, without language restrictions. Seven databases from inception through February 2019 were accessed; only randomized clinical trials (RCTs) that examined the maintenance effect of acupuncture on hot flushes or menopause symptoms after treatment were included. Cochrane criteria were followed and RevMan 5.2 software was used to analyze trials.Results: In total, 943 patients from 13 RCTs were analyzed. The meta-analysis showed that acupuncture had no significant long-term maintenance effect on the frequency or severity of hot flushes (p = 0.29; p = 0.34), but had a significant 3-month maintenance effect of ameliorating menopause symptoms at 3 months after treatment ended (p = 0.001). No adverse events were reported.Conclusions: Acupuncture significantly alleviated menopause symptoms for at least 3 months, but not hot flushes. Breast cancer patients concerned about the adverse effects of hormone therapy could consider acupuncture as an alternative. Additional acupuncture at 3 months after the initial treatment course could be considered. A large-scale study may help to define the optimal guideline for this issue.
Collapse
Affiliation(s)
- T-J Chien
- Division of Hemato-Oncology, Department of Internal Medicine, Branch of Zhong-Zhou and Jen-Ai, Taipei City Hospital, Taipei, Taiwan.,Institute of Traditional Medicine, National Yang-Ming University, Taipei, Taiwan
| | - C-Y Liu
- Institute of Traditional Medicine, National Yang-Ming University, Taipei, Taiwan.,School of Traditional Chinese Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan.,School of Chinese Medicine, China Medical University, Taichung, Taiwan.,Flourish Traditional Chinese Medicine Clinic, Taipei, Taiwan
| | - C-J Fang
- Medical Library, National Cheng Kung University, Tainan, Taiwan.,Department of Secretariat, College of Medicine, National Cheng Kung University Hospital, National Cheng Kung University, Tainan, Taiwan
| | - C-Y Kuo
- Institute of Traditional Medicine, National Yang-Ming University, Taipei, Taiwan
| |
Collapse
|
14
|
Martin BR. Complementary Medicine Therapies That May Assist With Weight Loss: A Narrative Review. J Chiropr Med 2019; 18:115-126. [PMID: 31367198 DOI: 10.1016/j.jcm.2018.10.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Revised: 08/03/2018] [Accepted: 10/28/2018] [Indexed: 10/26/2022] Open
Abstract
Objective The purpose of this study was to review the potential effects of traditional Chinese medicine-which includes acupuncture; electroacupuncture; plum blossom needle hammer; auricular acupuncture; herbs that balance hormones, regulate neurotransmitters, induce sedative effects, and increase thermogenesis; and functional foods that can suppress the appetite-as an adjunct therapy for weight loss. Methods A narrative review of the current literature was performed using searches of MEDLINE and 4 scholarly texts. The inclusion criteria for the review consisted of studies that were performed from 2005 to 2016. Results In general, some traditional Chinese medicine modalities claim to promote weight loss. Acupuncture, electroacupuncture, and herbs aim to reduce stress-related food cravings. These therapeutic approaches aim to downregulate dopamine and leptin levels, suppressing the appetite. Other attributes of these therapies are increasing uncoupling protein-1 activity promoting thermogenesis, which contributes to weight loss. In addition, acupuncture, electroacupuncture, and Cimicifuga racemosa may regulate estrogen, which could attenuate the appetite, assisting in weight-loss programs. Conclusion The literature reviewed includes information that describes how traditional Chinese medicine, herbal medicine, or functional foods as adjunct therapies may be beneficial for weight-loss programs.
Collapse
Affiliation(s)
- Brett R Martin
- Basic Science Department, National University of Health Sciences, Pinellas Park, Florida
| |
Collapse
|
15
|
Pan Y, Yang K, Shi X, Liang H, Shen X, Wang R, Ma L, Cui Q, Yu R, Dong Y. Clinical Benefits of Acupuncture for the Reduction of Hormone Therapy-Related Side Effects in Breast Cancer Patients: A Systematic Review. Integr Cancer Ther 2019; 17:602-618. [PMID: 30117343 PMCID: PMC6142070 DOI: 10.1177/1534735418786801] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
Importance. Acupuncture can help reduce unpleasant side effects associated with endocrine therapy for breast cancer. Nevertheless, comprehensive evaluation of current evidence from randomized controlled trials(RCTs) is lacking. Objective. To estimate the efficacy of acupuncture for the reduction of hormone therapy-related side effects in breast cancer patients. Evidence review. RCTs of acupuncture in breast cancer patients that examined reductions in hormone therapy–related side effects were retrieved from PubMed, EMBASE, Web of Science, Ovid MEDLINE, and Cochrane Library databases through April 2016. The quality of the included studies was evaluated according to the 5.2 Cochrane Handbook standards, and CONSORT and STRICTA (Revised Standards for Reporting Interventions in Clinical Trials of Acupuncture) statements. Intervention. Interventions included conventional acupuncture treatment compared with no treatment, placebo, or conventional pharmaceutical medication. Major outcome measures were the alleviation of frequency and symptoms and the presence of hormone therapy–related side effects. Findings/Results. A total of 17 RCTs, including a total of 810 breast cancer patients were examined. The methodological quality of the trials was relatively rigorous in terms of randomization, blinding, and sources of bias. Compared with control therapies, the pooled results suggested that acupuncture had moderate effects in improving stiffness. No significant differences were observed in hot flashes, fatigue, pain, gastrointestinal symptoms, Kupperman index, general well-being, physical well-being, tumor necrosis factor (TNF), and interleukin (IL). Conclusions. Acupuncture therapy appears to be potentially useful in relieving functional stiffness. However, further large-sample trials with evidence-based design are still needed to confirm these findings.
Collapse
Affiliation(s)
- Yuanqing Pan
- 1 Tianjin Medical College, Tianjin, China.,2 Lanzhou University, Lanzhou, Gansu, China
| | - Kehu Yang
- 2 Lanzhou University, Lanzhou, Gansu, China
| | - Xiue Shi
- 3 Gansu Rehabilitation Center Hospital, Lanzhou, China
| | | | | | | | - Li Ma
- 5 General Hospital of Tianjin Medical University, Tianjin, China
| | - Qi Cui
- 6 The First Affiliated Hospital of Lanzhou University, Lanzhou, Gansu, China
| | - Runze Yu
- 1 Tianjin Medical College, Tianjin, China
| | - Yi Dong
- 1 Tianjin Medical College, Tianjin, China
| |
Collapse
|
16
|
Greenlee H, DuPont-Reyes MJ, Balneaves LG, Carlson LE, Cohen MR, Deng G, Johnson JA, Mumber M, Seely D, Zick SM, Boyce LM, Tripathy D. Clinical practice guidelines on the evidence-based use of integrative therapies during and after breast cancer treatment. CA Cancer J Clin 2017; 67:194-232. [PMID: 28436999 PMCID: PMC5892208 DOI: 10.3322/caac.21397] [Citation(s) in RCA: 402] [Impact Index Per Article: 57.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Answer questions and earn CME/CNE Patients with breast cancer commonly use complementary and integrative therapies as supportive care during cancer treatment and to manage treatment-related side effects. However, evidence supporting the use of such therapies in the oncology setting is limited. This report provides updated clinical practice guidelines from the Society for Integrative Oncology on the use of integrative therapies for specific clinical indications during and after breast cancer treatment, including anxiety/stress, depression/mood disorders, fatigue, quality of life/physical functioning, chemotherapy-induced nausea and vomiting, lymphedema, chemotherapy-induced peripheral neuropathy, pain, and sleep disturbance. Clinical practice guidelines are based on a systematic literature review from 1990 through 2015. Music therapy, meditation, stress management, and yoga are recommended for anxiety/stress reduction. Meditation, relaxation, yoga, massage, and music therapy are recommended for depression/mood disorders. Meditation and yoga are recommended to improve quality of life. Acupressure and acupuncture are recommended for reducing chemotherapy-induced nausea and vomiting. Acetyl-L-carnitine is not recommended to prevent chemotherapy-induced peripheral neuropathy due to a possibility of harm. No strong evidence supports the use of ingested dietary supplements to manage breast cancer treatment-related side effects. In summary, there is a growing body of evidence supporting the use of integrative therapies, especially mind-body therapies, as effective supportive care strategies during breast cancer treatment. Many integrative practices, however, remain understudied, with insufficient evidence to be definitively recommended or avoided. CA Cancer J Clin 2017;67:194-232. © 2017 American Cancer Society.
