Two types of acupuncture may relieve pain in cancer survivors

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After a three-year clinical trial that included 360 cancer survivors — the largest of its kind to date — Memorial Sloan Kettering researchers found that two types of acupuncture significantly reduced survivors’ chronic pain. Jun Mao, head of MSK’s department of integrative medicine, explains how the results published in JAMA Oncology on March 18, 2021, could improve cancer care and hopefully lead to greater insurance coverage for this therapy.

How can acupuncture help people with cancer?

For people with a history of cancer, acupuncture is a drug-free option to help control and improve the side effects of chemotherapy, radiation therapy, and surgery. Studies have shown that acupuncture can relieve pain, fatigue, insomnia, neuropathy, and nausea.

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Your study was on electroacupuncture and auricular acupuncture. What is the difference?

Electroacupuncture uses very small, thin needles – about the width of a hair – and a very low frequency electric current to stimulate points on the body. It is different from other types of acupuncture which do not use current. Electroacupuncture is highly customizable to each patient and the needles come out after each session. Auricular (ear) acupuncture uses small studs that look like tiny earrings to stimulate up to ten points in a patient’s ear. The points are the same for each person and the needles stay in the person’s ear for three to four days.

Electroacupuncture takes many months or years to learn, but a provider can learn auricular acupuncture in a day. It is much easier to implement and therefore may be more accessible to patients. For example, a community or rural hospital might start offering auricular acupuncture before implementing a larger acupuncture program.

Acupuncture

Acupuncture is effective in treating chronic pain and some symptoms associated with cancer treatment.

Learn more “

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What was the purpose of your study?

We know that electroacupuncture can help reduce chronic pain. We wanted to test whether auricular acupuncture was as effective. We divided the participants into three random groups: people who received electroacupuncture, people who received auricular acupuncture, and people who received traditional care, which sometimes involved painkillers, including opioids. and over-the-counter medications. Acupuncture was performed weekly for ten weeks. We followed each group for 12 weeks to see if the treatments worked. We saw them again 12 weeks later to see if the effects of their treatment were lasting.

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What did you find?

We found that electroacupuncture and auricular acupuncture significantly reduced people’s chronic pain compared with usual care with or without medication; however, auricular acupuncture is not as effective as electroacupuncture. Compared to people receiving usual care, electroacupuncture reduced pain intensity by 1.9 points and auricular acupuncture by 1.6 points on a scale of 0 to 10. A reduction of one point of the pain is clinically significant, so that’s a pretty big drop. Pain relief from acupuncture lasts for months, which differs from painkillers, which must be taken frequently.

People may also tolerate electroacupuncture better. Less than 1% of participants receiving electroacupuncture discontinued treatment due to treatment side effects, which were most commonly bruising. Eleven percent of people receiving ear acupuncture discontinued the treatment, mostly because of ear pain.

Pain relief from acupuncture lasts for months, which differs from painkillers, which must be taken frequently.


Jun J.Mao
integrative medicine specialist

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What makes this study unique?

This is the largest acupuncture trial for cancer survivors. We recruited patients from our Manhattan and regional sites and included a significant portion of minority patients. We also included people with different types of cancer. Many previous studies of acupuncture have focused on women with breast cancer. Here we included people with prostate cancer, lymphoma, and many other types of diseases.

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What are the implications?

I hope these results will lead to greater insurance coverage for cancer survivors receiving acupuncture. In 2020, Medicare began covering acupuncture for lower back pain. Coverage of acupuncture for pain in cancer survivors, however, is inconsistent. And some cancer survivors have heart, kidney or liver problems as a result of the treatment, which means they shouldn’t take too many painkillers. Hopefully, this data will encourage health care regulators to expand coverage. The urgency is enormous: people from lower socio-economic status may not have the same access to acupuncture if it remains uncovered.

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