Acupuncture and Acupressure


Guidelines
Wellness
Risk
Access
Cautions
Integrative
Programs
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Information

Also known by these names

  • Acustimulation
  • Electroacupuncture
  • Manual acupuncture

Key Points

  • Acupuncture is a component of traditional Chinese medicine that is widely practiced in Western medicine.
  • Acupuncture and acupressure treatments stimulate designated points on the body with fine needles, pressure, or electricity.
  • BCCT’s interest in these therapies is in their success in treating symptoms related to cancer and treatments, especially pain, nausea and vomiting.
  • Acupuncture is recommended by the Society for Integrative Medicine and the American College of Chest Physicians for symptom management.
  • Acupuncture is generally safe, well tolerated and cost-effective. A few side effects are noted, and some medical conditions may make acupuncture inappropriate.
  • Acupuncture is widely available, and many conventional physicians refer patients for acupuncture therapy.

Acupuncture is an ancient Chinese therapy that has generally become widely accepted in Western medicine. The World Health Organization published an extensive review of evidence in 2002 concluding that acupuncture is an effective treatment for many diseases, symptoms or conditions, including pain and other cancer symptoms.1

Treatment involves stimulation of one or more designated points on the body with needles (acupuncture), pressure (acupressure), or electricity (electroacupuncture, EA).

Clinical Practice Guidelines

Chronic Pain

The 2016 American Society of Clinical Oncology clinical practice guideline for management of chronic pain in survivors of adult cancers concluded that benefits of acupuncture outweigh harms, although evidence quality is low. The guidelines give a weak recommendation for acupuncture to manage chronic pain.2

Breast Cancer

In the 2009 Society for Integrative Oncology clinical practice guidelines, “acupuncture is strongly recommended as a complementary therapy when pain is poorly controlled, when side effects from other modalities are clinically significant, when chemotherapy-induced nausea and vomiting (CINV) are poorly controlled, or when reducing the amount of pain medicine becomes a clinical goal. Acupuncture may also have a role in reducing xerostomia [dry mouth].”3

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Lung Cancer

2013 clinical practice guidelines from the American College of Chest Physicians recommended acupuncture or related techniques as an adjunct treatment option for lung cancer patients with these conditions:6

Managing Side Effects and Promoting Wellness

Managing or relieving side effects or symptoms, reducing treatment toxicity, supporting quality of life or promoting general well-being

Anxiety or Depression

A 2018 clinical study compared relaxing acupressure, stimulating acupressure and usual care in breast cancer survivors. The study found significantly improved depressive symptoms for both acupressure treatments over usual care, with relaxing acupressure showing the most benefit. Both acupressure groups were associated with greater improvements in anxiety than usual care.7

Dry Mouth (Xerostomia)

Preliminary evidence suggests acupuncture may be effective in reducing xerostomia with breast cancer8 and head and neck cancer.9

Fatigue

A 2018 meta-analysis concluded that "acupuncture had a marked effect on fatigue in cancer patients, regardless of concurrent anti-cancer treatment, particularly among breast cancer patients."10

Hot Flashes

A randomized placebo control trial of women with breast cancer experiencing bothersome hot flashes found that electroacupuncture (EA) produced the greatest reduction in hot flashes with fewer adverse events than daily gabapentin. EA was also associated with the longest duration of effect 16 weeks after study treatment completion.11

A 2010 review of treatments for hot flashes in men after prostate cancer found preliminary evidence of benefit from acupuncture.12

Ileus and Bowel Function

In a randomized study of postoperative ileus (obstruction of the ileum or other part of the intestine) after colorectal cancer resection, patients receiving simo decoction (SMD, a traditional Chinese medicine) and acupuncture for five consecutive days following surgey experienced significantly shorter hospital stays, shorter times to first flatus and shorter times to defecation than patients receiving another intervention or no intervention..13

Nausea and Vomiting

Randomized trials showed evidence of reduced nausea and vomiting with electroacupuncture after thoracic surgery.14

Pain

A systematic review in 2016 made these conclusions regarding acupuncture's effects on pain, noting that all studies had a high risk of bias:15