Collapse
Affiliation(s)
- Heather Greenlee
- Assistant Professor, Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY
- Member, Herbert Irving Comprehensive Cancer Center, Columbia University, New York, NY
| | - Melissa J DuPont-Reyes
- Doctoral Fellow, Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY
| | - Lynda G Balneaves
- Associate Professor, College of Nursing, Rady Faculty of Health Sciences, Winnipeg, MB, Canada
| | - Linda E Carlson
- Professor, Department of Oncology, University of Calgary, Calgary, AB, Canada
| | - Misha R Cohen
- Adjunct Professor, American College of Traditional Chinese Medicine at California Institute of Integral Studies, San Francisco, CA
- Clinic Director, Chicken Soup Chinese Medicine, San Francisco, CA
| | - Gary Deng
- Medical Director, Integrative Oncology, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Jillian A Johnson
- Post-Doctoral Scholar, Department of Biobehavioral Health, The Pennsylvania State University, University Park, PA
| | | | - Dugald Seely
- Executive Director, Ottawa Integrative Cancer Center, Ottawa, ON, Canada
- Executive Director of Research, Canadian College of Naturopathic Medicine, Toronto, ON, Canada
| | - Suzanna M Zick
- Research Associate Professor, Department of Family Medicine, Michigan Medicine, University of Michigan, Ann Arbor, MI
- Research Associate Professor, Department of Nutritional Sciences, School of Public Health, University of Michigan, Ann Arbor, MI
| | - Lindsay M Boyce
- Research Informationist, Memorial Sloan Kettering Library, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Debu Tripathy
- Professor, Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| |
Collapse
|
17
|
Effects of non-pharmacological supportive care for hot flushes in breast cancer: a meta-analysis. Support Care Cancer 2017; 25:2335-2347. [DOI: 10.1007/s00520-017-3691-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2016] [Accepted: 03/31/2017] [Indexed: 12/31/2022]
|
18
|
Carlos L, da Cruz LAP, Leopoldo VC, de Campos FR, de Almeida AM, Silveira RCDCP. Effectiveness of Traditional Chinese Acupuncture versus Sham Acupuncture: a Systematic Review. Rev Lat Am Enfermagem 2016; 24:e2762. [PMID: 27533271 PMCID: PMC4996090 DOI: 10.1590/1518-8345.0647.2762] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2015] [Accepted: 12/19/2015] [Indexed: 12/26/2022] Open
Abstract
OBJECTIVE to identify and synthesize the evidence from randomized clinical trials that tested the effectiveness of traditional Chinese acupuncture in relation to sham acupuncture for the treatment of hot flashes in menopausal women with breast cancer. METHOD systematic review guided by the recommendations of the Cochrane Collaboration. Citations were searched in the following databases: MEDLINE via PubMed, Web of Science, CENTRAL, CINAHL, and LILACS. A combination of the following keywords was used: breast neoplasm, acupuncture, acupuncture therapy, acupuncture points, placebos, sham treatment, hot flashes, hot flushes, menopause, climacteric, and vasomotor symptoms. RESULTS a total of 272 studies were identified, five of which were selected and analyzed. Slight superiority of traditional acupuncture compared with sham acupuncture was observed; however, there were no strong statistical associations. CONCLUSIONS the evidence gathered was not sufficient to affirm the effectiveness of traditional acupuncture compared with sham acupuncture. OBJETIVO identificar e sintetizar as evidências oriundas de ensaios clínicos randomizados que testaram a efetividade da acupuntura tradicional chinesa em relação à sham acupuntura para o tratamento dos fogachos em mulheres com câncer de mama no climatério. MÉTODO revisão sistemática guiada pelas recomendações da Colaboração Cochrane. A busca foi realizada nas bases de dados: MEDLINE via PubMed, Web of Science, CENTRAL Cochrane, CINAHL e LILACS. Adotou-se a combinação dos descritores: breast neoplasm, acupuncture, acupuncture therapy, acupuncture points, placebos, sham treatment, hot flashes, hot flushes, menopause, climacteric, vasomotor symptoms. RESULTADOS foram identificados 272 estudos, sendo 5 selecionados e analisados. Foi observada discreta superioridade da acupuntura tradicional em relação à sham, entretanto, sem fortes associações estatísticas. CONCLUSÕES as evidências obtidas não foram suficientes para afirmar quanto à efetividade da acupuntura tradicional em relação à sham. OBJETIVO Identificar y sintetizar la evidencia de un ensayo clínico aleatorizado que examinó la eficacia de la acupuntura tradicional en relación a la acupuntura sham para el tratamiento de sofocos en las mujeres menopáusicas con cáncer de mama. MÉTODO Revisión sistemática guiada por las recomendaciones de la Colaboración Cochrane. Las referencias bibliográficas se buscaron en las siguientes bases de datos: MEDLINE vía PubMed, Web of Science, Cochrane Central Register of Controlled Trials (CENTRAL), CINAHL y LILACS. Se utilizó una combinación de las siguientes palabras clave: breast neoplasm, acupuncture, acupuncture therapy, acupuncture points, placebos, sham treatment, hot flashes, hot flushes, menopause, climacteric, vasomotor symptoms. RESULTADOS Se identificó un total de 272 estudios, cinco de los cuales fueron seleccionados y analizados. Se encontró una ligera superioridad de la acupuntura tradicional comparada con la acupuntura sham; sin embargo, no se encontraron asociaciones estadísticas fuertes. CONCLUSIONES La evidencia obtenida no fue suficiente para confirmar la eficacia de la acupuntura tradicional comparada con la acupuntura sham.
