Acupuncture in Cancer Treatment

Board Certified Oncologist and MARF Board Member

A frequently asked question by patients undergoing cancer treatment is, “Can acupuncture help me?”

The issue then becomes: is there a place for acupuncture in the vast field of cancer with its diverse treatment modalities?

“Vast” since cancer is not one disease but over 300 different malignancies, each with its own unique histology, patho-physiology, and clinical behavior. ‘Diverse” because of the different chemotherapeutic classes of agents, hormonal agents, types of High-energy particle beam generators, and various delivery systems for radiation treatment. “Diverse” also because it encompasses various types of surgical procedures, nutritional support, and the body-mind holistic approach.

Timely diagnosis and early surgery offer the most favorable possibility of a cure for solid tumors. The germinal cancers and Hodgkin’s lymphoma, along with some hematologic malignancies such as childhood leukemia, are the few exceptions. These are treated with chemotherapy, radiation therapy, bone marrow or stem cell transplantation singly or in combination. Some of the latter are the most predictably curable malignancies with or without surgery.

If the diagnosis is late, surgery unsuccessful, or should the tumor recur after surgery, then the chance of a cure, with rare exceptions, is considered lost This class of patients, along with those not amenable to surgical approaches, are treated palliatively. Palliative therapies also consist of chemotherapy, hormonal therapy, and radiation therapy and/or palliative surgery.

The role of acupuncture in the curative group is in its adjunctive use in anesthesia, in post-operative pain control, and in aiding and hastening recovery from the side effects of the various therapies. Acupuncture is effective for control of pain, of local swelling post-operatively, for shortening the resolution of hematoma and tissue swelling and for minimizing use of medications and their attendant side effects. Energetic acupuncture, an approach consisting of the use of needles with electricity and moxibustion (a form of local heating with herbs imparts a sense of well being and accelerates patients’ recovery. In conjunction with nutritional support, its use is routinely employed in some cancer institutions.

The dreaded nausea and vomiting which commonly occurs in some patients undergoing chemotherapy and inevitably, with the use of certain classes of agents, can often be worse than the disease itself. Most oncologists have experienced the patients who start vomiting at the thought of their next clinic visit. At the University of Los Angeles (UCLA) School of Medicine, a well-controlled study completed over two Years ago, the authors of the published paper reported significant reduction of nausea and vomiting when pre-treated with. It is now routinely administered before, after and in between chemotherapy treatment sessions for control or nausea and emesis. Such treatments are relatively simple and easily executed in an outpatient setting. Its effectiveness helps in minimizing the use of standard, expensive multi-drug anti-nausea regimens with their attendant side effects, given along with the chemotherapeutic agents.

That acupuncture is a powerful tool for general pain control is widely known. . Less known is its success use in some cancer-related pain and in reducing narcotic use and thereby minimizing the side effects confusion, disturbed mentation, behavioral changes, nausea and severe constipation.

Needling a variety of trigger and painful points, percutaneous electrical nerve stimulation, and osteo-puncture, along with whole body energetic acupuncture support, .are approaches available to the acupuncturists. In the acupuncture paradigm, any chronic disease process depletes the energy level in the organism. Such depletion can be ameliorated, at least temporarily, by tonification, a process of imparting energy into the system. This is deemed necessary for more durable, successful pain control. It can also add to the patients’ sense of well being and decrease the malaise associated with any chronic disease, especially cancer.

Nutritional support as an aid in boosting immune response in cancer patients, along with minimizing the immune and white blood cell suppression that occurs with most chemotherapeutic agents, has been receiving greater attention and funding for research.. Kenneth Conklin, M.D., Ph.D., an anesthesiologist at UCLA working with the Oncology Department, reports gratifying results utilizing nutrition and supplements combined with energetic acupuncture.

Energetic acupuncture repletes energy level to the organism as a whole, reestablishes homeostasis by re-balancing energy distribution and un-blocking energy flow. This systems approach to deal with system wide patho-physiology can be complemented by distinct meridian acupuncture, which directs healing energy to specific organ pathology and is a routine approach in treating diseased organs such as liver, pancreas kidney, including those ravaged by cancers.

While the degree of beneficial results from acupuncture treatment is dependent on various clinical factors such as presenting symptoms, clinical staging, timing of the encounter in the course of the illness, areas of involvement, the answer to the opening question “can acupuncture help me?” is, in all probability, that it can help in the care of the cancer patient.

Acupuncture in Stroke Treatment

Acupuncture therapy for stroke-caused conditions such as paralysis, speech and swallowing problems, and depression is commonly used in the Orient. In China and Japan, an acupuncturist is likely to start therapy as soon as possible after a stroke. However, my recommendation is a delay of 2 weeks before acupuncture for strokes caused by bleeding in the brain, 10 to 20% of strokes (instead of the usual blood vessel block or clot). The wait is due to studies showing that acupuncture opens blood vessels for better flow and decreases clotting and inflammation. These effects are desired early when arteries are blocked, but after a stroke caused by bleeding has occurred, it is safer to wait until the bleeding blood vessel has clotted and is unlikely to bleed further before providing the acupuncture.

