Acupuncture Shows Promise in Treating Fatigue
Women with moderate cancer-related fatigue may benefit from acupuncture treatment, a recent clinical trial found. The study supports past research that shows acupuncture may help manage fatigue caused by cancer and other factors.
Cancer-related fatigue that lasts beyond the end of treatment is common in women with breast cancer. Often, it is caused by adjuvant chemotherapy, or chemotherapy given after surgery. Women with cancer-related fatigue feel exhausted, lose motivation to do everyday activities and sometimes experience depression and anxiety.
Acupuncture, a traditional Chinese practice of inserting very thin needles into specific points of the skin, is a form of complementary treatment believed to help reduce pain and stress.
Researchers performed a smaller, two-week trial to test the effect of acupuncture on cancer-related fatigue and found it lessened but then returned a month after treatment ended. This study explored the use of acupuncture over a longer period.
Participants were randomly assigned to one of two treatment groups. In the first group, 227 women had acupuncture treatment once a week for six weeks. In the second group, 75 women received a book with methods to manage fatigue.
The acupuncture targeted three points during each 20-minute session: the back of the hand between the thumb and index finger (point LI4), the front of the leg just below the knee (point ST36), and the inner side of the leg just above the ankle (point SP6). Alternative points were used if a woman had lymphedema or other issues.
After six weeks, participants self-reported changes in fatigue through the Multidimensional Fatigue Inventory General Fatigue Score, a 20-question survey that assesses the impact of fatigue on physical, cognitive and mental function, as well as quality of life.
Participants, ages 25 to 80, had stage I, II or IIIA breast cancer, reported moderate-level fatigue before the study and completed chemotherapy between one month and five years before the start of the trial. They were followed for 18 weeks.
The women who had acupuncture reported their general fatigue dropped just over 3 points more on the 20-point score than those in the standard care group. The acupuncture group also decreased physical fatigue and mental fatigue compared to their peers. Age, intensity of fatigue (moderate versus severe), and hormonal therapy treatment did not impact the effect of acupuncture.
Before the trial started, researchers asked women whether they expected acupuncture to affect their fatigue; data analysis showed their expectations did not influence the study outcome.
This study suggests acupuncture may be beneficial for fatigue caused by chemotherapy, but more research is needed because of certain limitations:
- Because participants self-reported, some data were lost that may lead to skewed outcomes.
- The number of participants asked to join the trial versus chose to participate on their own is unknown.
- Though researchers used methods to avoid placebo effect, the belief that a treatment is working because the participant thinks it will, they acknowledge it may still occur in trials testing acupuncture.
- Aspects of acupuncture sessions such as attention, conversation and education by the practitioner may enhance the benefits of treatment as a whole but were avoided during this trial to control the potential for a placebo effect.
What This Means For You
Integrative treatments like acupuncture are available at many cancer centers and through private practitioners. If you are interested in acupuncture or any other complementary treatments, talk with your doctor about the benefits and risks of combining them with your current treatment. Talk with your doctor if you have lymphedema or other health issues that may be affected by acupuncture, and before making an appointment with a licensed acupuncturist.
Molassiotis, Alex, Bardy, Joy, et al: Acupuncture for Cancer-Related Fatigue in Patients With Breast Cancer: A Pragmatic Randomized Controlled Trial. J Clin Oncol (October 2012) 30.