Collapse
Affiliation(s)
- Luís Carlos
- Doctoral Student, Escola de Enfermagem de Ribeirão Preto, Universidade
de São Paulo, PAHO/WHO Collaborating Centre for Nursing Research Development, Ribeirão
Preto, SP, Brazil
| | - Lóris Aparecida Prado da Cruz
- Master's Student, Escola de Enfermagem de Ribeirão Preto, Universidade
de São Paulo, PAHO/WHO Collaborating Centre for Nursing Research Development, Ribeirão
Preto, SP, Brazil
| | - Vanessa Cristina Leopoldo
- Master's Student, Escola de Enfermagem de Ribeirão Preto, Universidade
de São Paulo, PAHO/WHO Collaborating Centre for Nursing Research Development, Ribeirão
Preto, SP, Brazil. RN, Hospital das Clínicas, Faculdade de Medicina de Ribeirão Preto,
Universidade de São Paulo, Ribeirão Preto, SP, Brazil
| | - Fabrício Ribeiro de Campos
- Master's Student, Escola de Enfermagem de Ribeirão Preto, Universidade
de São Paulo, PAHO/WHO Collaborating Centre for Nursing Research Development, Ribeirão
Preto, SP, Brazil. RN, Fundação Santa Casa de Misericórdia de Franca, Franca, SP,
Brazil
| | - Ana Maria de Almeida
- PhD, Associate Professor, Escola de Enfermagem de Ribeirão Preto,
Universidade de São Paulo, PAHO/WHO Collaborating Centre for Nursing Research
Development, Ribeirão Preto, SP, Brazil
| | - Renata Cristina de Campos Pereira Silveira
- PhD, Professor, Escola de Enfermagem de Ribeirão Preto, Universidade de
São Paulo, PAHO/WHO Collaborating Centre for Nursing Research Development, Ribeirão
Preto, SP, Brazil
| |
Collapse
|
19
|
Acupuncture for treating hot flashes in breast cancer patients: an updated meta-analysis. Support Care Cancer 2016; 24:4895-4899. [PMID: 27497608 DOI: 10.1007/s00520-016-3345-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2016] [Accepted: 07/10/2016] [Indexed: 10/21/2022]
Abstract
PURPOSE The aim of this study was to evaluate the effectiveness of acupuncture for treatment of hot flash in women with breast cancer. METHODS The aspects considered in this study included searching for 12 data bases until April 2015 and consulting reference lists of reviews and related articles. Additional features studied comprised all articles on human patients with breast cancer treated with needle acupuncture with or without electrical stimulation for the treatment of hot flashes. The methodological quality was assessed using the modified Jadad score. RESULT The searches identified 12 relevant articles for inclusion. The meta-analysis without any subgroup or moderator failed to show favorable effects of acupuncture on reducing the frequency of hot flashes after intervention (n = 680, SMD = - 0.478, 95 % CI -0.397 to 0.241, P = 0.632) but exhibited marked heterogeneity of the results (Q value = 83.200, P = 0.000, I^2 = 83.17, τ^2 = 0.310). CONCLUSION The meta-analysis used had contradictory results and yielded no convincing evidence to suggest that acupuncture was an effective treatment of hot flash in patients with breast cancer. Multi-central studies including large sample size are required to investigate the efficiency of acupuncture for treating hot flash in patients with breast cancer.
Collapse
|
20
|
Acupuncture: could it become everyday practice in oncology? Contemp Oncol (Pozn) 2016; 20:119-23. [PMID: 27358589 PMCID: PMC4925730 DOI: 10.5114/wo.2016.60065] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2014] [Accepted: 07/16/2014] [Indexed: 12/04/2022] Open
Abstract
Acupuncture is a complementary and alternative medical treatment (CAM) which is increasingly used in the care of cancer patients. Traditionally derived from Chinese medicine, nowadays it is becoming a part of evidence-based oncology. The use of acupuncture in these patients has been recommended by the American Cancer Society (ACS) for the treatment of side effects associated with conventional cancer therapy and cancer-related ailments. A growing body of evidence supports the use of acupuncture in the treatment of cancer-induced pain and chemotherapy-related nausea and vomiting. Also other indications, such as xerostomia, fatigue, hot flashes, anxiety and peripheral neuropathy, are being constantly evaluated. This article summarizes the most important discoveries related to the possible usefulness of this method in contemporary oncology. Emphasis is placed on the results of randomized controlled trials with an adequate level of evidence. However, explanation of the mechanisms responsible for these effects requires confirmation in further studies with an adequate level of evidence. In future, acupuncture may become an interesting and valuable addition to conventional medicine.
Collapse
|
21
|
|
22
|
Tao WW, Jiang H, Tao XM, Jiang P, Sha LY, Sun XC. Effects of Acupuncture, Tuina, Tai Chi, Qigong, and Traditional Chinese Medicine Five-Element Music Therapy on Symptom Management and Quality of Life for Cancer Patients: A Meta-Analysis. J Pain Symptom Manage 2016; 51:728-747. [PMID: 26880252 DOI: 10.1016/j.jpainsymman.2015.11.027] [Citation(s) in RCA: 117] [Impact Index Per Article: 14.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2014] [Revised: 11/19/2015] [Accepted: 11/20/2015] [Indexed: 10/22/2022]
Abstract
CONTEXT Most cancer patients suffer from both the disease itself and symptoms induced by conventional treatment. Available literature on the clinical effects on cancer patients of acupuncture, Tuina, Tai Chi, Qigong, and Traditional Chinese Medicine Five-Element Music Therapy (TCM-FEMT) reports controversial results. OBJECTIVES The primary objective of this meta-analysis was to evaluate the effect of acupuncture, Tuina, Tai Chi, Qigong, and TCM-FEMT on various symptoms and quality of life (QOL) in patients with cancer; risk of bias for the selected trials also was assessed. METHODS Studies were identified by searching electronic databases (MEDLINE via both PubMed and Ovid, Cochrane Central, China National Knowledge Infrastructure, Chinese Scientific Journal Database, China Biology Medicine, and Wanfang Database). All randomized controlled trials (RCTs) using acupuncture, Tuina, Tai Chi, Qigong, or TCM-FEMT published before October 2, 2014, were selected, regardless of whether the article was published in Chinese or English. RESULTS We identified 67 RCTs (5465 patients) that met our inclusion criteria to perform this meta-analysis. Analysis results showed that a significant combined effect was observed for QOL change in patients with terminal cancer in favor of acupuncture and Tuina (Cohen's d: 0.21-4.55, P < 0.05), whereas Tai Chi and Qigong had no effect on QOL of breast cancer survivors (P > 0.05). The meta-analysis also demonstrated that acupuncture produced small-to-large effects on adverse symptoms including pain, fatigue, sleep disturbance, and some gastrointestinal discomfort; however, no significant effect was found on the frequency of hot flashes (Cohen's d = -0.02; 95% CI = -1.49 to 1.45; P = 0.97; I(2) = 36%) and mood distress (P > 0.05). Tuina relieved gastrointestinal discomfort. TCM-FEMT lowered depression level. Tai Chi improved vital capacity of breast cancer patients. High risk of bias was present in 74.63% of the selected RCTs. Major sources of risk of bias were lack of blinding, allocation concealment, and incomplete outcome data. CONCLUSION Taken together, although there are some clear limitations regarding the body of research reviewed in this study, a tentative conclusion can be reached that acupuncture, Tuina, Tai Chi, Qigong, or TCM-FEMT represent beneficial adjunctive therapies. Future study reporting in this field should be improved regarding both method and content of interventions and research methods.