Acupuncture is done on a daily basis in China. Uncertain as to whether daily acupuncture is essential, even in Western countries, some acupuncturists with experience in treating stroke with acupuncture believe treatment 3 times a week is optimal. Several different approaches have been used to treat stroke, demonstrating that acupuncture for this disorder remains a healthcare art: Traditional Chinese Yang meridian point therapy, Chinese scalp acupuncture,

Dr. Yamamoto’s YNSA Japanese scalp therapy, Korean Koryo Chim hand acupuncture, supplemental ear (auricular) acupuncture, and Xingnao KaiQiao (a newer therapy by Professor Shi Xuemin) are each advocated by a number of treatment centers in Oriental countries. One need not know in depth the approach of each, but it is important to know that more than one approach is available and used.

Does acupuncture really work to help stroke victims improve? Many studies involving thousands of patients have been published in China and Japan, and 2 of 3 studies from Scandinavia, demonstrated significant help. These studies indicate that patients get well faster, perform better in self-care, require less nursing and rehabilitation therapy, and use less healthcare dollars. However, since most studies come from China, they get little credence from the Western medical community because researchers in China do not appear to be published unless their results are highly positive, so publication bias is possible. And, no money has been made available in the United States for studies needed to confirm the claims of experts in China and Japan of indeed helping stroke patients. Such studies, if done well, demand significant funding; sources of such money are difficult to find. Most physicians, including rehabilitation experts, have appeared unwilling to consider acupuncture therapy, not due to bias but because the published studies do not necessarily meet research study criteria for the United States.

Acupuncture is a safe therapy, and my experience has taught that this is especially true when helping stroke victims. Even discomfort is generally minimal. If one compares the possible positive help to be obtained with the risks associated with acupuncture, my contention is that acupuncture is worthy to attempt for stroke therapy. Studies are needed in the United States to prove this to medical skeptics. It will be important for such studies to involve skilled acupuncturists with experience in stroke therapy.

Adding acupuncture to rehabilitation therapy obviously increases the cost; daily-to-3 times-weekly treatment is needed for 2-4 weeks or longer. Concern for added cost would perhaps disappear if the end result demonstrates more self-care and less dependence on family and health providers.

Acupuncture and Seasonal Allergies

Symptoms of running nose, sneezing, and watery itchy eyes that recur during specific parts of the year (especially Spring and Fall) are a cause of much suffering of a large segment of the U.S. population. Millions of dollars are spent on medications and the allergy shots for the treatment of seasonal allergies.

Western medicine views seasonal allergies as a form of immediate hypersensitivity reaction which occurs when anti-bodies produced by lymphocytes interact with airborne particles such as pollen. Western medicine describes the locations of lymphocytes in addition to being in the blood stream as also in Peyer’s patches in the gastrointestinal tract, spleen, lymph nodes, and bone marrow. Interestingly in my practice of acupuncture the Spleen, Stomach, and Large Intestine meridians are utilized a great deal. One sees an interesting overlap of Western and Chinese medical thought. Also, Chinese medical thought sees sweets as being harmful to the Spleen (Chinese sense of the Spleen) function. In my practice sweets are often a major factor in the persistence and intensity of seasonal allergy symptoms.

I find it gratifying to treat seasonal allergies with acupuncture. There is often a quick response. Often patients get some relief during the first visit while lying on the exam table with their acupuncture needles in place. Patients are asked to score their nose stuffiness on a zero to ten scale. Zero meaning no stuffiness at all and 10 being the worst possible stuffiness for the patient. A score may be determined before and after the acupuncture treatment. Patients can also determine the effectiveness of acupuncture treatment by tracking the number of sneezes per day and the number of itching episodes around their eyes. After an initial series of treatments, patients come in for further treatments on an as needed basis. Some patients come back in once or twice a year for a booster while others may come more often. In general, patients do better if they avoid sugar and milk in their diets. They have better and longer lasting responses. I have seen many patients who failed medication and allergy shots respond to acupuncture. Patients continue with whatever standard treatments they are currently undergoing while getting acupuncture treatments. Most patients end up significantly reducing or eliminating their dependence on allergy medications.

There are many different ways of performing acupuncture, for example TCM (Traditional Chinese Medicine), Japanese, Korean, French Energetics, Worsley 5 Elements, ear, hand, etc. In choosing an acupuncturist the specific style a practitioner uses is not so important as the success rate a practitioner obtains with whatever style they use. Prospective patients should speak with the acupuncturist and inquire about past experience in treating seasonal allergies and their success rate.

In conclusion, it is my opinion that acupuncture is an excellent treatment option for seasonal allergies.