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Davy C, Hughes J. Teaching self-acupuncture survey report. Acupunct Med 2021; 40:333-338. [PMID: 34892982 DOI: 10.1177/09645284211056658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND People have been teaching self-acupuncture (SA) in the United Kingdom since 1977. More recently, a small body of research has been conducted on SA. However, detailed guidelines on teaching and delivery of SA have so far, to our knowledge, not been developed. METHODS Acupuncturists were invited to participate in an online survey about their experiences of teaching SA. Data from the survey were extracted, analysed using descriptive statistics and translated into SA teaching guidelines. RESULTS One hundred thirty-eight acupuncturists completed the survey. Nineteen percent of participants had taught SA. The most common symptoms for which acupuncturists taught SA were pain, nausea, anxiety, hot flushes, headaches/migraines and breathlessness. The six most commonly taught traditional acupuncture point locations were LI4, ST36, SP6, PC6, LR3 and TE5. No participants had received reports of adverse effects from their patients. CONCLUSION Acupuncturists who teach SA find it to be an acceptable and safe option for patients. The presented data have important implications for guiding the practice of SA.
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Affiliation(s)
- Catrina Davy
- Royal London Hospital for Integrated Medicine, London, UK
| | - John Hughes
- Royal London Hospital for Integrated Medicine, London, UK
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2
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Integrative Medicine—Acupuncture on Yourself? SCI 2021. [DOI: 10.3390/sci3040043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The aim of this editorial is to demonstrate publications on self-acupuncture from both the East (China) and the West and to bring new variants such as self-applied laser medicine into the focus of interest. Self-acupuncture with needles may of course only be carried out according to the applicable laws of the respective country and these are naturally very different. However, important evidence from the studies published so far has not yet been clearly proven. The answer to a question resulting from the editorial, how tradition and innovation in the field of self-acupuncture can be efficiently combined, will have to be proven by future studies.
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Abstract
Die Selbstakupunktur wird seit vielen Jahren nicht nur in China angewendet, die wissenschaftlichen Untersuchungen dazu sind aber sehr spärlich. Es gibt Hinweise, vor allem in chinesischer Sprache, dass eine Selbstakupunktur mit Nadeln durchaus praktikabel möglich ist und auch im Bereich der Lehre dort selbstverständlich angewendet wird. Zur Behandlung einzelner Krankheiten existieren aber nur sehr wenige relevante wissenschaftliche Arbeiten. Ziel dieser kurzen Übersichtsarbeit ist es, diese Publikationen aus der Sicht der Wissenschaft zu beleuchten und auch neue Varianten wie beispielsweise die selbstapplizierte Lasermedizin in den Fokus des Interesses zu stellen. Ein wichtiger Punkt ist auch jener, dass die Selbstakupunktur mit Nadeln selbstverständlich immer nur nach den gültigen Gesetzen des jeweiligen Landes erfolgen kann und darf. Die Fragestellung, wie man Tradition und Innovation auf dem Gebiet der Selbstakupunktur effizient kombinieren kann, wird auch hier eine der Herausforderungen für die Entwicklung der Akupunktur in der heutigen modernen Gesellschaft sein.
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Affiliation(s)
- Gerhard Litscher
- Leiter der Forschungseinheit für Biomedizinische Technik in Anästhesie und Intensivmedizin, der Forschungseinheit für Komplementäre und Integrative Lasermedizin, Chairman des TCM Forschungszentrums Graz, Medizinische Universität Graz, _Auenbruggerplatz 39, EG19, 8036 Graz, Österreich
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Ebrahimi A, Tayebi N, Fatemeh A, Akbarzadeh M. Investigation of the role of herbal medicine, acupressure, and acupuncture in the menopausal symptoms: An evidence-based systematic review study. J Family Med Prim Care 2020; 9:2638-2649. [PMID: 32984100 PMCID: PMC7491766 DOI: 10.4103/jfmpc.jfmpc_1094_19] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Revised: 12/09/2019] [Accepted: 04/15/2020] [Indexed: 11/04/2022] Open
Abstract
Background Menopause is an important physiological phenomenon in women's lives. Women's concern about taking the hormone treatment to ease menopausal symptoms is increasing. Over the past decade, the use of complementary and alternative medicine for the treatment of menopausal problems instead of hormone therapy has increased. Objective This study aimed to investigate the role of herbal medicine, acupressure, and acupuncture in the menopausal symptoms. Methods Data source: related articles were searched from internal scientific databases and external databases of "Web of Scopus, Cochrane, PubMed, Science Direct, Ovid, and Google scholar." Study Eligibility Criteria The keywords such as menopause, menopausal symptoms, complementary menopausal medicine, acupuncture in menopause, herbal medicine in menopause, and acupuncture in menopause were searched in the studies from 1987 to 2019. Exclusion criteria were inadequate information in the study, lack of access to full-text articles, animal studies, and reports. At the end of the search, 145 articles out of a total of 400 articles were reviewed. Results In various studies, different herbs such as licorice, valerian, soy, sage, ginseng, etc., were used to improve menopausal symptoms. In addition, acupuncture and acupressure were used to reduce menopausal symptoms. Conclusion The efficacy and use of complementary and alternative medicine, along with other classical medicine care, can be a new model for improving menopausal symptoms in women. It is recommended that further clinical and review studies be conducted to develop complementary and alternative medicine.
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Affiliation(s)
- Abed Ebrahimi
- Department of Operating Room, Faculty of Para Medicine, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Naeimeh Tayebi
- Department of Midwifery, School of Nursing and Midwifery, Bam University of Medical Sciences, Bam, Iran
| | - Ahmadinezhad Fatemeh
- Department of Midwifery, Firoozabad Branch, Islamic Azad University, Firoozabad, Iran
| | - Marzieh Akbarzadeh
- Department of Midwifery, Maternal-Fetal Medicine Research Center, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
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Hughes JG, Davy C. ‘I’m not too bad with needles’: A qualitative service evaluation of chronic pain patients’ experiences of self-acupuncture. Eur J Integr Med 2020. [DOI: 10.1016/j.eujim.2020.101106] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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6
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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: 10] [Impact Index Per Article: 2.0] [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.
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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
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Harvie A, Steel A, Wardle J. Traditional Chinese Medicine Self-Care and Lifestyle Medicine Outside of Asia: A Systematic Literature Review. J Altern Complement Med 2019; 25:789-808. [PMID: 31274332 DOI: 10.1089/acm.2018.0520] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Background: Chinese medicine, when applied as a whole system of care, traditionally incorporates self-care techniques and patient understanding as key aspects of patient recovery and health maintenance. Objectives: This review aims to explore the literature to date on Traditional Chinese Medicine (TCM) self-care in settings outside of Asia, beyond the sole application of t'ai chi or qigong, to consider simple self-care techniques as health care interventions that may be generalized to a wider population. Design: AMED, CINAHL, EMBASE, PubMed, and MEDLINE databases were searched for articles from inception to July 2018. Studies were included, which were undertaken in settings outside of Asia and/or Asian communities, and were excluded if they solely examined t'ai chi or qigong. Results: Findings of the included studies (n = 37) were categorized into four key areas in relation to the TCM self-care component evaluated: self-acupressure, self-acupuncture, self-moxibustion, and the adoption of prescribed lifestyle, diet, and exercise advice based on a TCM diagnosis. The studies included randomized clinical trials, case studies, hospital audits, and qualitative evaluations. The studies assessed TCM self-care in relation to a wide range of health conditions, with the majority of studies concluding positive findings. Conclusion: This review draws attention to the potential role of TCM self-care techniques, in settings outside of Asia, beyond the sole practices of t'ai chi and qigong, as an adjunct to health maintenance and recovery. Only tentative conclusions can be drawn from the existing research, however, due to variability across studies in reporting transparency and the overall low number of studies retrieved. Further research is warranted.
