Acupuncture and Cancer CaRE

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In 1997, the National Institutes of Health (NIH) began looking at how well acupuncture worked as a complementary therapy for cancer -related symptoms and side effects of cancer treatments. Studies of acupuncture in cancer care also have been done in China and other countries.

  • Nausea and vomiting caused by chemotherapy, surgery, and radiation therapy

    The strongest evidence for acupuncture has come from clinical trials on the use of acupuncture to relieve nausea and vomiting.

    • A 2013 review that included 41 randomized controlled trials found that acupuncture helped treat nausea and vomiting caused by chemotherapy.
    • Another review from 11 randomized clinical trials, found that fewer chemotherapy patients in the acupuncture groups had acute vomiting compared to the control group.
    • A comparison of studies suggests that the specific acupuncture point used may make a difference in how well acupuncture works to relieve nausea caused by chemotherapy.
    • Patients who received either true acupuncture or sham acupuncture were compared to patients who received only standard care to prevent nausea and vomiting from radiation therapy. The study found that patients in both the true and sham acupuncture groups had less nausea and vomiting than those in the standard care group.
    • In a 2016 randomized clinical trial of auricular acupressure in 48 breast cancer patients treated with chemotherapy, patients who received auricular acupressure had less intense and less frequent nausea and vomiting compared with those who did not have auricular acupressure. These findings are limited since the study had a small number of patients and no placebogroup.
  • Pain

    Acupuncture has been studied to help relieve pain in cancer patients. The results are mixed due to small sample sizes and design problems.

    • Cancer pain

      In one review, acupuncture reduced cancer pain in some patients with various cancers, although the studies were small. Another review concluded acupuncture with pain medicine worked better than the pain medicine alone. This review was limited by poor quality of clinical trials.

    • Postoperative pain

      In several randomized clinical trials on pain after surgery, acupuncture reduced the pain, but sample sizes were small and additional treatments were unknown. Some studies reported that when acupuncture was used with standard care, pain relief was better.

      In two randomized clinical trials in patients having a bone marrow aspiration and biopsy, acupressure was found to relieve pain and anxiety compared to sham acupressure.

    • Muscle and joint pain from aromatase inhibitors

      Aromatase inhibitors, a type of hormone therapy for postmenopausal women who have hormone-dependent breast cancer, may cause muscle and joint pain.

      • Four randomized controlled trials compared the effects of real and sham acupuncture in reducing pain. All four trials showed no side effects from either real acupuncture or sham acupuncture. One trial showed real acupuncture was better than sham acupuncture in relieving joint and muscle pain, but the other three trials did not. In one of the studies, patients receiving real acupuncture had more pain relief than a control group of patients who were waiting to receive treatment later.
      • Observational studies have also reported both real acupuncture and sham acupuncture may relieve pain more than standard care.
      • A review of 17,922 patients reported that real acupuncture relieved pain better than sham acupuncture.
      • An ongoing randomized clinical trial of 228 patients is comparing real acupuncture, sham acupuncture, and standard care in breast cancer survivors with muscle and joint pain from aromatase inhibitors.
    • Peripheral neuropathy

      Several small studies have been done on the use of acupuncture in treating peripheral neuropathy caused by chemotherapy or other anticancer drugs. Most of these studies found acupuncture decreased pain and improved nerve function. A randomized controlled trial, however, found that acupuncture did not work better than a placebo.

  • Hot flashes

    Hormone therapy may cause hot flashes in women with breast cancer and men with prostate cancer. Studies of the use of acupuncture to relieve hot flashes have shown mixed results.

