Acupuncture

Purported Benefits, Side Effects & More

Acupuncture

Purported Benefits, Side Effects & More
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Acupuncture is a therapeutic component of Traditional Chinese Medicine.

Common Names

  • Manual acupuncture
  • Electroacupuncture
  • Acustimulation
  • Acupressure

For Patients & Caregivers

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What is it?

According to TCM, acupuncture points are located at specific areas along channels or meridians. Qi (pronounced chee, meaning energy) is believed to flow in this network which connects different parts of the body. Pain and disease symptoms are thought to arise when Qi is not flowing. Acupuncture treatments are used to promote this flow and balance of Qi to relieve symptoms. It is also known to release pain-relieving or feel-good chemicals in the brain.

Studies in animals and humans have shown that acupuncture can stimulate pain relief and reduce stress, anxiety, and depression. Other studies have shown it can improve sleep, increases blood flow, and may help reduce inflammation, which may also explain pain-relieving effects.

MRI studies show that acupuncture causes changes in the brain that reflect changes in the body. Other studies show that certain acupoints for dry mouth correlate to saliva production. Acupuncture also improves nerve signaling in patients with nerve pain.

Researchers are continuing to examine the mechanisms by which acupuncture exerts these effects. Additional findings may help to optimize treatment regimens in the future.

What are the potential uses and benefits?
  • Cancer treatment symptoms
    Clinical trials support the use of acupuncture to relieve pain, nausea and vomiting, dry mouth, fatigue, hot flashes, and nerve pain resulting from cancer treatments. In some studies, benefits lasted well after treatment.
  • Pain
    Clinical trials demonstrate that acupuncture can help reduce pain, including joint or nerve pain associated with cancer treatments as well as other types of chronic pain.
  • Sleep
    Several trials in cancer patients show that acupuncture improves sleep.
  • Fatigue
    Several trials show that acupuncture reduces fatigue, including cancer-related fatigue.
  • Anxiety
    Several studies show that acupressure and acupuncture can help relieve anxiety related to tests and procedures. It may also help with anxiety in general.
  • Nausea and vomiting
    Acupuncture can reduce chemotherapy-induced nausea and vomiting.
  • Constipation
    Some evidence suggests acupuncture may help relieve constipation.
What are the side effects?

Acupuncture is generally safe when performed by trained practitioners. Some conditions require continuous treatments in order to achieve long-term effects.

Pregnant women, patients who wear pacemakers, and those with lymphedema or low platelet count should inform their practitioners before receiving treatment.

What else do I need to know?

What Is It:

Acupuncture is a therapeutic component of Traditional Chinese Medicine. Treatment involves the use of very thin needles along with heat, pressure, or electricity to stimulate points on the body, promoting the flow and balance of internal energy.

Acupuncture treatment can help reduce

  • Pain
  • Fatigue
  • Hot flashes

It can also help improve

  • Sleep
  • Dry mouth
  • Nausea and vomiting

Cancer guidelines recommend acupuncture as part of management for cancer pain, fatigue, and hot flashes. Further, a newly released guideline from the Society for Integrative Oncology and ASCO recommends acupuncture for aromatase inhibitor–related joint pain, musculoskeletal pain, and general cancer pain.

Cancer patients considering acupuncture should seek certified or state-licensed practitioners who have training or experience in working with cancer patients. Some oncology physicians may also be board-certified acupuncturists.

The Integrative Medicine Service at MSK offers acupuncture and other integrative therapies to support the recovery and wellbeing of cancer patients. In addition, clinical trials continue to evaluate acupuncture for patients with cancer.

Who Can Provide this Service:

Cancer patients considering acupuncture should seek certified or state-licensed practitioners who have training or experience in working with this population. Some oncology physicians may also be board-certified acupuncturists.

Where Can I Get Treatment:

A majority of National Cancer Institute-designated cancer centers offer acupuncture as part of supportive care.

The Integrative Medicine Service at MSK offers acupuncture and other integrative therapies to support the recovery and wellbeing of cancer patients.

Clinical trials continue to evaluate acupuncture for patients with cancer.

For Healthcare Professionals

Clinical Summary

Acupuncture is an integral component of Traditional Chinese Medicine (TCM) that originated over 2,000 years ago. Treatment involves stimulation of predetermined body points using thin needles, sometimes along with heat (moxibustion) or electricity (electroacupuncture) for therapeutic effect.

Acupuncture treatment can help reduce

  • Pain
  • Fatigue
  • Hot flashes

It can also help improve

  • Sleep
  • Xerostomia
  • Nausea and vomiting

Oncology guidelines recommend acupuncture
Current oncology guidelines recommend acupuncture for cancer pain, fatigue, and hot flashes (1) (2). Newly released guidelines from the Society for Integrative Oncology and ASCO recommend acupuncture for aromatase inhibitor–related joint pain, musculoskeletal pain, and general cancer pain (3), and for anxiety (60).

