In a preliminary study, women with side effects from breast cancer chemotherapy were helped by both acupuncture and a similar treatment where needles don't puncture the skin. (Credit: Shutterstock)

acupuncture

Acupuncture reduces chemo hot flashes for women

Acupuncture and similar pinprick sensations offer some relief from the hot flashes and pain caused by breast cancer chemotherapy treatment, a small study shows.

Investigators at the University of Maryland Greenebaum Cancer Center and Johns Hopkins University set out to see if weekly acupuncture could reduce the severity of side effects linked to aromatase inhibitors. Those drugs, used to treat breast cancer or prevent it from recurring after surgery, block estrogen production in postmenopausal patients. They thus can cause moderate to severe hot flashes, similar to those experienced during menopause. They can also cause musculoskeletal problems, such as joint and muscle pain.

The preliminary study adds to evidence that even the sensation of skin pricks simulating genuine acupuncture needle sticks might be enough to generate natural chemicals that improve symptoms.

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Though more study is needed, both acupuncture and the “sham” non-penetrating needle treatment may have the potential to displace conventional hot-flash and pain drugs for breast cancer chemo patients, says senior author Vered Stearns, co-director of the breast cancer program at the Johns Hopkins University Kimmel Cancer Center. Such drugs have their own side effects.

“These women have had a lot of different treatments, and some really try to avoid additional medications,” says Stearns.

Study results, published in the journal Cancer, showed few differences overall in benefits between those receiving real and sham acupuncture. No patients experienced significant side effects from acupuncture.

Pinpointing effectiveness

Investigators studied 47 postmenopausal women with hormone receptor-positive breast cancer at stages zero through III. All had been receiving AI therapy for at least a month and reported some AI-associated musculoskeletal symptoms. Patients were randomly assigned to receive eight weekly real or sham acupuncture treatments; 23 patients received real acupuncture and 24 received sham acupuncture.

The women completed weekly hot-flash diaries during weeks zero through eight and in week 12. They also answered questions about their menopausal symptoms, mood, sleep quality, depression, anxiety, and quality of life at the study’s start and four, eight, and 12 weeks later.

Among those receiving real acupuncture, researchers says, there were statistically significant improvements in depression, hot-flash severity and frequency, hot flash-related daily interference, and other menopausal symptoms. In those receiving sham acupuncture, researchers noted statistically significant improvements in quality of life, hot flash-related daily interference, and menopausal symptoms. Women saw an average reduction in hot-flash severity of 31 percent to 54 percent, respectively, from the real and simulated acupuncture treatments.

To compare the effects of real acupuncture sessions with those of sham acupuncture, for the latter, the team used non-penetrating, retractable needles placed in 14 locations on the skin between points used for real acupuncture. The non-penetrating needles produce a pricking sensation on the skin so that research subjects could not tell if they were getting the real treatment or not.

Racial differences

Although the researchers were not specifically studying racial differences in patients’ response, they found that African-American women more often had less frequent or severe hot flashes after real acupuncture, but not after the sham treatments. However, only nine African-Americans participated in the study; that was not enough, the researchers says, to draw firm conclusions.

Studies indicate that up to 60 percent of women with early stage breast cancer who receive AIs experience hot flashes, Stearns says.

The authors are planning a randomized controlled trial to look further into the racial differences seen in response to real versus sham acupuncture.

The fact that some women had benefits from sham acupuncture raised the question of whether the pricking sensation of sham acupuncture triggers physiological effects, says lead author Ting Bao, assistant professor of medicine at the University of Maryland.

Another study published by the researchers earlier this year in the journal Breast Cancer Research and Treatment showed that both real and sham acupuncture treatments helped improve AI-associated musculoskeletal symptoms, including a statistically significant reduction in the inflammatory protein IL-17.

“The current interventions for musculoskeletal side effects are limited to oral analgesics and exercise,” Bao says. “But the efficacy of these approaches is limited, and long-term use of oral analgesics can be challenging. If patients are open to acupuncture, this is a reasonable alternative for them.”

The American Society of Clinical Oncology Foundation, a Susan Komen Postdoctoral Fellowship Award, the Breast Cancer Research Foundation, and a Craft grant from the Maryland Affiliate of Susan G. Komen for the Cure supported the study. The cancer centers at Johns Hopkins and the University of Maryland also received funding from the National Cancer Institute.

Source: Johns Hopkins University

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