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Affiliation(s)
- Alaia Harvie
- 1Faculty of Health, University of Technology Sydney, Sydney, Australia
| | - Amie Steel
- 1Faculty of Health, University of Technology Sydney, Sydney, Australia.,2Australian Research Centre in Complementary and Integrative Medicine, Faculty of Health, University of Technology Sydney, Sydney, Australia
| | - Jon Wardle
- 1Faculty of Health, University of Technology Sydney, Sydney, Australia.,2Australian Research Centre in Complementary and Integrative Medicine, Faculty of Health, University of Technology Sydney, Sydney, Australia
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Filshie J, Hester J. Guidelines for Providing Acupuncture Treatment for Cancer Patients – a Peer-Reviewed Sample Policy Document. Acupunct Med 2018; 24:172-82. [PMID: 17264836 DOI: 10.1136/aim.24.4.172] [Citation(s) in RCA: 66] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Clinical guidelines are statements that have been systematically developed and which aim to assist clinicians in making decisions about treatment for specific conditions, and promote best practice. They are linked to evidence and are meant to facilitate good medical practice. We are not aware of any guidelines for the safe practice of acupuncture in a conventional healthcare setting, yet they are necessary as acupuncture may be performed in a variety of settings and by a variety of healthcare professionals: doctors, nurses, physiotherapists, midwives, and non medically trained practitioners. These guidelines were developed for use in cancer patients, mainly for pain but also for some non-pain indications such as hot flushes. They are presented here as a template for other acupuncturists who are requested to provide policies for acupuncture treatment for cancer patients. This article includes a general review of the evidence on mechanisms, effectiveness and safety of acupuncture that is intended to be used in conjunction with the guidelines; and the guidelines themselves. An appendix includes instructions for self acupuncture. The guidelines contain sections on roles and responsibilities, criteria for acupuncture practice, indications for acupuncture, contraindications and cautions, acupuncture treatment, and review and audit. These guidelines set basic, minimum standards of care, and need reassessment and ongoing validation as further data and evidence accumulate.
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9
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Sandberg M. Acupuncture Procedures Must be Accurately Described. Acupunct Med 2018; 24:92-4; author reply 94-5; discussion 95-6. [PMID: 16783285 DOI: 10.1136/aim.24.2.92] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Choi V, Cobbin D, Walsh S. Does Modern Research Concerning Chinese Medicine Acupoints Relate to Original Prescriptions? If Not, Why Not? Med Acupunct 2018; 30:336-347. [PMID: 30671154 DOI: 10.1089/acu.2018.1300] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Objective: Huang Fu Mi's Zhen Jiu Jia Yi Jing (ZJJYJ) is regarded as the earliest text (282 ce) on differential diagnosis and clinical acumoxa therapy in Chinese Medicine. Are contemporary manual acupuncture practices consistent with those reported in the ZJJYJ? The aim of this research was to investigate if modern manual acupuncture uses reported in research are consistent with classical practices reported in the ZJJYJ. Materials and Methods: A database search of human research studies from 1995 to 2016 was performed for all 270 acupoints for all 8 leg/body channels. The clinical foci of these modern publications were compared with acupoint clinical indications documented in the Song Dynasty Chinese edition (1077) of the ZJJYJ and the sole English translation (translated and compiled by Yang and Chace in 1994) of The Systematic Classic of Acupuncture and Moxibustion. Results: Of 2149 articles in English, 63 met the search criteria. These articles predominately reported acupoints on the lower leg, back, chest, and head. Correlations between the acupoints used in modern research and those used in the ZJJYJ were minimal. Clinical indications from the ZJJYJ typically involved symptoms relating to pain, swelling, fever, seizures, hallucinatory states, dysentery, malaria, and tuberculosis, which are now treated pharmacologically. However, one-third of modern studies were functional magnetic resonance imaging (fMRI) investigations of neurophysiologic effects of manual acupuncture on the human brain. Conclusions: While, superficially, the ZJJYJ might seem irrelevant in modern manual acupuncture practices, well-documented physical effects (e.g., pain relief) of manual acupuncture do provide measurable outcomes for use in fMRI research. Therefore, the classical text does provide a guide for future research on influential acupoints on the leg and body channels.
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Affiliation(s)
- Victoria Choi
- Faculty of Science, School of Life Sciences, University of Technology Sydney, Sydney, New South Wales, Australia
| | - Deirdre Cobbin
- Faculty of Science, School of Life Sciences, University of Technology Sydney, Sydney, New South Wales, Australia
| | - Sean Walsh
- Faculty of Science, School of Life Sciences, University of Technology Sydney, Sydney, New South Wales, Australia
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12
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Yun H, Sun L, Mao JJ. Growth of Integrative Medicine at Leading Cancer Centers Between 2009 and 2016: A Systematic Analysis of NCI-Designated Comprehensive Cancer Center Websites. J Natl Cancer Inst Monogr 2018; 2017:4617819. [PMID: 29140485 DOI: 10.1093/jncimonographs/lgx004] [Citation(s) in RCA: 97] [Impact Index Per Article: 16.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2017] [Accepted: 08/07/2017] [Indexed: 11/14/2022] Open
Abstract
Background Cancer centers have increasingly offered integrative medicine therapies in response to their patients' unmet needs. We evaluated the growth of integrative medicine in leading academic cancer centers in the United States as reflected by their public-facing websites. Methods We performed a systematic review of 45 National Cancer Institute (NCI)-designated comprehensive cancer center websites. Two researchers independently evaluated whether the websites provided information regarding integrative medicine modalities and, if so, whether the services were provided in the same health system. They compared the proportion of cancer centers providing the information on each modality in 2016 with the data from the prior study in 2009. Results The most common integrative medicine therapies mentioned on the 45 NCI-designated comprehensive cancer center websites were exercise (97.8%) and acupuncture and meditation (88.9% each), followed by yoga (86.7%), massage (84.4%), and music therapy (82.2%). The majority of the websites also provided information on nutrition (95.6%), dietary supplements (93.3%), and herbs (88.9%). The most common therapies offered in the health systems were acupuncture/massage (73.3% each), meditation/yoga (68.9% each), and consultations about nutrition (91.1%), dietary supplements (84.4%), and herbs (66.7%). Compared with 2009, there was a statistically significant increase in the number of websites mentioning acupuncture, dance therapy, healing touch, hypnosis, massage, meditation, Qigong, and yoga (all P < .05). Conclusions Leading US cancer centers increasingly present integrative medicine content on their websites, and the majority of them provide these services to patients in the same health systems.