Collapse
Affiliation(s)
- Wei-Wei Tao
- College of Nursing, Dalian Medical University, Dalian, People's Republic of China.
| | - Hua Jiang
- School of Nursing, Peking University, Beijing, People's Republic of China
| | - Xiao-Mei Tao
- Beijing Shijitan Hospital, Beijing, People's Republic of China
| | - Ping Jiang
- Graduate School, Dalian Medical University, Dalian, People's Republic of China.
| | - Li-Yan Sha
- College of Nursing, Dalian Medical University, Dalian, People's Republic of China
| | - Xian-Ce Sun
- College of Public Health, Dalian Medical University, Dalian, People's Republic of China
| |
Collapse
|
23
|
Johns C, Seav SM, Dominick SA, Gorman JR, Li H, Natarajan L, Mao JJ, Irene Su H. Informing hot flash treatment decisions for breast cancer survivors: a systematic review of randomized trials comparing active interventions. Breast Cancer Res Treat 2016; 156:415-426. [PMID: 27015968 PMCID: PMC4838539 DOI: 10.1007/s10549-016-3765-4] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2016] [Accepted: 03/21/2016] [Indexed: 01/06/2023]
Abstract
Patient-centered decision making about hot flash treatments often incorporates a balance of efficacy and side effects in addition to patient preference. This systematic review examines randomized controlled trials (RCTs) comparing at least two non-hormonal hot flash treatments in breast cancer survivors. In July 2015, PubMed, SCOPUS, CINAHL, Cochrane, and Web of Science databases were searched for RCTs comparing active, non-hormonal hot flash treatments in female breast cancer survivors. Thirteen trials were included after identifying 906 potential studies. Four trials were dose comparison studies of pharmacologic treatments citalopram, venlafaxine, gabapentin, and paroxetine. Hot flash reduction did not differ by tamoxifen or aromatase inhibitor use. Citalopram 10, 20, and 30 mg daily had comparable outcomes. Venlafaxine 75 mg daily improved hot flashes without additional side effects from higher dosing. Gabapentin 900 mg daily improved hot flashes more than 300 mg. Paroxetine 10 mg daily had fewer side effects than 20 mg. Among four trials comparing different pharmacologic treatments, venlafaxine alleviated hot flash symptoms faster than clonidine; participants preferred venlafaxine over gabapentin. Five trials compared pharmacologic to non-pharmacologic treatments. Acupuncture had similar efficacy to venlafaxine and gabapentin but may have longer durability after completing treatment and fewer side effects. We could not perform a pooled meta-analysis because outcomes were not reported in comparable formats. Clinical trial data on non-hormonal hot flash treatments provide comparisons of hot flash efficacy and other patient important outcomes to guide clinical management. Clinicians can use the information to help patients select hot flash interventions.
Collapse
Affiliation(s)
- Claire Johns
- School of Medicine, University of California, San Francisco, 513 Parnassus Ave, San Francisco, CA, 94143-0401, USA
| | - Susan M Seav
- School of Medicine, University of California, San Diego, 3855 Health Sciences Drive #0901, La Jolla, CA, 92093-0901, USA
| | - Sally A Dominick
- Department of Reproductive Medicine, Moores Cancer Center, University of California, San Diego, 3855 Health Sciences Drive #0901, La Jolla, CA, 92093-0901, USA
| | - Jessica R Gorman
- College of Public Health and Human Sciences, Oregon State University, 2250 SW Jefferson Way, Corvallis, OR, 97331-6406, USA
| | - Hongying Li
- Department of Biostatistics, Moores Cancer Center, University of California, San Diego, 3855 Health Sciences Drive #0901, La Jolla, CA, 92093-0901, USA
| | - Loki Natarajan
- Department of Family Medicine & Public Health, Moores Cancer Center, University of California, San Diego, 3855 Health Sciences Drive #0901, La Jolla, CA, 92093-0901, USA
| | - Jun James Mao
- The Bendheim Center for Integrative Medicine, Memorial Sloan-Kettering Cancer Center, 1429 First Avenue, New York City, NY, 10021, USA
| | - H Irene Su
- Department of Reproductive Medicine, Moores Cancer Center, University of California, San Diego, 3855 Health Sciences Drive #0901, La Jolla, CA, 92093-0901, USA.
| |
Collapse
|
24
|
Greenlee H, Balneaves LG, Carlson LE, Cohen M, Deng G, Hershman D, Mumber M, Perlmutter J, Seely D, Sen A, Zick SM, Tripathy D. Clinical practice guidelines on the use of integrative therapies as supportive care in patients treated for breast cancer. J Natl Cancer Inst Monogr 2015; 2014:346-58. [PMID: 25749602 DOI: 10.1093/jncimonographs/lgu041] [Citation(s) in RCA: 163] [Impact Index Per Article: 18.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND The majority of breast cancer patients use complementary and/or integrative therapies during and beyond cancer treatment to manage symptoms, prevent toxicities, and improve quality of life. Practice guidelines are needed to inform clinicians and patients about safe and effective therapies. METHODS Following the Institute of Medicine's guideline development process, a systematic review identified randomized controlled trials testing the use of integrative therapies for supportive care in patients receiving breast cancer treatment. Trials were included if the majority of participants had breast cancer and/or breast cancer patient results were reported separately, and outcomes were clinically relevant. Recommendations were organized by outcome and graded based upon a modified version of the US Preventive Services Task Force grading system. RESULTS The search (January 1, 1990-December 31, 2013) identified 4900 articles, of which 203 were eligible for analysis. Meditation, yoga, and relaxation with imagery are recommended for routine use for common conditions, including anxiety and mood disorders (Grade A). Stress management, yoga, massage, music therapy, energy conservation, and meditation are recommended for stress reduction, anxiety, depression, fatigue, and quality of life (Grade B). Many interventions (n = 32) had weaker evidence of benefit (Grade C). Some interventions (n = 7) were deemed unlikely to provide any benefit (Grade D). Notably, only one intervention, acetyl-l-carnitine for the prevention of taxane-induced neuropathy, was identified as likely harmful (Grade H) as it was found to increase neuropathy. The majority of intervention/modality combinations (n = 138) did not have sufficient evidence to form specific recommendations (Grade I). CONCLUSIONS Specific integrative therapies can be recommended as evidence-based supportive care options during breast cancer treatment. Most integrative therapies require further investigation via well-designed controlled trials with meaningful outcomes.
Collapse
Affiliation(s)
- Heather Greenlee
- Department of Epidemiology, Mailman School of Public Health (HG, DH), Herbert Irving Comprehensive Cancer Center, (HG, DH), and Department of Medicine, College of Physicians and Surgeons (DH), Columbia University, New York, NY (HG, DH); School of Nursing, University of British Columbia, Vancouver, BC, Canada (LGB); Department of Oncology, University of Calgary, Calgary, AB, Canada (LEC); Institute for Health and Aging, University of California San Francisco, CA (MC); Chicken Soup Chinese Medicine, San Francisco, CA (MC); Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY (GD); Harbin Clinic, Rome, GA (MM); Gemini Group, Ann Arbor, MI (JP); Ottawa Integrative Cancer Center, Ottawa, ON, Canada (DS); Canadian College of Naturopathic Medicine, Toronto, ON, Canada (DS); Department of Family Medicine, University of Michigan Health System (AS, SMZ), Department of Environmental Health Sciences, School of Public Health (SMZ), and Department of Biostatistics (AS), University of Michigan, Ann Arbor, MI (AS, SMZ); Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX (DT).
