Introduction
Oncology acupuncture, rooted in Traditional Chinese Medicine, has attracted significant attention in recent years for its potential in alleviating pain and enhancing quality of life for cancer patients (Deng & Cassileth 2005). While conventional treatments such as medication and physical therapy remain foundational in pain management, the integration of acupuncture into cancer care has emerged as a complementary approach. This article explores the mechanisms, evidence, and practical applications of oncology acupuncture in managing pain among cancer patients.
Oncology Acupuncture
Acupuncture, a key component of Traditional Chinese Medicine, involves the insertion of thin, single-use, sterile needles into specific acupuncture points to stimulate physiological responses. The theoretical framework underlying acupuncture suggests that the stimulation of specific acupuncture points regulates the flow of Qi (vital energy) along meridians, restoring balance and promoting the recovery of health. In oncology, acupuncture is recognized as an effective and safe adjunct therapy tailored to address cancer-related symptoms and the side effects of cancer treatments, including pain, nausea, fatigue, xerostomia (dry mouth) and emotional distress (Lu et al. 2008).
Mechanisms of Action
The mechanisms through which oncology acupuncture exerts its analgesic effects are multifaceted. Research indicates that acupuncture activates various biological responses within the central nervous system, primarily mediated by sensory neurons, as well as the hypothalamus and the pituitary gland, resulting in a wide range of systemic effects. These effects include alterations in peptides, hormones, neurotransmitters, and the regulation of blood flow ('NIH Consensus Conference. Acupuncture' 1998). Additionally, acupuncture may modulate neurotransmitters such as serotonin and norepinephrine, which play pivotal roles in pain perception and mood regulation (Han & Terenius 1982).
Pain Management
One of the most debilitating aspects of cancer and its treatments is pain. While traditional analgesics may provide relief, their efficacy can be limited, and their side effects profound. Several studies have investigated the efficacy of acupuncture in managing cancer-related pain, yielding promising results. A recent research published in JAMA Oncology found that acupuncture is more effective at reducing chronic musculoskeletal pain in cancer survivors comparing to usual care such as analgesic medications, physical therapy and glucocorticoid injections (Mao et al. 2021). Moreover, a systematic review and meta-analysis published in the JAMA Oncology, comprising more than 14 randomized clinical trials, unequivocally demonstrated acupuncture's effectiveness in alleviating cancer-related pain and may decrease the analgesic use (He et al. 2020). This meta-analysis stands as a testament to the transformative potential of acupuncture as a complementary pain management modality. Furthermore, a recent systematic review published in BMJ Supportive & Palliative Care indicated that acupuncture is safe and provides pain relief in palliative care in patients with cancer (Yang et al. 2021).
Safety and Considerations
While acupuncture is generally safe and well-tolerated, certain precautions should be observed, particularly in the oncological setting. Patients with compromised immune systems or low platelet counts may be at increased risk of infection or bleeding, and necessitating careful selection of acupuncture points. Additionally, communication between the oncology team and acupuncturist is paramount to ensure alignment with ongoing cancer treatments and symptom management strategies.
Conclusion
Oncology acupuncture represents a valuable adjunctive therapy in the comprehensive management of cancer-related pain. By harnessing the body's innate healing mechanisms and modulating pain pathways, acupuncture offers a holistic approach to symptom relief and improves quality of life for cancer patients. As research continues to elucidate the mechanisms and optimize the clinical applications of acupuncture, its integration into mainstream oncological care holds promise for enhancing patient outcomes and well-being.
Reference
Deng, G. & Cassileth, B.R. 2005, 'Integrative oncology: complementary therapies for pain, anxiety, and mood disturbance', CA Cancer J Clin, vol. 55, no. 2, pp. 109-16.
Han, J.S. & Terenius, L. 1982, 'Neurochemical Basis of Acupuncture Analgesia', Annual Review of Pharmacology and Toxicology, vol. 22, no. Volume 22, 1982, pp. 193-220.
He, Y., Guo, X., May, B.H., Zhang, A.L., Liu, Y., Lu, C., Mao, J.J., Xue, C.C. & Zhang, H. 2020, 'Clinical Evidence for Association of Acupuncture and Acupressure With Improved Cancer Pain: A Systematic Review and Meta-Analysis', JAMA Oncology, vol. 6, no. 2, pp. 271-8.
Lu, W., Dean-Clower, E., Doherty-Gilman, A. & Rosenthal, D.S. 2008, 'The value of acupuncture in cancer care', Hematol Oncol Clin North Am, vol. 22, no. 4, pp. 631-48, viii.
Mao, J.J., Liou, K.T., Baser, R.E., Bao, T., Panageas, K.S., Romero, S.A.D., Li, Q.S., Gallagher, R.M. & Kantoff, P.W. 2021, 'Effectiveness of Electroacupuncture or Auricular Acupuncture vs Usual Care for Chronic Musculoskeletal Pain Among Cancer Survivors: The PEACE Randomized Clinical Trial', JAMA Oncol, vol. 7, no. 5, pp. 720-7.
'NIH Consensus Conference. Acupuncture' 1998, JAMA, vol. 280, no. 17, pp. 1518-24.
Yang, J., Wahner-Roedler, D.L., Zhou, X., Johnson, L.A., Do, A., Pachman, D.R., Chon, T.Y., Salinas, M., Millstine, D.M. & Bauer, B.A. 2021, 'Acupuncture for palliative cancer pain management: systematic review', BMJ Supportive & Palliative Care, vol. 11, pp. 264 - 70.
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