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Affiliation(s)
- Hyeongjun Yun
- Memorial Sloan Kettering Cancer Center, New York, NY; Harvard T. H. Chan School of Public Health, Boston, MA; Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Lingyun Sun
- Memorial Sloan Kettering Cancer Center, New York, NY; Harvard T. H. Chan School of Public Health, Boston, MA; Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Jun J Mao
- Memorial Sloan Kettering Cancer Center, New York, NY; Harvard T. H. Chan School of Public Health, Boston, MA; Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
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Chien TJ, Hsu CH, Liu CY, Fang CJ. Effect of acupuncture on hot flush and menopause symptoms in breast cancer- A systematic review and meta-analysis. PLoS One 2017; 12:e0180918. [PMID: 28829776 PMCID: PMC5568723 DOI: 10.1371/journal.pone.0180918] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2017] [Accepted: 06/23/2017] [Indexed: 11/18/2022] Open
Abstract
Background Many breast cancer patients suffer from hot flush and medical menopause as side effects of treatment. Some patients undergo acupuncture, rather than hormone therapy, to relieve these symptoms, but the efficacy of acupuncture is uncertain. This meta-analysis evaluated the efficacy of acupuncture on hot flush and menopause symptoms in women with breast cancer. Methods A literature search was performed, following the PRISMA Statement and without language restrictions, of 7 databases from inception through March 2017. All selected studies were randomized clinical trials (RCTs) that examined the effect of needle acupuncture on hot flush and menopause symptoms in patients with breast cancer. The methodological quality of these trials was assessed using Cochrane criteria, and meta-analysis software (RevMan 5.2) was used to analyze the data. Results We examined 844 breast cancer patients (average age: 58 years-old) from 13 RCTs. The trials had medium-to-high quality, based on the modified Jadad scale. The meta-analysis showed that acupuncture had no significant effect on the frequency and the severity of hot flush (p = 0.34; p = 0.33), but significantly ameliorated menopause symptoms (p = 0.009). None of the studies reported severe adverse events. Conclusions Acupuncture significantly alleviated menopause symptoms, but had no effect on hot flush. Breast cancer patients concerned about the adverse effects of hormone therapy should consider acupuncture. Further large-scale studies that also measure biomarkers or cytokines may help to elucidate the mechanism by which acupuncture alleviates menopause symptoms in patients with breast cancer.
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Affiliation(s)
- Tsai-Ju Chien
- Institute of Traditional Medicine, National Yang-Ming University, Taipei, Taiwan
- Division of Hemato-Oncology, Department of Internal Medicine, Branch of Zhong-xing, Taipei City Hospital, Taipei, Taiwan
- Branch of Linsen, Chinese Medicine and Kunming, Taipei City Hospital, Taipei, Taiwan
- * E-mail: ,
| | - Chung-Hua Hsu
- Institute of Traditional Medicine, National Yang-Ming University, Taipei, Taiwan
- Branch of Linsen, Chinese Medicine and Kunming, Taipei City Hospital, Taipei, Taiwan
- School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan
| | - Chia-Yu Liu
- Institute of Traditional Medicine, National Yang-Ming University, Taipei, Taiwan
- Branch of Linsen, Chinese Medicine and Kunming, Taipei City Hospital, Taipei, Taiwan
| | - Ching-Ju Fang
- Medical Library, National Cheng Kung University, Tainan, Taiwan
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Cahir C, Barron TI, Sharp L, Bennett K. Can demographic, clinical and treatment-related factors available at hormonal therapy initiation predict non-persistence in women with stage I-III breast cancer? Cancer Causes Control 2017; 28:215-225. [PMID: 28210883 DOI: 10.1007/s10552-017-0851-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2016] [Accepted: 01/15/2017] [Indexed: 11/28/2022]
Abstract
PURPOSE To investigate whether demographic, clinical and treatment-related risk factors known at treatment initiation can be used to reliably predict future hormonal therapy non-persistence in women with breast cancer, and to inform intervention development. METHODS Women with stage I-III breast cancer diagnosed 2000-2012 and prescribed hormonal therapy were identified from the National Cancer Registry Ireland (NCRI) and linked to pharmacy claims data from Ireland's Primary Care Reimbursement Services (PCRS). Non-persistence was defined as a treatment gap of ≥180 days within 5 years of initiation. Seventeen demographic, clinical and treatment-related risk factors, identified from a systematic review, were abstracted from the NCRI-PCRS dataset. Multivariate binomial models were used to estimate relative risks (RR) and risk differences (RD) for associations between risk factors and non-persistence. Calibration and discriminative performance of the models were assessed. The analysis was repeated for early non-persistence (<1 year of initiation). RESULTS Within 5 years of treatment initiation 680 women (19.9%) were non-persistent. Women aged <50 years (adjusted RR 1.41, 95% CI 1.16-1.70) and those prescribed antidepressants (RR 1.22, 95% CI 1.04-1.45) had increased risk of non-persistence. Married women (RR 0.82 95% CI 0.71-0.94) and those with prior medication use (RR 0.62 95% CI 0.51-0.75) had reduced risk of non-persistence. The area under the receiver-operating characteristic (ROC) curve for non-persistence was 0.61. Findings were similar for early non-persistence. CONCLUSION The risk prediction model did not discriminate well between women at higher and lower risk of non-persistence at treatment initiation. Future studies should consider other factors, such as psychological characteristics and experience of side-effects.
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Affiliation(s)
- Caitriona Cahir
- Division of Population Health Sciences, Royal College of Surgeons in Ireland, Beaux Lane House, Mercer Street Lower, Dublin 2, Ireland.
| | - Thomas I Barron
- Trinity College Dublin, Ireland and Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Linda Sharp
- Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK
| | - Kathleen Bennett
- Division of Population Health Sciences, Royal College of Surgeons in Ireland, Beaux Lane House, Mercer Street Lower, Dublin 2, Ireland
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16
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Ferzoco RM, Ruddy KJ. Optimal delivery of male breast cancer follow-up care: improving outcomes. BREAST CANCER-TARGETS AND THERAPY 2015; 7:371-9. [PMID: 26648754 PMCID: PMC4664432 DOI: 10.2147/bctt.s75630] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Male breast cancer is a rare disease. There are limited data to inform optimal treatment and follow-up strategies in this population. Currently, most follow-up guidelines are drawn from the vast literature on female breast cancer, despite the fact that male breast cancer has unique biological characteristics. In this review, we discuss clinical characteristics of male breast cancer as well as current best practices for long-term care with a focus on surveillance, screening, and treatment-related symptom management in male breast cancer survivors.
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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.
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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
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Helping Patients to Help Themselves after Breast Cancer Treatment. Clin Oncol (R Coll Radiol) 2015; 27:640-6. [PMID: 26047887 DOI: 10.1016/j.clon.2015.05.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2015] [Accepted: 05/11/2015] [Indexed: 01/11/2023]
Abstract
There is a rise in the number of women living with the long-term consequences of cancer and continuing to suffer unmet need as breast cancer survival improves. This paper includes an introduction to self-management and a discussion of the evidence around the effectiveness of the key intervention types that could help patients to help themselves after treatment. Self-management interventions are particularly beneficial in reducing bother from symptoms, without patients having to take on the additional burden of more unwanted side-effects frequently seen with pharmacological interventions. There is a need to prioritise the funding of these financially viable self-management strategies to ensure equity of access and that these interventions are available for those in need.