| | - Lynda G Balneaves
- Department of Epidemiology, Mailman School of Public Health (HG, DH), Herbert Irving Comprehensive Cancer Center, (HG, DH), and Department of Medicine, College of Physicians and Surgeons (DH), Columbia University, New York, NY (HG, DH); School of Nursing, University of British Columbia, Vancouver, BC, Canada (LGB); Department of Oncology, University of Calgary, Calgary, AB, Canada (LEC); Institute for Health and Aging, University of California San Francisco, CA (MC); Chicken Soup Chinese Medicine, San Francisco, CA (MC); Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY (GD); Harbin Clinic, Rome, GA (MM); Gemini Group, Ann Arbor, MI (JP); Ottawa Integrative Cancer Center, Ottawa, ON, Canada (DS); Canadian College of Naturopathic Medicine, Toronto, ON, Canada (DS); Department of Family Medicine, University of Michigan Health System (AS, SMZ), Department of Environmental Health Sciences, School of Public Health (SMZ), and Department of Biostatistics (AS), University of Michigan, Ann Arbor, MI (AS, SMZ); Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX (DT)
| | - Linda E Carlson
- Department of Epidemiology, Mailman School of Public Health (HG, DH), Herbert Irving Comprehensive Cancer Center, (HG, DH), and Department of Medicine, College of Physicians and Surgeons (DH), Columbia University, New York, NY (HG, DH); School of Nursing, University of British Columbia, Vancouver, BC, Canada (LGB); Department of Oncology, University of Calgary, Calgary, AB, Canada (LEC); Institute for Health and Aging, University of California San Francisco, CA (MC); Chicken Soup Chinese Medicine, San Francisco, CA (MC); Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY (GD); Harbin Clinic, Rome, GA (MM); Gemini Group, Ann Arbor, MI (JP); Ottawa Integrative Cancer Center, Ottawa, ON, Canada (DS); Canadian College of Naturopathic Medicine, Toronto, ON, Canada (DS); Department of Family Medicine, University of Michigan Health System (AS, SMZ), Department of Environmental Health Sciences, School of Public Health (SMZ), and Department of Biostatistics (AS), University of Michigan, Ann Arbor, MI (AS, SMZ); Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX (DT)
| | - Misha Cohen
- Department of Epidemiology, Mailman School of Public Health (HG, DH), Herbert Irving Comprehensive Cancer Center, (HG, DH), and Department of Medicine, College of Physicians and Surgeons (DH), Columbia University, New York, NY (HG, DH); School of Nursing, University of British Columbia, Vancouver, BC, Canada (LGB); Department of Oncology, University of Calgary, Calgary, AB, Canada (LEC); Institute for Health and Aging, University of California San Francisco, CA (MC); Chicken Soup Chinese Medicine, San Francisco, CA (MC); Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY (GD); Harbin Clinic, Rome, GA (MM); Gemini Group, Ann Arbor, MI (JP); Ottawa Integrative Cancer Center, Ottawa, ON, Canada (DS); Canadian College of Naturopathic Medicine, Toronto, ON, Canada (DS); Department of Family Medicine, University of Michigan Health System (AS, SMZ), Department of Environmental Health Sciences, School of Public Health (SMZ), and Department of Biostatistics (AS), University of Michigan, Ann Arbor, MI (AS, SMZ); Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX (DT)
| | - Gary Deng
- Department of Epidemiology, Mailman School of Public Health (HG, DH), Herbert Irving Comprehensive Cancer Center, (HG, DH), and Department of Medicine, College of Physicians and Surgeons (DH), Columbia University, New York, NY (HG, DH); School of Nursing, University of British Columbia, Vancouver, BC, Canada (LGB); Department of Oncology, University of Calgary, Calgary, AB, Canada (LEC); Institute for Health and Aging, University of California San Francisco, CA (MC); Chicken Soup Chinese Medicine, San Francisco, CA (MC); Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY (GD); Harbin Clinic, Rome, GA (MM); Gemini Group, Ann Arbor, MI (JP); Ottawa Integrative Cancer Center, Ottawa, ON, Canada (DS); Canadian College of Naturopathic Medicine, Toronto, ON, Canada (DS); Department of Family Medicine, University of Michigan Health System (AS, SMZ), Department of Environmental Health Sciences, School of Public Health (SMZ), and Department of Biostatistics (AS), University of Michigan, Ann Arbor, MI (AS, SMZ); Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX (DT)
| | - Dawn Hershman
- Department of Epidemiology, Mailman School of Public Health (HG, DH), Herbert Irving Comprehensive Cancer Center, (HG, DH), and Department of Medicine, College of Physicians and Surgeons (DH), Columbia University, New York, NY (HG, DH); School of Nursing, University of British Columbia, Vancouver, BC, Canada (LGB); Department of Oncology, University of Calgary, Calgary, AB, Canada (LEC); Institute for Health and Aging, University of California San Francisco, CA (MC); Chicken Soup Chinese Medicine, San Francisco, CA (MC); Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY (GD); Harbin Clinic, Rome, GA (MM); Gemini Group, Ann Arbor, MI (JP); Ottawa Integrative Cancer Center, Ottawa, ON, Canada (DS); Canadian College of Naturopathic Medicine, Toronto, ON, Canada (DS); Department of Family Medicine, University of Michigan Health System (AS, SMZ), Department of Environmental Health Sciences, School of Public Health (SMZ), and Department of Biostatistics (AS), University of Michigan, Ann Arbor, MI (AS, SMZ); Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX (DT)
| | - Matthew Mumber
- Department of Epidemiology, Mailman School of Public Health (HG, DH), Herbert Irving Comprehensive Cancer Center, (HG, DH), and Department of Medicine, College of Physicians and Surgeons (DH), Columbia University, New York, NY (HG, DH); School of Nursing, University of British Columbia, Vancouver, BC, Canada (LGB); Department of Oncology, University of Calgary, Calgary, AB, Canada (LEC); Institute for Health and Aging, University of California San Francisco, CA (MC); Chicken Soup Chinese Medicine, San Francisco, CA (MC); Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY (GD); Harbin Clinic, Rome, GA (MM); Gemini Group, Ann Arbor, MI (JP); Ottawa Integrative Cancer Center, Ottawa, ON, Canada (DS); Canadian College of Naturopathic Medicine, Toronto, ON, Canada (DS); Department of Family Medicine, University of Michigan Health System (AS, SMZ), Department of Environmental Health Sciences, School of Public Health (SMZ), and Department of Biostatistics (AS), University of Michigan, Ann Arbor, MI (AS, SMZ); Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX (DT)
| | - Jane Perlmutter
- Department of Epidemiology, Mailman School of Public Health (HG, DH), Herbert Irving Comprehensive Cancer Center, (HG, DH), and Department of Medicine, College of Physicians and Surgeons (DH), Columbia University, New York, NY (HG, DH); School of Nursing, University of British Columbia, Vancouver, BC, Canada (LGB); Department of Oncology, University of Calgary, Calgary, AB, Canada (LEC); Institute for Health and Aging, University of California San Francisco, CA (MC); Chicken Soup Chinese Medicine, San Francisco, CA (MC); Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY (GD); Harbin Clinic, Rome, GA (MM); Gemini Group, Ann Arbor, MI (JP); Ottawa Integrative Cancer Center, Ottawa, ON, Canada (DS); Canadian College of Naturopathic Medicine, Toronto, ON, Canada (DS); Department of Family Medicine, University of Michigan Health System (AS, SMZ), Department of Environmental Health Sciences, School of Public Health (SMZ), and Department of Biostatistics (AS), University of Michigan, Ann Arbor, MI (AS, SMZ); Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX (DT)
| | - Dugald Seely
