True Acupuncture Shows Promise for Patients with Head and Neck Cancer

By Hannah Slater for CancerNetwork.com
December 13, 2019

A phase III study published in JAMA Network indicated that true acupuncture resulted in significantly fewer and less severe radiation-induced xerostomia (RIX) symptoms 1 year after treatment compared to standard care control (SCC) in patients with head and neck cancer.1

This research suggests that acupuncture may be considered for the prevention of RIX, however further studies are necessary to confirm clinical relevance and generalization of this finding, as well as to evaluate inconsistencies in response to sham acupuncture between patients in the U.S. and China.

“Although a cost-benefit analysis was not an aim of the current study, acupuncture is minimally invasive and has a very low incidence of adverse effects,” the researchers wrote.

In this 2-center, phase III cohort of 399 patients, 112 patients received true acupuncture, 115 received sham acupuncture, and 112 patients with SCC. The adjusted least square mean xerostomia score in the true acupuncture group (26.6 [17.7]) was significantly lower than in the SCC group (34.8 vs 18.7; = 0.001; effect size = -.044) and marginally lower but not statistically significantly different from the sham acupuncture group (31.3 [18.6; = 0.06; effect size = -0.26).

True acupuncture was significantly different from sham acupuncture only at Fudan University Cancer Center, Shanghai, China, and no adverse events (AEs) were reported at the University of Texas MD Anderson Cancer Center were related to acupuncture. Only 1 AE related to acupuncture was reported at Fudan (pain from needling at 1 site in the ear).

In an accompanying editorial written by Matthias Karst, MD, PhD, Hannover Medical School, and Changwei Li, MD, PhD, MPH, University of Georgia College of Public Health, it was suggested that because in China most patients are well aware of the differences in sham acupuncture and true acupuncture, their confidence in the sham treatment decreased.2

“Findings in this study by Garcia et al support the idea that acupuncture exerts its effects not only or not mainly by needle site activity and specific neurophysiological mechanisms but also by expectations, conditioning, and suggestibility of clinicians and patients,” Karst and Li wrote.

Moreover, the perception of the effects of true acupuncture vs sham acupuncture may have a differential effect at the central nervous system level and could be moderated by culture. A 2008 study reported that cultural background moderates the activation of brain networks engaged during simple tasks. The placebo effect was also found to differ between Chinese and U.S. acupuncture sessions in another study.

However, for primary analysis researchers were interested in the sample as a whole; differentiation by group was included as part of secondary post hoc analysis.

Dental complications, dysgeusia, dysphagia, odynophagia, and difficulty sleeping and speaking affect quality of life and are often associated with RIX. There is currently no reliable method to treat established RIX, though there is some success with cytoprotection and physical techniques designed to reduce salivary gland exposure during the delivery of radiation therapy.

References:

1. Garcia MK, Meng Z, Rosenthal DI, et al. Effect of True and Sham Acupuncture on Radiation-Induced Xerostomia Among Patients With Head and Neck Cancer. JAMA Netw Open. doi:10.1001/jamanetworkopen.2019.16910.

2. Karst M, Li C. Acupuncture – A Question of Culture. JAMA Netw Open. doi:10.1001/jamanetworkopen.2019.16929.

lucypostolov.com

2019-12-16T13:22:29+00:00December 16th, 2019|

Patrick Dempsey’s cancer center offers acupuncture, and he swears by the needle treatments himself, too

Actor Patrick Dempsey isn’t a doctor, but he played Dr. Derek “McDreamy” Shepherd on TV for so many years that he says people often get confused.

The mix-up can become especially pronounced when he heads home to Lewiston, Maine and visits the Dempsey Center, a complementary cancer care center that he founded in 2008, just over a decade after his mother was first diagnosed with ovarian cancer. Local patients and their families can visit for fitness, nutrition classes, counseling — all free of cost.

“Every person has a different need,” Dempsey said, speaking at The Atlantic’s People v Cancer conference in New York on Tuesday. “We do not treat the disease, we treat the person. We treat the whole person, the family, the caregivers, the children, everyone.”

Among the cancer patients, there is one favorite treatment that rises above the rest: acupuncture.

Dempsey enjoys getting the needle treatments, too.

“I mean, everybody likes to get massage,” he said.

Acupuncture — a  traditional Chinese needle, heat, and pressure system that has been around for thousands of years — has been shown to relieve some of the most painful and stomach-churning side effects of cancer treatments. But while many people do feel better after an acupuncture treatment, scientists have evidence that a lot of what’s going on is a placebo effect.

dempsey cancer center
Patrick Dempsey leads the pack at the start of the Dempsey Challenge cycling tour in Lewiston, Maine. The event’s a fundraiser for Dempsey’s center, which he founded after his mother contracted ovarian cancer.
Tim Greenway/Portland Press Herald via Getty Images

Acupuncture can help cancer patients feel better, but it may not be because of the needles

Acupuncture relies on tapping specific points on the body, called “acupoints.” The idea is that acupuncture can influence the body’s “qi” or “chi,” aka energy. Typically, treatment is done with needles that are almost as thin as a human hair, but some acupuncturists might also use heat or apply pressure.

The tradition piqued the interest of the US National Institutes of Health, where scientists started studying acupuncture in 1997. Turned out, the needling technique was effective at easing some of the nasty side effects of cancer radiation and chemotherapy, especially the nausea and severe vomiting. Acupuncture may also help patients with fatigue.

But scientists have also discovered that the benefits of acupuncture may have nothing to do with the needles or specific pressure points. Many studies which have pitted acupuncture against “sham” pricking treatments suggest there may be a powerful placebo effect at work.

“You could randomly poke somebody with toothpicks, and some studies literally do that, and that’s just as effective as doing all the things that an acupuncturist is supposed to do,” Dr Steven Novells, a neurologist at Yale, previously told Business Insider.

Whatever the mechanism, Dempsey said he sees notable changes when patients try acupuncture at his cancer center.

“It’s nice to see when people are hesitant at the beginning, and then they try it, and they’re a few sessions in, and they notice a difference,” he said. “Then they’re like, ‘Ahh, yeah.'”

The right kind of touch may be an important part of this equation. Virtually any good massage therapy can help treat pain and improve quality of life for cancer patients, needles included or not.

Perhaps that’s why Dempsey is such a vocal proponent of wellness centers like his, arguing they should be “in every hospital” and part of every cancer patient’s support.

“You need to be prepared physically, emotionally, and mentally for the journey,” he said. “The whole family does.”

2019-12-03T12:23:28+00:00December 3rd, 2019|