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Bardy J, Mackereth P, Finnegan-John J, Molassiotis A. Training in self-needling and performing it as part of a clinical trial: the practitioner and patient experience. Acupunct Med 2015; 33:210-6. [PMID: 25746086 DOI: 10.1136/acupmed-2014-010708] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/16/2015] [Indexed: 11/03/2022]
Abstract
OBJECTIVE To explore the experience of training and performing self-needling from both the practitioners' and patients' perspective. METHODS A qualitative study was conducted using focus groups and interviews, nested within our multi-site randomised controlled trial, Acupuncture for Cancer-Related Fatigue in Patients with Breast Cancer. Patients allocated to self-needling across two UK study sites and all therapists who were involved in the trial were invited to participate. The interviews/focus groups were then transcribed verbatim and analysed thematically by the process of content analysis. RESULTS Of the 67 eligible patients, 8 (12%) contributed to the focus groups and 15 practitioners (100%), contributed to the study by either attending a focus group or being interviewed. Themes identified for patients included: the allocation to self-needling, teaching techniques and practical considerations and whether they would self-needle again. Themes identified for practitioners included: views on self-needling, teaching self-needling and future implications of self-needling. CONCLUSIONS Self-needling was found to be acceptable to, and manageable by, patients, and enthusiastically adopted by most practitioners. Methods of teaching self-needling need to be developed and evaluated with guidelines recommended for best practice.
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Affiliation(s)
- Joy Bardy
- School of Nursing, Social Work & Midwifery, University of Manchester, Manchester, UK The Christie NHS Foundation Trust, Manchester, UK
| | | | | | - Alexander Molassiotis
- School of Nursing, Social Work & Midwifery, University of Manchester, Manchester, UK
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Halsey EJ, Xing M, Stockley RC. Acupuncture for joint symptoms related to aromatase inhibitor therapy in postmenopausal women with early-stage breast cancer: a narrative review. Acupunct Med 2015; 33:188-95. [PMID: 25733539 DOI: 10.1136/acupmed-2014-010735] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/02/2015] [Indexed: 12/20/2022]
Abstract
BACKGROUND Aromatase inhibitor-induced musculoskeletal syndrome (AIMSS) leads to discontinuation of aromatase inhibitor therapy in a significant proportion of patients with breast cancer. Acupuncture is popular among cancer patients and has previously been shown to improve symptoms in a range of musculoskeletal complaints. AIM To determine the effectiveness and safety of acupuncture for the management of AIMSS in postmenopausal women with early-stage breast cancer. METHODS A literature search was carried out for randomised controlled trials (RCTs) on acupuncture for AIMSS in postmenopausal women with early-stage breast cancer. Characteristics of trials and outcomes were extracted from the retrieved articles, which were also assessed for risk of bias and quality of reporting. RESULTS Four RCTs were retrieved of sample size 32-67 (totalling 190 participants). Compliance with treatment was high and rates of adverse events were low. Of the three two-arm RCTs, two found no difference between acupuncture and sham acupuncture and one found that acupuncture was statistically superior to sham acupuncture. The fourth RCT, which incorporated three arms, found acupuncture and sham acupuncture to be statistically superior to usual care but there was no difference between true and sham acupuncture. Three trials that used non-penetrating sham as the control found no effect of acupuncture over sham, but the one trial that used superficial needle insertion found acupuncture to be superior. CONCLUSIONS Acupuncture is safe and results in improvement in AIMSS symptoms, but similar benefits are also elicited by non-penetrating sham acupuncture. Future research should seek to establish the durability of improvements.
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Affiliation(s)
- Elizabeth J Halsey
- Department of Health Professions, Manchester Metropolitan University, Manchester, UK
| | - Mei Xing
- Department of Health Professions, Manchester Metropolitan University, Manchester, UK
| | - Rachel C Stockley
- Department of Health Professions, Manchester Metropolitan University, Manchester, UK
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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]
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Skolarus TA, Wittmann D, Northouse L, An LC, Olson KB, Rew KT, Jimbo M, Heidelbaugh JJ, Phillips J, Holmes-Rovner M. Recommendations for Prostate Cancer Survivorship Care: An Update to the 2009 Michigan Cancer Consortium Guidelines for the Primary Care Management of Prostate Cancer Post-Treatment Sequelae. JOURNAL OF MEN'S HEALTH 2014. [DOI: 10.1089/jomh.2014.0026] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Fleckenstein J, Baeumler PI, Gurschler C, Weissenbacher T, Simang M, Annecke T, Geisenberger T, Irnich D. Acupuncture for post anaesthetic recovery and postoperative pain: study protocol for a randomised controlled trial. Trials 2014; 15:292. [PMID: 25047046 PMCID: PMC4223649 DOI: 10.1186/1745-6215-15-292] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2014] [Accepted: 07/01/2014] [Indexed: 11/30/2022] Open
Abstract
Background We report on the design and implementation of a study protocol entitled Acupuncture randomised trial for post anaesthetic recovery and postoperative pain - a pilot study (ACUARP) designed to investigate the effectiveness of acupuncture therapy performed in the perioperative period on post anaesthetic recovery and postoperative pain. Methods/Design The study is designed as a randomised controlled pilot trial with three arms and partial double blinding. We will compare (a) press needle acupuncture, (b) no treatment and (c) press plaster acupressure in a standardised anaesthetic setting. Seventy-five patients scheduled for laparoscopic surgery to the uterus or ovaries will be allocated randomly to one of the three trial arms. The total observation period will begin one day before surgery and end on the second postoperative day. Twelve press needles and press plasters are to be administered preoperatively at seven acupuncture points. The primary outcome measure will be time from extubation to ‘ready for discharge’ from the post anaesthesia care unit (in minutes). The ‘ready for discharge’ end point will be assessed using three different scores: the Aldrete score, the Post Anaesthetic Discharge Scoring System and an In-House score. Secondary outcome measures will comprise pre-, intra- and postoperative variables (which are anxiety, pain, nausea and vomiting, concomitant medication). Discussion The results of this study will provide information on whether acupuncture may improve patient post anaesthetic recovery. Comparing acupuncture with acupressure will provide insight into potential therapeutic differences between invasive and non-invasive acupuncture techniques. Trial registration NCT01816386 (First received: 28 October 2012)
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Affiliation(s)
- Johannes Fleckenstein
- Multidisciplinary Pain Centre, Department of Anaesthesiology, University of Munich, Pettenkoferstrasse 8 A, 80336 München, Germany.
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Liu F, Fang J, Shao X, Liang Y, Wu Y, Jin Y. Electroacupuncture exerts an anti-inflammatory effect in a rat tissue chamber model of inflammation via suppression of NF-κB activation. Acupunct Med 2014; 32:340-5. [PMID: 24820260 DOI: 10.1136/acupmed-2013-010460] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVE Electroacupuncture (EA) has beneficial effects in patients with various inflammatory diseases. However, the underlying mechanism remains unclear. As the kappa B inhibitor/nuclear factor-kappa B (IκB/NF-κB) pathway exerts a pivotal role in the mammalian immune response, we examined the involvement of the IκB/NF-κB pathway in EA-induced anti-inflammation. METHODS Ninety tissue chamber implanted rats were randomly divided into control (C), model (M) and EA (E) groups. Physiological saline and human recombinant interleukin-1β (hr IL-1β) were injected into the rats in groups C and M, respectively, and EA treatment was applied to the rats in group E after IL-1β injection. Nuclear staining of p65 (a subunit of NF-κB) was quantified in the exudate cells by immunohistochemical analysis and IκBα expression in the cytoplasm was quantified by western blot analysis. RESULTS Our results showed that, compared with group C, the percentage of cells with nuclear-localised p65 was increased in group M by 71.3%, 50.7% and 33.1% at 1, 5 and 24 h time points (p<0.01), respectively. This increase was fully inhibited in group E at 5 and 24 h time points (p<0.01). The expression of IκBα was stably enhanced in group M (p<0.05) during the test period. Compared with group M, greater expression of IκBα in group E was only observed at the 1 h time point (p<0.01). CONCLUSIONS Collectively, our data suggest that EA inhibits the nuclear translocation of p65 and increases the expression of IκBα, which leads to the suppression of NF-κB activation in a rat tissue chamber model of inflammation.