- Department of Epidemiology, Mailman School of Public Health (HG, DH), Herbert Irving Comprehensive Cancer Center, (HG, DH), and Department of Medicine, College of Physicians and Surgeons (DH), Columbia University, New York, NY (HG, DH); School of Nursing, University of British Columbia, Vancouver, BC, Canada (LGB); Department of Oncology, University of Calgary, Calgary, AB, Canada (LEC); Institute for Health and Aging, University of California San Francisco, CA (MC); Chicken Soup Chinese Medicine, San Francisco, CA (MC); Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY (GD); Harbin Clinic, Rome, GA (MM); Gemini Group, Ann Arbor, MI (JP); Ottawa Integrative Cancer Center, Ottawa, ON, Canada (DS); Canadian College of Naturopathic Medicine, Toronto, ON, Canada (DS); Department of Family Medicine, University of Michigan Health System (AS, SMZ), Department of Environmental Health Sciences, School of Public Health (SMZ), and Department of Biostatistics (AS), University of Michigan, Ann Arbor, MI (AS, SMZ); Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX (DT)
| | - Ananda Sen
- Department of Epidemiology, Mailman School of Public Health (HG, DH), Herbert Irving Comprehensive Cancer Center, (HG, DH), and Department of Medicine, College of Physicians and Surgeons (DH), Columbia University, New York, NY (HG, DH); School of Nursing, University of British Columbia, Vancouver, BC, Canada (LGB); Department of Oncology, University of Calgary, Calgary, AB, Canada (LEC); Institute for Health and Aging, University of California San Francisco, CA (MC); Chicken Soup Chinese Medicine, San Francisco, CA (MC); Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY (GD); Harbin Clinic, Rome, GA (MM); Gemini Group, Ann Arbor, MI (JP); Ottawa Integrative Cancer Center, Ottawa, ON, Canada (DS); Canadian College of Naturopathic Medicine, Toronto, ON, Canada (DS); Department of Family Medicine, University of Michigan Health System (AS, SMZ), Department of Environmental Health Sciences, School of Public Health (SMZ), and Department of Biostatistics (AS), University of Michigan, Ann Arbor, MI (AS, SMZ); Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX (DT)
| | - Suzanna M Zick
- Department of Epidemiology, Mailman School of Public Health (HG, DH), Herbert Irving Comprehensive Cancer Center, (HG, DH), and Department of Medicine, College of Physicians and Surgeons (DH), Columbia University, New York, NY (HG, DH); School of Nursing, University of British Columbia, Vancouver, BC, Canada (LGB); Department of Oncology, University of Calgary, Calgary, AB, Canada (LEC); Institute for Health and Aging, University of California San Francisco, CA (MC); Chicken Soup Chinese Medicine, San Francisco, CA (MC); Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY (GD); Harbin Clinic, Rome, GA (MM); Gemini Group, Ann Arbor, MI (JP); Ottawa Integrative Cancer Center, Ottawa, ON, Canada (DS); Canadian College of Naturopathic Medicine, Toronto, ON, Canada (DS); Department of Family Medicine, University of Michigan Health System (AS, SMZ), Department of Environmental Health Sciences, School of Public Health (SMZ), and Department of Biostatistics (AS), University of Michigan, Ann Arbor, MI (AS, SMZ); Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX (DT)
| | - Debu Tripathy
- Department of Epidemiology, Mailman School of Public Health (HG, DH), Herbert Irving Comprehensive Cancer Center, (HG, DH), and Department of Medicine, College of Physicians and Surgeons (DH), Columbia University, New York, NY (HG, DH); School of Nursing, University of British Columbia, Vancouver, BC, Canada (LGB); Department of Oncology, University of Calgary, Calgary, AB, Canada (LEC); Institute for Health and Aging, University of California San Francisco, CA (MC); Chicken Soup Chinese Medicine, San Francisco, CA (MC); Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY (GD); Harbin Clinic, Rome, GA (MM); Gemini Group, Ann Arbor, MI (JP); Ottawa Integrative Cancer Center, Ottawa, ON, Canada (DS); Canadian College of Naturopathic Medicine, Toronto, ON, Canada (DS); Department of Family Medicine, University of Michigan Health System (AS, SMZ), Department of Environmental Health Sciences, School of Public Health (SMZ), and Department of Biostatistics (AS), University of Michigan, Ann Arbor, MI (AS, SMZ); Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX (DT)
| | | |
Collapse
|
25
|
Lin YH, Shiu JH, Chen FP, Chiu JH. Building an Integrative Outpatient Care Program for Breast Cancer Patients in Taiwan. Integr Cancer Ther 2015; 15:343-8. [PMID: 26453537 PMCID: PMC5739177 DOI: 10.1177/1534735415607630] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Background. Breast cancer patients may experience various symptoms that affect the quality of life significantly and they seek complementary and alternative medicine (CAM). To meet the needs of patients, we developed an integrative outpatient care program. Methods. This program provided CAM consultation and acupuncture for breast cancer patients at Taipei Veterans General Hospital. The outcome measures included Medical Outcomes Study 12-Item Short-Form Health Survey (SF-12) and patient satisfaction questionnaires on the first visit (baseline) and at 6 months. Results. Forty-five breast cancer patients were enrolled. All patients completed the study. The median age was 53.3 (±8.3). The symptoms most often experienced during previous cancer treatments were fatigue (35.6%), arthralgia (20%), nausea (6.7%), and insomnia (6.7%). The symptoms most wished to be diminished by the patients were arthralgia (22.2%), insomnia (17.8%), and fatigue (15.6%). Thirty-four patients (75.6%) had sought CAM therapy to reduce these symptoms. Fifteen patients (33.3%) received CAM consultation only and 30 (66.7%) received acupuncture in addition. Sixteen patients completed at least 6 sessions of acupuncture. No serious adverse effect was reported. In the SF-12 Questionnaire on all the patients, physical component summary (PCS) was 49.6 (±5.6) at baseline and 44.9 (±7.6) at 6 months (P = .001); the mental component summary (MCS) was 44.7 (±6.1) at baseline and 52.3 (±9.3) at 6 months (P < .001). For patients who had completed acupuncture, PCS was 49.2 (±4.9) at baseline and 41.4 (±7.6) at 6 months (P = .148); the MCS was 45.6 (±6.2) at baseline and 49.7 (±11) at 6 months (P = .07). Thirty-eight (84.4%) patients were satisfied with this program. Conclusions. Our results demonstrated that an integrative outpatient care program of conventional and Chinese medicine is feasible. Most patients were satisfied with this program and the quality of life was improved. It is important to conduct more research to build a model that integrates CAM with conventional medicine in Taiwan.
Collapse
Affiliation(s)
- Yi-Hsien Lin
- Cheng Hsin General Hospital, Taipei, Taiwan National Yang-Ming University, Taipei, Taiwan
| | | | - Fang-Pey Chen
- National Yang-Ming University, Taipei, Taiwan Taipei Veterans General Hospital, Taipei, Taiwan
| | - Jen-Hwey Chiu
- Cheng Hsin General Hospital, Taipei, Taiwan National Yang-Ming University, Taipei, Taiwan Taipei Veterans General Hospital, Taipei, Taiwan
| |
Collapse
|
26
|
Abstract
In a previous systematic review of the worldwide literature of randomized controlled trials (RCTs) involving needle insertion into acupuncture points for symptom management in cancer patients, we identified only one high-quality RCT that was deemed to have a low risk of bias. Medline, Embase, CINAHL, Cochrane (all databases), Scopus, and PubMed were searched from inception through December 2011 with no language limits applied. A total of 41 RCTs met all inclusion criteria and were rated. In the current review, we examined 18 trials published since our last report. The purpose of this update was to emphasize important recent findings and discuss how concerns such as blinding, separating non-specific placebo effects from specific needling effects, determining biologic mechanisms and dosing parameters, evaluating determinants of response such as expectation, controlling for sources of bias, and the lack of standardization in treatment and study methods may affect the interpretation of study results.