  • Benefits of acupuncture over conventional medication for late-stage unspecified cancer
  • No difference between real and sham electroacupuncture for pain associated with ovarian cancer
  • Benefits for auricular (ear) acupuncture over placebo for chronic neuropathic pain related to cancer
  • No differences between conventional analgesia and acupuncture within the first 10 days of treatment for stomach carcinoma—acupuncture relieved pain as well as conventional analgesia

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Peripheral Neuropathy

Preliminary evidence suggests that acupuncture can relieve peripheral neuropathy in breast cancer survivors.20

Sleep Disruption

A small randomized, sham-controlled study found no evidence of improved insomnia in women with ovarian cancer during chemotherapy.21

An uncontrolled study of patients with a variety of cancer types found improved sleep severity scores after eight weeks of acupuncture.22

Reducing Risk

Reducing the risk of developing cancer or the risk of recurrence

An important function of many integrative cancer therapy protocols is to alter the tumor microenvironment so that it is inhospitable to the development, growth and spread of cancer. Chronic inflammation, such as occurs when a wound doesn’t heal, can lead to fibrosis, which can then contribute to cancer growth.

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Access

Acupuncture has become widely but not universally available in hospitals and independent small practices. Conventional physicians and nurse practitioners often refer patients for acupuncture treatments. If your healthcare team cannot refer you to or recommend an acupuncturist, an internet search may locate one nearby. BCCT encourages you to check licensing and certification of acupuncturists before scheduling.

Cautions

Acupuncture is generally safe, well tolerated, and cost-effective. However, some adverse effects are experienced by up to 10 percent of patients, although some studies report a much lower number.24 and others a higher number.25 Effects may include these:

Expand list

Patients are advised to find fully qualified, licensed and certified acupuncturists. Many conventional physicians make referrals to such acupuncturists.

Patients with any of these conditions may be advised not to engage in treatments:26

  • Pregnancy
  • Lymphedema (in the affected limb)
  • Pacemaker use
  • Low platelet count or other severe clotting disorder
  • An unstable spine
  • Neutropenia

According to the Society for Integrative Oncology clinical practice guidelines for integrative therapies in breast cancer care, “electroacupuncture should not be used in patients with a pacemaker or implantable defibrillators and that special attention is required when treating patients who are pregnant, have seizure disorders, or are disoriented.”27

Integrative Programs, Protocols and Medical Systems

For more information about programs and protocols see our Integrative Programs and Protocols page.
 

Non-cancer Uses of Acupuncture or Acupressure

BCCT has not reviewed the effectiveness of this therapy for non-cancer uses.

Acupuncture

  • Osteoarthritis of the knee
  • Chronic neck pain
  • Chronic headache
  • Fibromyalgia symptoms
  • Low back pain
  • Bell’s palsy
  • High blood pressure
  • Hot flash severity in postmenopausal women
  • Depression symptoms
  • Reducing stroke risk in patients with traumatic brain injury
  • Allergic rhinitis
  • Allergic asthma
  • Smoking cessation
  • Adjunct to standard treatment for dyspnea on exertion
  • Autologous hematopoietic stem cell transplantation for autoimmune disorders and other non-cancer diseases and disorders
  • Peripheral neuropathy due to diabetes, AIDS and other non-cancer conditions

Electroacupuncture

  • Stress urinary incontinence
  • Improving reproductive outcomes in women following in vitro fertilization
  • Polycystic ovary syndrome (PCOS)
  • Chronic prostatitis/chronic pelvic pain
  • Procedural anxiety in patients undergoing lithotripsy
  • Reducing postoperative nausea and vomiting

Acupressure

  • Preprocedural anxiety in children

Written by Nancy Hepp, MS, with review by Laura Pole, RN, MSN, OCNS; most recent update on June 20, 2019. This summary draws from the Memorial Sloan Kettering Cancer Center’s About Herbs, National Cancer Institute’s Acupuncture (PDQ®), Ottawa Integrative Cancer Centre's Evidence-Based Monographs: Acupuncture, CAM-Cancer’s The Summaries, and other sources as noted.

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