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Affiliation(s)
- Fang Liu
- Department of Neurobiology and Acupuncture Research, The Third Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, Zhejiang Provicine, China Department of acu-moxibusion, Zhejiang Hospital of Integrated Chinese & Western Medicine, Hangzhou, China
| | - Jianqiao Fang
- Department of Neurobiology and Acupuncture Research, The Third Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, Zhejiang Provicine, China
| | - Xiaomei Shao
- Department of Neurobiology and Acupuncture Research, The Third Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, Zhejiang Provicine, China
| | - Yi Liang
- Department of Neurobiology and Acupuncture Research, The Third Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, Zhejiang Provicine, China
| | - Yuanyuan Wu
- Department of Neurobiology and Acupuncture Research, The Third Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, Zhejiang Provicine, China
| | - Yabei Jin
- Department of acu-moxibusion, Zhejiang Hospital of Integrated Chinese & Western Medicine, Hangzhou, China
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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.
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Affiliation(s)
- Jill Hervik
- Pain Clinic, Vestfold Hospital, Tønsberg, Norway
| | - Odd Mjåland
- Department of Abdominal Surgery, Sørlandet Sykehus, Kristiansand, Norway
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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.
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Affiliation(s)
- Jessica W Frisk
- Division of Obstetrics and Gynecology, Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
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Kondo T, Kawamoto M. Acupuncture and moxibustion for stress-related disorders. Biopsychosoc Med 2014; 8:7. [PMID: 24456818 PMCID: PMC3903561 DOI: 10.1186/1751-0759-8-7] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2013] [Accepted: 01/20/2014] [Indexed: 12/29/2022] Open
Abstract
Acupuncture and moxibustion, which medical doctors are licensed by the government of Japan to perform, can improve the psychological relationship between doctors and patients, especially when it is disturbed by a “game”, a dysfunctional interpersonal interaction that is repeated unintentionally. This advantage is due to the essential properties of acupuncture and moxibustion. Acupuncture and moxibustion are helpful in treating somatoform disorders, especially musculoskeletal symptoms. In Japan, a holistic acupuncture and moxibustion therapy called Sawada-style has been developed. This is based on fundamental meridian points that are considered to have effects on central, autonomic nervous, immune, metabolic, and endocrine systems to regulate the whole body balance. In addition, some of the fundamental points have effects on Qi, blood, and water patterns associated with major depression, generalized anxiety disorder, eating disorders, and somatoform disorders. The fixed protocol of Sawada-style would be suitable for large-scale, randomized, controlled studies in the future. Recent systematic reviews indicate that electroacupuncture would be a useful addition to antidepressant therapy for some symptoms accompanying fibromyalgia. Acupuncture and moxibustion are also recommended for irritable bowel syndrome, instead of Western drug therapy. Surprisingly, the dorsal prefrontal cerebral cortex, which is associated with a method of scalp acupuncture applied for gastrointestinal disorders, has been found to be activated in patients with irritable bowel syndrome. It is quite possible that regulation of this cortical area is related to the effect of scalp acupuncture. This acupuncture method can be effective not only for irritable bowel syndrome but also for other stress-related gastrointestinal disorders.
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Affiliation(s)
- Tetsuya Kondo
- Kansai University of Health Sciences, 2-11-1, Wakaba, Kumatori-cho, Sennan-gun 590-0482, Japan.
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Dyer L, Venton K, Forrester M. Home Electroacupuncture for Persistent Postsurgical Pain: A Patient's Report. Acupunct Med 2013; 31:425-9. [DOI: 10.1136/acupmed-2013-010421] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
A 30-year-woman presented with iatrogenic myofascial facial pain of 12 months’ duration after surgical treatment for bilateral temporomandibular joint dysfunction. Limited response to manual acupuncture was followed by a trial of electroacupuncture. Response to electroacupuncture was limited in duration and one option was to teach her partner to perform electroacupuncture at home. The patient and partner, trained in beauty therapy, embraced this idea and it proved equally effective as therapist-provided acupuncture. We describe this case report from the perspective of the patient, caregiver or acupuncture partner and therapist. Home electroacupuncture seems to be safe, acceptable and practicable as a maintenance treatment for patients with persistent postsurgical pain of myofascial origin.
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Affiliation(s)
| | | | - Max Forrester
- Department of Orthopaedics, Musgrove Park Hospital, Taunton, Somerset, UK
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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.
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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
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A randomized, controlled trial of acupuncture self-needling as maintenance therapy for cancer-related fatigue after therapist-delivered acupuncture. Ann Oncol 2013; 24:1645-52. [DOI: 10.1093/annonc/mdt034] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
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Long-term chinese herbs decoction administration for management of hot flashes associated with endocrine therapy in breast cancer patients. Chin J Cancer Res 2013; 23:74-8. [PMID: 23467638 DOI: 10.1007/s11670-011-0074-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2010] [Accepted: 12/14/2010] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVE To evaluate the effect of Chinese herbs decoction Shu-Gan-Liang-Xue on endocrine therapy- associated hot flashes symptom in breast cancer patients. METHODS Sixty-six patients with breast cancer receiving adjuvant endocrine therapy were categorized to two groups, the control group received endocrine therapy alone, the other group is administered with Chinese herbs decoction Shu-Gan-Liang-Xue besides the endocrine therapy: Shu-Gan-Liang-Xue decoction was administered above 6 months per year for more than 2 years. Frequency of hot flashes per day was recorded, and the effect of Shu-Gan-Liang-Xue decoction on hot flashes symptom being assessed with Kupperman Scoring Index. RESULTS Sixty cases were analyzed, 32 cases in endocrine therapy combining Chinese herbs decoction group, 28 cases in mere endocrine therapy group. For hot flashes symptom, in Chinese herbs decoction administration group, 7 cases (21.9%) reported symptom disappeared, 22 cases (68.7%) reported symptom alleviated, 3 cases (9.4%) reported symptom not changed; in endocrine therapy alone group, 5 cases (17.9%) reported symptom disappeared, 13 cases (46.4%) reported symptom alleviated, 10 cases (10/28, 35.7%) reported symptom not changed. The difference between two groups was statistically significant (P=0.013). For sleeping disorder, in Chinese herbs decoction administration group, 27 cases (84.4%) reported symptom improved, 5 cases (15.6%) reported no change; in endocrine therapy alone group, 16 cases (57.1%) symptom improved, 12 cases (42.9%) reported no change in sleeping disorder (P=0.019), the difference was also of significance statistically. CONCLUSION Long-term Chinese herbs decoction administration remarkably improved hot flashes symptom and sleeping disorder associated with endocrine therapy, meanwhile without definite toxicity and influence on the risk of recurrence of tumor.