Collapse
|
27
|
Garcia MK, Graham-Getty L, Haddad R, Li Y, McQuade J, Lee RT, Spano M, Cohen L. Systematic review of acupuncture to control hot flashes in cancer patients. Cancer 2015; 121:3948-58. [PMID: 26281028 DOI: 10.1002/cncr.29630] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2015] [Revised: 07/21/2015] [Accepted: 07/22/2015] [Indexed: 01/10/2023]
Abstract
Hot flashes (HFs) are a common side effect of cancer treatment. The purpose of this systematic review was to evaluate evidence related to the use of acupuncture for HFs in cancer patients. EMBASE, MEDLINE, Cochrane (all databases), PubMed, the Cumulative Index to Nursing and Allied Health Literature, and Scopus were searched from their inception through December 2014. Included studies had to be randomized controlled trials with a usual-care and/or placebo comparison group that investigated acupuncture to treat HFs in cancer patients. No language limits were applied. The risk of bias (ROB) was rated as low, high, or unclear according to Cochrane criteria. Both within-group and between-group changes were evaluated. Four hundred two items were identified, and 192 duplicates were omitted; this left 210 publications to be screened. Eight studies met the inclusion criteria, and all involved women with breast cancer. All studies showed significant within-group improvement from the baseline for true acupuncture (TA). One study showed significant improvement in favor of TA over sham acupuncture (SA; P < .001), 1 study found in favor of TA over SA for nighttime HFs only (P = .03), and 1 study found in favor of TA over SA or untreated controls (P < .01 and P < .001, respectively). Between-group (TA vs SA) effect size (ES) estimates for daytime and nighttime HFs were calculated (ES range, 0.04-0.9) whenever possible. No studies were rated with a low ROB. In conclusion, the current level of evidence is insufficient to either support or refute the benefits of acupuncture for the management of HFs in cancer patients. Future studies should provide within-group and between-group ES estimates in addition to P values.
Collapse
Affiliation(s)
- M Kay Garcia
- Integrative Medicine Program, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | | | - Robin Haddad
- Integrative Medicine Program, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Yisheng Li
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Jennifer McQuade
- Integrative Medicine Program, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Richard T Lee
- Integrative Medicine Program, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Michael Spano
- Integrative Medicine Program, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Lorenzo Cohen
- Integrative Medicine Program, The University of Texas MD Anderson Cancer Center, Houston, Texas
| |
Collapse
|
28
|
Abstract
Background: The therapeutic mainstays of cancer remain surgery, radiotherapy, and chemotherapy. However, radiotherapy and chemotherapy are often associated with serious side-effects, such as nausea and vomiting. Acupuncture has been used widely to treat disorders in clinical practice for at least 3000 years. According to the National Institutes of Health (NIH) Consensus Statement, chemotherapy-induced nausea and vomiting are suitable for acupuncture intervention. Objectives: The goal of this review is to analyze the applications of acupuncture for treating cancer and to look ahead at the potential advantages of acupuncture for patients with cancer. Materials and Methods: The PubMed database was searched for articles on acupuncture therapy and neoplasms. The different distributions of scientific papers were analyzed preliminarily. Results: The articles found showed that acupuncture was used to address various symptoms related to different types of cancer. Conclusions: The results of clinical trials in acupuncture have provided important clues in oncologic practice. The evidence suggests that acupuncture is a safe and effective therapy for managing cancer and treatment-related symptoms, such as nausea and vomiting and fatigue caused by chemotherapy. As more evidence emerges, the potential advantages of acupuncture in tumor treatment will eventually be clear.
Collapse
Affiliation(s)
- Guangjun Wang
- Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences , Dongzhimennei, Beijing, China . ; Research Unit for Complementary and Integrative Laser Medicine, Research Unit of Biomedical Engineering in Anesthesia and Intensive Care Medicine, and TCM Research Center Graz, Medical University of Graz , Graz, Austria
| | - Gerhard Litscher
- Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences , Dongzhimennei, Beijing, China . ; Research Unit for Complementary and Integrative Laser Medicine, Research Unit of Biomedical Engineering in Anesthesia and Intensive Care Medicine, and TCM Research Center Graz, Medical University of Graz , Graz, Austria
| |
Collapse
|
29
|
Kaplan M, Mahon S. Hot Flash Management: Update of the Evidence for Patients With Cancer. Clin J Oncol Nurs 2014; 18 Suppl:59-67. [DOI: 10.1188/14.cjon.s3.59-67] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
|
30
|
Expectations from an integrative medicine consultation in breast cancer care: a registry protocol-based study. Support Care Cancer 2014; 23:317-24. [DOI: 10.1007/s00520-014-2361-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2014] [Accepted: 07/21/2014] [Indexed: 01/30/2023]
|
31
|
Hervik J, Mjåland O. Long term follow up of breast cancer patients treated with acupuncture for hot flashes. SPRINGERPLUS 2014; 3:141. [PMID: 25674442 PMCID: PMC4320138 DOI: 10.1186/2193-1801-3-141] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/26/2014] [Accepted: 02/27/2014] [Indexed: 11/24/2022]
Abstract
Objective Short term effects of acupuncture treatment for hot flashes (HF) in breast cancer patients have been demonstrated in several studies, including a randomized controlled trial, by the present authors. Results for the first 59 Tamoxifen medicated women receiving a 10 week course of acupuncture treatment have already been published. A significant reduction in the number of hot flashes was demonstrated both day and night, for up to three months following treatment in the women receiving traditional Chinese acupuncture. The control group receiving sham (minimal acupuncture) demonstrated a HF reduction only at night during treatment, however the effect did not remain significant during the following 12 weeks. The study was continued in order to investigate longer term effects of acupuncture treatment, and patient’s quality of life two years after treatment. Methods and materials Eighty patients, who had 2 years previously been randomized to either a course of 15 acupuncture treatments or sham acupuncture (control) over a period of 10 weeks, were asked to fill out a Kupperman index (KI) indicating health related quality of life. Results Sixty one women returned KI questionnaires. A mixed models procedure with diagonal covariance matrix was used for statistical analyses. Baseline values between the sham-group and acupuncture group were not significantly different. However scores at the end of treatment and after 3 months showed a statistically significant difference between the groups, this difference lost its significance when scores were analyzed after 2 years. Conclusion Acupuncture seems to have a positive effect on health related quality of life for up three months post-treatment, this study suggests that these effects may be longer-term, however there was no significant effect 2 years later.
Collapse
Affiliation(s)
- Jill Hervik
- Pain Clinic, Vestfold Hospital, Tønsberg, Norway
| | - Odd Mjåland
- Department of Abdominal Surgery, Sørlandet Sykehus, Kristiansand, Norway
| |
Collapse
|
32
|
Frisk JW, Hammar ML, Ingvar M, Spetz Holm ACE. How long do the effects of acupuncture on hot flashes persist in cancer patients? Support Care Cancer 2014; 22:1409-15. [PMID: 24477325 DOI: 10.1007/s00520-014-2126-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2013] [Accepted: 01/08/2014] [Indexed: 11/25/2022]
Abstract
PURPOSE Acupuncture has been suggested as therapy for hot flashes in women with breast cancer and men with prostate cancer. In this systematic review, we sought to evaluate the long-term effects on vasomotor symptoms after the end of a defined treatment period of acupuncture in women with breast cancer and men with prostate cancer. METHODS A literature search revealed 222 articles within the field. With defined exclusion criteria, we identified 17 studies. We also used the Jadad quality score and identified seven studies with a score of at least 3. RESULTS Six of seven identified studies qualified for inclusion in an analysis that measured frequency of hot flashes weighted in relation to number of patients (n=172). The average reduction from baseline to end of acupuncture (ranging between 5 and 12 weeks of treatment) showed 43.2 % reduction of hot flashes. At the last follow-up (mean 5.8 months, range 3-9 months) after the end of therapy, the weighted reduction from baseline was sustained at 45.6 % in the 153 of 172 patients (89 %) who were followed up. CONCLUSIONS Data from six prospective analyzed studies indicate at least 3-month effects after the end of acupuncture treatment for flashes in women with breast cancer and men with prostate cancer. However, larger randomized trials with long-term follow-up will be needed to confirm these preliminary findings.