    • Six randomized clinical trials studied the use of acupuncture to prevent hot flashes in breast cancer survivors. These trials found that acupuncture was safe and decreased hot flashes. It was not clear whether real acupuncture worked better than sham acupuncture.
    • A 2015 randomized trial of electroacupuncture in breast cancer survivors with hot flashes had four groups for treatment: electroacupuncture, sham acupuncture, gabapentin, and placebo. The trial looked at how well sham acupuncture worked compared to the placebo and compared hot flash relief in all groups. The study found that sham acupuncture worked better than gabapentin or the placebo, and both electroacupuncture and sham acupuncture gave better relief than gabapentin.
    • A 2016 randomized trial compared acupuncture plus self-care (as described in an information booklet provided to all patients) to self-care alone in breast cancer survivors. The study found that adding acupuncture reduced hot flashes after 12 weeks of treatment and at the 3- and 6-month follow-up visits. The study also found that acupuncture improved the patients' quality of life.
    • A 2016 review of 12 randomized trials in breast cancer survivors with hot flashes included 6 studies that compared real acupuncture with sham acupuncture. Of these, only 2 studies found that real acupuncture had a benefit compared with the sham treatment. The other studies found that acupuncture was no better than hormone therapy, venlafaxine, or relaxation therapy in relieving hot flashes.
    • Some studies have reported that acupuncture may relieve hot flashes in prostate cancer patients on androgen-deprivation therapy.
  • Fatigue

    Fatigue is a common symptom in patients with cancer and a frequent side effect of chemotherapy and radiation therapy.

    • Several randomized clinical trials have studied the use of acupuncture in reducing cancer-related fatigue. These trials found that acupuncture improved fatigue when compared to standard care alone. It is not clear whether real acupuncture works better than sham acupuncture.
    • A 2016 randomized clinical trial of 78 cancer survivors with cancer-related fatigue showed that infrared laser acupuncture used on certain acupoints was safe in cancer patients. Patients who received infrared laser acupuncture 3 times per week for 4 weeks had less fatigue than those who received sham treatment.
  • Dry mouth (xerostomia)

    Several clinical trials have studied the effect of acupuncture in the treatment and prevention of xerostomia (dry mouth) caused by radiation therapy in patients with nasopharyngeal carcinomaand head and neck cancer.

    Other trials are ongoing.

    • In studies that compared acupuncture with standard care for preventing dry mouth in patients being treated with radiation therapy, patients treated with acupuncture during radiation therapy had fewer symptoms and better saliva flow.
    • Two randomized controlled trials compared real and sham acupuncture for the prevention and treatment of dry mouth. These trials found that both real and sham acupuncture increased the flow of saliva.
    • A study on the long-term effects of acupuncture on dry mouth found that patients had better saliva flow at 6 months compared to before treatment. Patients who received additional acupuncture had more saliva flow at 3 years compared to patients who did not continue acupuncture treatment.
  • Lymphedema

    There have been a number of case reports and studies that show acupuncture is safe and may decrease swelling and relieve symptoms in patients with lymphedema in the arms and legs. In one randomized clinical trial, acupuncture was found to keep lymphedema from getting worse but did not decrease swelling or symptoms.

    In a 2016 study, 23 breast and head and neck cancer patients with lymphedema who had acupuncture and moxibustion treatments reported improved levels of energy and decreased pain.

    In a 2016 randomized clinical trial of 30 breast cancer patients with lymphedema, about half of those treated with warm acupuncture (acupuncture and moxibustion) had improved symptoms of lymphedema. About one-fourth of the control group (drug therapy) had improved symptoms. The acupuncture and moxibustion group also had improved shoulder joint range of motion and quality of life compared with the control group.

  • Ileus

    After cancer surgery, some patients develop ileus. Randomized clinical trials that studied acupuncture for ileus had mixed results.

  • Sleep problems

    A study that compared acupuncture with fluoxetine found that acupuncture worked better in relieving depression and improving sleep. Another study found that acupuncture improved sleep slightly better than standard care.

  • The immune system

    Studies that suggest acupuncture may improve the immune system are limited.

  • Other symptoms of cancer and side effects of cancer treatment

    Other clinical trials in cancer patients have studied the effects of acupuncture on cancer symptoms and side effects caused by cancer treatment, including weight loss, cough, coughing up blood, fever, anxiety, depression, proctitis, speech problems, blocked esophagus, and hiccups. Studies have shown that treatment with acupuncture either relieves symptoms or keeps them from getting worse.

    —From the National Cancer Institute.