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Bokmand S, Flyger H. Acupuncture relieves menopausal discomfort in breast cancer patients: a prospective, double blinded, randomized study. Breast 2012; 22:320-3. [PMID: 22906948 DOI: 10.1016/j.breast.2012.07.015] [Citation(s) in RCA: 71] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2012] [Revised: 07/13/2012] [Accepted: 07/30/2012] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND This study evaluates the effect of acupuncture on hot flashes and disturbed night sleep in patients treated for breast cancer. The effect of acupuncture was tested against a sham-acupuncture group and a no-treatment control group. Plasma estradiol was measured to rule out this as cause of effect. Side effects of the treatment were registered. METHODS We randomized 94 women into the study: 31 had acupuncture, 29 had sham acupuncture and 34 had no treatment. FINDINGS In the acupuncture group, 16 patients (52%) experienced a significant effect on hot flashes compared with seven patients (24%) in the sham group (p < 0.05). The effect came after the second acupuncture session and lasted for at least 12 weeks after last treatment. A statistically significant positive effect was seen on sleep in the acupuncture group compared with the sham-acupuncture and no-treatment groups. The effect was not correlated with increased levels of plasma estradiol. No side effects of acupuncture were registered. INTERPRETATION We find that acupuncture significantly relieves hot flashes and sleep disturbances and is a good and safe treatment in women treated for breast cancer.
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A pilot randomized, single-blind, placebo-controlled trial of traditional acupuncture for vasomotor symptoms and mechanistic pathways of menopause. Menopause 2012; 19:54-61. [PMID: 21968279 DOI: 10.1097/gme.0b013e31821f9171] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
OBJECTIVE The aim of this study was to conduct a pilot study for the feasibility of planning a definitive clinical trial comparing traditional acupuncture (TA) with sham acupuncture (SA) and waiting control (WC) on menopause-related vasomotor symptoms (VMS), quality of life, and the hypothalamic-pituitary-adrenal axis in perimenopausal and postmenopausal women. METHODS Thirty-three perimenopausal and postmenopausal women with at least seven VMS daily were randomized to TA, SA, or WC. The TA and SA groups were given three treatments per week for 12 weeks. Outcomes included the number and severity of VMS, Menopause-Specific Quality of Life Questionnaire, Beck Depression Inventory, Spielberg State-Trait Anxiety Instrument, Pittsburgh Quality Sleep Index, 24-hour urine cortisol and metabolites, and adrenocorticotropic hormone stimulation testing. RESULTS Both the TA and SA groups demonstrated improved VMS trends compared with the WC group (Δ -3.5 ± 3.00 vs -4.1 ± 3.79 vs -1.2 ± 2.4, respectively; P = 20) and significantly improved Menopause-Specific Quality of Life Questionnaire vasomotor scores (Δ -1.5 ± 2.02 vs -1.8 ± 1.52 vs -0.3 ± 0.64, respectively; P = 0.04). There were no psychosocial group differences. Exit 24-hour urinary measures were lower in the TA versus the SA or WC group in total cortisol metabolites (4,658.9 ± 1,670.9 vs 7,735.8 ± 3,747.9 vs 5,166.0 ± 2,234.5, P = 0.03; respectively) and dehydroepiandrosterone (41.4 ± 27.46, 161.2 ± 222.77, and 252.4 ± 385.40, respectively; P = 0.05). The response data on adrenocorticotropic hormone stimulation cortisol also trended in the hypothesized direction (P = 0.17). CONCLUSIONS Both TA and SA reduce VMS frequency and severity and improve VMS-related quality of life compared with WC; however, TA alone may impact the hypothalamic-pituitary-adrenal axis. This association is viewed as preliminary and hypothesis generating and should be explored in a large clinical trial.
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Should physiotherapists use acupuncture for treating patients with cancer-induced bone pain? A discussion paper. Physiotherapy 2011; 97:256-63. [DOI: 10.1016/j.physio.2010.08.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2010] [Accepted: 08/08/2010] [Indexed: 01/26/2023]
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Frisk J, Källström AC, Wall N, Fredrikson M, Hammar M. Acupuncture improves health-related quality-of-life (HRQoL) and sleep in women with breast cancer and hot flushes. Support Care Cancer 2011; 20:715-24. [PMID: 21468626 DOI: 10.1007/s00520-011-1134-8] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2010] [Accepted: 03/06/2011] [Indexed: 11/30/2022]
Abstract
PURPOSE Evaluate effects of electro-acupuncture (EA) and hormone therapy (HT) on health-related quality-of-life (HRQoL) and sleep in breast cancer survivors with vasomotor symptoms. METHODS Forty-five women, randomized to EA (n = 27) for 12 weeks or HT (n = 18) for 24 months, were followed for up to 2 years. Distress caused by, and numbers of, hot flushes, hours slept and times woken up/night, Psychological and General Well-being Index (PGWB) and Women's Health Questionnaire (WHQ) were registered before and during treatment and at 6, 9, 12, 18 and 24 months after start of treatment. RESULTS After 12 weeks of EA (n = 19), WHQ improved from 0.32 (IQR 0.23-0.53) at baseline to 0.24 (IQR 0.12-0.39; p < 0.001) and PGWB from 78 (IQR 53-89) to 79 (IQR 68-93; p = 0.002). All sleep parameters improved and Hot Flush Score (HFS) decreased by 80%. At 12 months, WHQ, PGWB and all sleep parameters remained significantly improved (n = 14) and HFS decreased by 65%. After 12 weeks of HT (n = 18), WHQ improved from 0.29 (IQR 0.15-0.44) at baseline to 0.15 (IQR 0.05-0.22; p = 0.001), PGWB from 75 (IQR 59-88) to 90 (62-97; p = 0.102) and three of five sleep parameters improved. CONCLUSION Both EA and HT increased HRQoL and sleep, probably through decreasing numbers of and distress by hot flushes. Although flushes decreased less in the EA group than in the HT group, HRQoL improved at least to the same extent maybe due to other effects of EA, not induced by HT, e.g. on anxiety, vitality and sleep, supported by subscale analyses. EA should be further evaluated as treatment for women with breast cancer and climacteric complaints, since HT no longer can be recommended for these women.
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Affiliation(s)
- Jessica Frisk
- Obstetrics and Gynaecology, Faculty of Health Sciences, Linköping University, University Hospital, 581 85 Linköping, Sweden.