Collapse
Affiliation(s)
- Jessica W Frisk
- Division of Obstetrics and Gynecology, Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
| | | | | | | |
Collapse
|
33
|
Barba M, Pizzuti L, Sergi D, Maugeri-Saccà M, Vincenzoni C, Conti F, Tomao F, Vizza E, Di Lauro L, Di Filippo F, Carpano S, Mariani L, Vici P. Hot flushes in women with breast cancer: state of the art and future perspectives. Expert Rev Anticancer Ther 2013; 14:185-98. [DOI: 10.1586/14737140.2013.856271] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
|
34
|
Liao GS, Apaya MK, Shyur LF. Herbal medicine and acupuncture for breast cancer palliative care and adjuvant therapy. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2013; 2013:437948. [PMID: 23840256 PMCID: PMC3694462 DOI: 10.1155/2013/437948] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/21/2013] [Revised: 05/14/2013] [Accepted: 05/21/2013] [Indexed: 11/17/2022]
Abstract
Breast cancer is a life-threatening disease among women worldwide with annual rates of reported incidence and death increasing alarmingly. Chemotherapy is a recommended and effective treatment option for breast cancer; however, the narrow therapeutic indices and varied side effects of currently approved drugs present major hurdles in increasing its effectiveness. An increasing number of literature evidence indicate that complementary and alternative medicine (CAM) used in treatment-related symptom control and alleviation of side effects plays an important role in increasing survival rate and quality of life in breast cancer patients. This review focuses on the use of herbal medicines and acupuncture in palliative care and as adjuvants in the treatment of breast cancer. Herbal medicinal treatments, the correlation of clinical use with demonstrated in vitro and in vivo mechanisms of action, and the use of certain acupoints in acupuncture are summarized. The aim of this review is to facilitate an understanding of the current practice and usefulness of herbal medicine and acupuncture as adjuvants in breast cancer therapy.
Collapse
Affiliation(s)
- Guo-Shiou Liao
- Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan
| | - Maria Karmella Apaya
- Agricultural Biotechnology Research Center, Academia Sinica, No. 128, Section 2, Academia Road, Nankang, Taipei 115, Taiwan
| | - Lie-Fen Shyur
- Agricultural Biotechnology Research Center, Academia Sinica, No. 128, Section 2, Academia Road, Nankang, Taipei 115, Taiwan
- Graduate Institute of Pharmacognosy, Taipei Medical University, Taipei 110, Taiwan
| |
Collapse
|
35
|
Azad A, John T. Do randomized acupuncture studies in patients with cancer need a sham acupuncture control arm? J Clin Oncol 2013; 31:2057-8. [PMID: 23610109 DOI: 10.1200/jco.2012.47.8750] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
|
36
|
Jeong YJ, Park YS, Kwon HJ, Shin IH, Bong JG, Park SH. Acupuncture for the treatment of hot flashes in patients with breast cancer receiving antiestrogen therapy: a pilot study in Korean women. J Altern Complement Med 2013; 19:690-6. [PMID: 23383974 DOI: 10.1089/acm.2012.0347] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
OBJECTIVES Antiestrogen therapy can cause vasomotor symptoms similar to those occurring during menopause, including hot flashes. Recent studies suggest that acupuncture is effective in reducing vasomotor symptoms in patients with breast cancer receiving tamoxifen. The purpose of this study was to assess the feasibility and safety of acupuncture for treatment of hot flashes in Korean patients with breast cancer receiving antiestrogen therapy. DESIGN This was a prospective single-arm observational study using before and after measurements. SETTINGS/LOCATION The study was located at the East-West Medical Center at Daegu Catholic University Medical Center, Daegu, Korea. SUBJECTS The subjects were 10 patients with breast cancer who were undergoing antiestrogen therapy with tamoxifen or anastrozole and who were suffering from hot flashes. INTERVENTIONS Acupuncture was administered 3 times a week for 4 consecutive weeks, for 20±5 minutes at each session. OUTCOME MEASURES The outcome measure was severity of hot flashes assessed by visual analogue scale (VAS) and total hot flash score. RESULTS During treatment, severity of hot flashes was reduced by 70%-95% in all patients. Acupuncture significantly alleviated severity of hot flashes assessed by a visual analogue scale (F=30.261; p<0.001) as well as the total hot flash score (F=21.698; p=0.006). Four (4) weeks after the final treatment, symptoms were not aggravated. CONCLUSIONS Acupuncture appeared to provide effective relief from hot flashes among Korean women receiving antiestrogen therapy after surgery for breast cancer, and the effects lasted for at least 1 month after termination of treatment. A randomized controlled prospective study with a larger sample size is required to clarify the role of acupuncture in the management of hot flashes in Korean patients with breast cancer.
Collapse
Affiliation(s)
- Young Ju Jeong
- Department of Surgery, School of Medicine, Catholic University of Daegu, Daegu, Korea
| | | | | | | | | | | |
Collapse
|
37
|
Garcia MK, McQuade J, Haddad R, Patel S, Lee R, Yang P, Palmer JL, Cohen L. Systematic review of acupuncture in cancer care: a synthesis of the evidence. J Clin Oncol 2013; 31:952-60. [PMID: 23341529 DOI: 10.1200/jco.2012.43.5818] [Citation(s) in RCA: 198] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE Many cancer centers offer acupuncture services. To date, a comprehensive systematic review of acupuncture in cancer care has not been conducted. The purpose of this review was to evaluate the efficacy of acupuncture for symptom management in patients with cancer. METHODS Medline, Embase, CINAHL, Cochrane (all databases), Scopus, and PubMed were searched from inception through December 2011 for prospective randomized clinical trials (RCT) evaluating acupuncture for symptom management in cancer care. Only studies involving needle insertion into acupuncture points were included. No language limitations were applied. Studies were assessed for risk of bias (ROB) according to Cochrane criteria. Outcomes by symptom were designated as positive, negative, or unclear. RESULTS A total of 2,151 publications were screened. Of those, 41 RCTs involving eight symptoms (pain, nausea, hot flashes, fatigue, radiation-induced xerostomia, prolonged postoperative ileus, anxiety/mood disorders, and sleep disturbance) met all inclusion criteria. One positive trial of acupuncture for chemotherapy-induced nausea and vomiting had low ROB. Of the remaining studies, eight had unclear ROB (four positive, three negative, and one with unclear outcomes). Thirty-three studies had high ROB (19 positive, 11 negative, and three with both positive and negative outcomes depending on the symptom). CONCLUSION Acupuncture is an appropriate adjunctive treatment for chemotherapy-induced nausea/vomiting, but additional studies are needed. For other symptoms, efficacy remains undetermined owing to high ROB among studies. Future research should focus on standardizing comparison groups and treatment methods, be at least single-blinded, assess biologic mechanisms, have adequate statistical power, and involve multiple acupuncturists.
Collapse
Affiliation(s)
- M Kay Garcia
- University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit 0462, Houston, TX 77030, USA
| | | | | | | | | | | | | | | |
Collapse
|