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de Valois BA, Young TE, Robinson N, McCourt C, Maher EJ. Using traditional acupuncture for breast cancer-related hot flashes and night sweats. J Altern Complement Med 2011; 16:1047-57. [PMID: 20954961 DOI: 10.1089/acm.2009.0472] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES Women taking tamoxifen experience hot flashes and night sweats (HF&NS); acupuncture may offer a nonpharmaceutical method of management. This study explored whether traditional acupuncture (TA) could reduce HF&NS frequency, improve physical and emotional well-being, and improve perceptions of HF&NS. DESIGN/SETTINGS/LOCATION: This was a single-arm observational study using before and after measurements, located in a National Health Service cancer treatment center in southern England. SUBJECTS Fifty (50) participants with early breast cancer completed eight TA treatments. Eligible women were ≥ 35 years old, ≥ 6 months post active cancer treatment, taking tamoxifen ≥ 6 months, and self-reporting ≥ 4 HF&NS incidents/24 hours for ≥ 3 months. INTERVENTIONS Participants received weekly individualized TA treatment using a core standardized protocol for treating HF&NS in natural menopause. OUTCOME MEASURES Hot Flash Diaries recorded HF&NS frequency over 14-day periods; the Women's Health Questionnaire (WHQ) assessed physical and emotional well-being; the Hot Flashes and Night Sweats Questionnaire (HFNSQ) assessed HF&NS as a problem. Measurements taken at five points over 30 weeks included baseline, midtreatment, end of treatment (EOT), and 4 and 18 weeks after EOT. Results for the primary outcome: Mean frequency reduced by 49.8% (95% confidence interval 40.5-56.5, p < 0.0001, n = 48) at EOT over baseline. Trends indicated longer-term effects at 4 and 18 weeks after EOT. At EOT, seven WHQ domains showed significant statistical and clinical improvements, including Anxiety/Fears, Memory/Concentration, Menstrual Problems, Sexual Behavior, Sleep Problems, Somatic Symptoms, and Vasomotor Symptoms. Perceptions of HF&NS as a problem reduced by 2.2 points (standard deviation = 2.15, n = 48, t = 7.16, p < 0.0001). CONCLUSIONS These results compare favorably with other studies using acupuncture to manage HF&NS, as well as research on nonhormonal pharmaceutical treatments. In addition to reduced HF&NS frequency, women enjoyed improved physical and emotional well-being, and few side-effects were reported. Further research is warranted into this approach, which offers breast cancer survivors choice in managing a chronic condition.
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Affiliation(s)
- Beverley A de Valois
- Supportive Oncology Research Team (SORT), Lynda Jackson Macmillan Centre (LJMC), Mount Vernon Hospital, Middlesex, United Kingdom.
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Kaplan M, Mahon S, Cope D, Keating E, Hill S, Jacobson M. Putting Evidence Into Practice. Clin J Oncol Nurs 2011; 15:149-57. [DOI: 10.1188/11.cjon.149-157] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Paley CA, Bennett MI, Johnson MI. Acupuncture for cancer-induced bone pain? EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2011; 2011:671043. [PMID: 21799687 PMCID: PMC3136818 DOI: 10.1093/ecam/neq020] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/08/2009] [Accepted: 02/22/2010] [Indexed: 12/13/2022]
Abstract
Bone pain is the most common type of pain in cancer. Bony metastases are common in advanced cancers, particularly in multiple myeloma, breast, prostate or lung cancer. Current pain-relieving strategies include the use of opioid-based analgesia, bisphosphonates and radiotherapy. Although patients experience some pain relief, these interventions may produce unacceptable side-effects which inevitably affect the quality of life. Acupuncture may represent a potentially valuable adjunct to existing strategies for pain relief and it is known to be relatively free of harmful side-effects. Although acupuncture is used in palliative care settings for all types of cancer pain the evidence-base is sparse and inconclusive and there is very little evidence to show its effectiveness in relieving cancer-induced bone pain (CIBP). The aim of this critical review is to consider the known physiological effects of acupuncture and discuss these in the context of the pathophysiology of malignant bone pain. The aim of future research should be to produce an effective protocol for treating CIBP with acupuncture based on a sound, evidence-based rationale. The physiological mechanisms presented in this review suggest that this is a realistic objective.
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Affiliation(s)
- Carole A Paley
- Faculty of Health, Leeds Metropolitan University, Leeds, UK
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O'Regan D, Filshie J. Acupuncture and cancer. Auton Neurosci 2010; 157:96-100. [DOI: 10.1016/j.autneu.2010.05.001] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2010] [Revised: 04/13/2010] [Accepted: 05/01/2010] [Indexed: 10/19/2022]
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Abstract
Breast cancer treatment currently requires the joint efforts of a multidisciplinary team to effectively combine chemotherapy, hormone therapy, biological agents, surgery and radiation therapy when needed. To develop such a treatment plan, it is important to know the benefits as well as the potential toxic effects of each therapy. Thus, many patients with early breast cancer complain of collateral adverse events such as fatigue, nausea, vomiting, loss of libido, hot flashes, night sweats or neuropathy due to the complex therapies they are receiving. To date, the treatment of such symptoms is an important issue that greatly affects the quality of life of these patients. In this review, we report the content of a multi-expert meeting where the incidence of and medical approach to some of the most common adverse events encountered during the treatment of patients with early breast cancer were analysed.
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Borud E, White A. A review of acupuncture for menopausal problems. Maturitas 2010; 66:131-4. [PMID: 20060667 DOI: 10.1016/j.maturitas.2009.12.010] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2009] [Accepted: 12/10/2009] [Indexed: 11/24/2022]
Abstract
Acupuncture is one of the complementary therapies that are increasingly used by women with menopausal hot flushes. Acupuncture can be understood as a form of neurological stimulation. Clinical trials of acupuncture use different control groups according to whether they wish to provide practical information on the role of acupuncture in health care, or theoretical information on the specific needle effect. Controls for the latter research question are highly problematic, and no convincingly inert 'placebo' needle has yet been designed. For natural menopause, one large study has shown acupuncture to be superior to self-care alone in reducing the number of hot flushes and improving the quality of life; five small studies have been unable to demonstrate that the effect of acupuncture is limited to any particular points, as traditional theory would suggest; and one study showed acupuncture was superior to blunt needle for flash frequency but not intensity. For flushes associated with induced menopause, clearly acupuncture is useful for reducing flushes in clinical practice, but there is mixed evidence on the nature of the effect: one trial found genuine acupuncture superior to control needling, but another showed no significant difference between acupuncture and blunt needle. The possible mechanisms of acupuncture for hot flushes are discussed. Current evidence clearly justifies further research into the most cost effective form of acupuncture for treating hot flushes.
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Affiliation(s)
- Einar Borud
- The National Research Center in Complementary and Alternative Medicine, University of Tromsø, Tromsø, Norway.
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Managing hot flushes in men after prostate cancer--a systematic review. Maturitas 2009; 65:15-22. [PMID: 19962840 DOI: 10.1016/j.maturitas.2009.10.017] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2009] [Revised: 10/27/2009] [Accepted: 10/27/2009] [Indexed: 12/21/2022]
Abstract
CONTEXT AND OBJECTIVE The aim of this study was to describe hot flushes in men with prostate cancer, and their treatment methods. METHOD A systematic review was conducted of the literature indexed between 1966 and 2009 on the MEDLINE, the ISI Web of Knowledge, Cinahl and PsycINFO. Of 252 articles identified, 32 were selected for consideration of their complete texts, of which five were subject to detailed analysis. RESULTS Diethylstilbestrol, megestrol acetate and cyproterone acetate have the strongest effect, giving a 75% or larger decrease of the number of hot flushes, but they may have severe or bothersome side-effects. Gabapentin has an uncertain effect. Clonidine is not proven effective for hot flushes. Long-term effects were not evaluated in any of the studies. SSRI/SNRI and acupuncture may have a moderate effect on hot flushes but are not proven in any RCTs. CONCLUSION Hot flushes are common and bothersome symptoms in men with prostate cancer and those taking anti-androgen treatment, and reduce quality of life. Few treatments are available and some are avoided for these patients. Additional prospective treatment studies are needed, with long-term follow-up, in order to evaluate the effects and risks of treatments. Treatments with few or no severe side-effects should be prioritised in future investigations. Experimental studies are also needed to elucidate the mechanism behind hot flushes in men and to suggest routes for the development of new treatments.
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Cassileth BR, Gubili J, Simon Yeung K. Integrative medicine: complementary therapies and supplements. Nat Rev Urol 2009; 6:228-33. [DOI: 10.1038/nrurol.2009.41] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
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Mohile SG, Mustian K, Bylow K, Hall W, Dale W. Management of complications of androgen deprivation therapy in the older man. Crit Rev Oncol Hematol 2008; 70:235-55. [PMID: 18952456 DOI: 10.1016/j.critrevonc.2008.09.004] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2008] [Revised: 08/12/2008] [Accepted: 09/03/2008] [Indexed: 02/07/2023] Open
Abstract
Prostate cancer is the most common malignancy in older men. With the aging of the population, the number of older men with prostate cancer will grow rapidly. Androgen deprivation therapy (ADT) is the mainstay of treatment for men with systemic disease and is increasingly utilized as primary therapy or in combination with other therapies for localized disease. Side effects of therapy are multifold and include hot flashes, osteoporosis, and adverse psychological and metabolic effects. Recent research has illustrated that ADT can negatively impact the functional, cognitive, and physical performance of older men. Patients with prostate cancer, despite recurrence of the disease, have a long life expectancy and may be subjected to the side effects of ADT for many years. This review highlights the complications of ADT and approaches to management. We also provide recommendations for assessment and management of ADT complications among the most vulnerable and frail older male patients.
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Affiliation(s)
- Supriya G Mohile
- James Wilmot Cancer Center, University of Rochester, Rochester, NY 14642, USA.
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Flaig TW, Glodé LM. Management of the side effects of androgen deprivation therapy in men with prostate cancer. Expert Opin Pharmacother 2008; 9:2829-41. [DOI: 10.1517/14656566.9.16.2829] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Hervik J, Mjåland O. Acupuncture for the treatment of hot flashes in breast cancer patients, a randomized, controlled trial. Breast Cancer Res Treat 2008; 116:311-6. [PMID: 18839306 DOI: 10.1007/s10549-008-0210-3] [Citation(s) in RCA: 97] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2008] [Accepted: 09/22/2008] [Indexed: 11/25/2022]
Abstract
Acupuncture has been used to treat the problem of hot flashes in healthy postmenopausal women. The object of this study was to investigate the efficacy of acupuncture in women with breast cancer suffering from hot flashes as a result of anti-oestrogen medication. In a prospective, controlled trial, 59 women suffering from hot flashes following breast cancer surgery and adjuvant oestrogen-antagonist treatment (Tamoxifen) were randomized to either 10 weeks of traditional Chinese acupuncture or sham acupuncture (SA). Mean number of hot flashes at day and night were recorded prior to treatment, during the treatment period as well as during the 12 weeks following treatment. A validated health score (Kupperman index) was conducted at baseline, at the end of the treatment period and at 12 weeks following treatment. During the treatment period mean number of hot flashes at day and night was significantly reduced by 50 and almost 60%, respectively from baseline in the acupuncture group, and was further reduced by 30% both at day and night during the next 12 weeks. In the sham acupuncture group a significant reduction of 25% in hot flashes at day was seen during treatment, but was reversed during the following 12 weeks. No reduction was seen in hot flashes at night. Kupperman index was reduced by 44% from baseline to the end of the treatment period in the acupuncture group, and largely maintained 12 weeks after treatment ended. No corresponding changes were seen in the sham acupuncture group. Acupuncture seems to provide effective relief from hot flashes both day and night in women operated for breast cancer, treated with Tamoxifen. This treatment effect seems to coincide with a general health improvement measured with the validated Kupperman index.
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Affiliation(s)
- Jill Hervik
- Pain Clinic, Vestfold Hospital, Tonsberg, Norway.
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Harding C, Harris A, Chadwick D. Auricular acupuncture: a novel treatment for vasomotor symptoms associated with luteinizing-hormone releasing hormone agonist treatment for prostate cancer. BJU Int 2008; 103:186-90. [PMID: 18710455 DOI: 10.1111/j.1464-410x.2008.07884.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To evaluate the role of auricular acupuncture (AA) in men receiving luteinizing-hormone releasing hormone (LHRH) analogues for carcinoma of the prostate, as vasomotor symptoms can affect the quality of life in such men, and similar symptoms in postmenopausal women have been successfully treated with AA. PATIENTS AND METHODS In all, 60 consecutive patients with prostate cancer and on LHRH agonist treatment (median age 74 years, range 58-83) consented to weekly AA for 10 weeks. The validated 'Measure Yourself Concerns and Well-Being' questionnaire (a six-point scale to assess symptom severity) was used to assess concerns and well-being before and after treatment. RESULTS All men completed the treatment with no adverse events recorded, apart from transient exacerbation of symptoms in two men; 95% of patients reported a decrease in the severity of symptoms, from a mean 5.0 to 2.1 (Student's t-test, P < 0.01). CONCLUSIONS The symptomatic improvement was at levels comparable with that from pharmacotherapy, and cost analysis showed AA to be a viable alternative. Larger randomized studies are needed to fully evaluate AA against more conventional treatments, and these are planned.
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Sagar SM. Acupuncture as an Evidence-Based Option for Symptom Control in Cancer Patients. Curr Treat Options Oncol 2008; 9:117-26. [DOI: 10.1007/s11864-008-0063-3] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2007] [Accepted: 07/09/2008] [Indexed: 10/21/2022]
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Frisk J, Carlhäll S, Källström AC, Lindh-Astrand L, Malmström A, Hammar M. Long-term follow-up of acupuncture and hormone therapy on hot flushes in women with breast cancer: a prospective, randomized, controlled multicenter trial. Climacteric 2008; 11:166-74. [PMID: 18365859 DOI: 10.1080/13697130801958709] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVE To evaluate the effects of electro-acupuncture (EA) and hormone therapy (HT) on vasomotor symptoms in women with a history of breast cancer. METHODS Forty-five women were randomized to EA (n = 27) for 12 weeks or HT (n = 18) for 24 months. The number of and distress caused by hot flushes were registered daily before, during and up to 24 months after start of treatment. RESULTS In 19 women who completed 12 weeks of EA, the median number of hot flushes/24 h decreased from 9.6 (interquartile range (IQR) 6.6-9.9) at baseline to 4.3 (IQR 1.0-7.1) at 12 weeks of treatment (p < 0.001). At 12 months after start of treatment, 14 women with only the initial 12 weeks of EA had a median number of flushes/24 h of 4.9 (IQR 1.8-7.3), and at 24 months seven women with no other treatment than EA had 2.1 (IQR 1.6-2.8) flushes/24 h. Another five women had a decreased number of flushes after having additional EA. The 18 women with HT had a baseline median number of flushes/24 h of 6.6 (IQR 4.0-8.9), and 0.0 (IQR 0.0-1.6; p = 0.001) at 12 weeks. CONCLUSION Electro-acupuncture is a possible treatment of vasomotor symptoms for women with breast cancer and should be further studied for this group of women.
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Affiliation(s)
- J Frisk
- Division of Obstetrics and Gynaecology, Department of Molecular and Clinical Medicine, Faculty of Health Sciences, University Hospital of Linköping, Sweden
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