Reductions in pain, fatigue, and other lingering symptoms
Data show that acupuncture helps manage cancer pain (3) (4) (5) (6) (7) (61), including persistent neuropathy (8) (9) (10) (11) (12) (13) and arthralgia (3) (14) (15) (16). Long-term benefits have been shown in patients with aromatase-inhibitor related joint pain (17), and a meta-analysis determined that effects on chronic pain are more than just placebo (18). Acupuncture can also decrease fatigue (19) (20) (21) (61) and pain medication use (22) (23) (24) (61) and improve sleep (25) (26) (27) (61), cognitive function (28), and health-related quality of life (29) (61).

Improvements in other symptoms caused by specific treatments
Acupuncture reduces treatment-related nausea and vomiting (30) (31) (32), hot flashes associated with hormonal therapy (33) (34) (35) (36), and xerostomia from radiotherapy (4) (37) (38) (39) (40) (41). Studies are mixed on whether it can reduce lymphedema (42) (43) or postoperative ileus (44) (45).

Cancer patients considering acupuncture should seek certified or state-licensed practitioners who have training or experience in working with cancer patients. Some oncology physicians may also be board-certified acupuncturists.

The Integrative Medicine Service at MSK offers acupuncture and other integrative therapies to support the recovery and wellbeing of cancer patients. In addition, clinical trials continue to evaluate acupuncture for patients with cancer.

Purported Uses and Benefits
  • Cancer treatment symptoms
  • Pain
  • Neuropathy
  • Fatigue
  • Sleep
  • Anxiety
  • Nausea, vomiting
  • Constipation
Mechanism of Action

According to TCM, acupuncture points are located at specific areas along channels or meridians. Qi (pronounced chee, meaning energy) is believed to flow in this network connecting different parts of the body. Pain and disease symptoms are thought to arise with stagnant Qi, and acupuncture treatments are used to promote Qi flow to relieve symptoms. It is also known to stimulate release of endogenous opioids.

Animal studies suggest acupuncture induces analgesia through different opioid receptors (46), an effect that can be blocked by naloxone (47). Further, mice lacking opiate receptors showed low analgesic effect following electroacupuncture (48).

In humans, an exploratory analysis showed acupuncture significantly increased serum BDNF, the decrease of which is associated with poor sleep (49) . In patients with fibromyalgia, analgesic effects are attributed to increased mu-Opioid receptor binding potential (50). In patients with peripheral neuropathy, it improved nerve conduction (51). fMRI studies show that acupuncture elicits brain changes correlating with neurological effects (52), and that needling of LI-2, one of several acupoints used to treat xerostomia, correlates to saliva production (53). fMRI research also confirms that acupuncture modulates a variety of brain activity including somatosensory, affective, and cognitive processing (54).

In hot flashes, moderators that may determine who benefits more from acupuncture include being carriers of at least 1 of 6 genotypes: ADORA1 rs41264025-GA or rs16851029-GG or rs12744240-GT, COMT rs6269-GA, TCL1A rs2369049-GG, and TRPV1 rs8065080-TT (55).

In a meta-analyses of high-quality acupuncture trials for chronic pain, among 5 patient characteristics – age, sex, pain duration, pain severity, and psychological distress – only baseline pain severity potentially moderated acupuncture treatment effects (56).

Contraindications
  • Neutropenia, thrombocytopenia, or history of endocarditis
    Acupuncture may increase risk of infection and bleeding. Use with caution.
  • Pregnancy
    Pregnant women should inform practitioners before seeking acupuncture treatment.
  • Pacemakers
    Electrical stimulation is contraindicated for patients wearing electronic medical devices.
Adverse Reactions

Acupuncture is generally safe for cancer patients (57) and well tolerated (58) (59). Some conditions require continuous treatments for long-term effects.

Cancer patients considering acupuncture should seek certified or state-licensed practitioners who have training or experience in working with cancer patients. Some oncology physicians may also be board-certified acupuncturists.

Pregnant women, patients who wear pacemakers, and those with lymphedema or low platelet count should inform their practitioners before receiving treatment.

Practitioners and Treatments

Cancer patients considering acupuncture should seek certified or state-licensed practitioners who have training or experience in working with this population. Some oncology physicians may also be board-certified acupuncturists.

A majority of National Cancer Institute-designated cancer centers offer acupuncture as part of supportive care. The Integrative Medicine Service at MSK offers acupuncture and other integrative therapies to support the recovery and wellbeing of cancer patients. In addition, clinical trials continue to evaluate acupuncture for patients with cancer.

Dosage (OneMSK Only)
References
  1. Lyman GH, Greenlee H, Bohlke K, et al. Integrative Therapies During and After Breast Cancer Treatment: ASCO Endorsement of the SIO Clinical Practice Guideline. J Clin Oncol. Sep 1 2018;36(25):2647-2655.
  2. National Comprehensive Cancer Network. NCCN Guidelines: Supportive Care.
  3. Mao JJ, Ismaila N, Bao T, et al. Integrative Medicine for Pain Management in Oncology: Society for Integrative Oncology-ASCO Guideline. J Clin Oncol. Sep 19 2022:Jco2201357.
  4. Pfister DG, Cassileth BR, Deng GE, et al. Acupuncture for pain and dysfunction after neck dissection: results of a randomized controlled trial. J Clin Oncol. May 20 2010;28(15):2565-2570.
  5. Paice JA, Portenoy R, Lacchetti C, et al. Management of Chronic Pain in Survivors of Adult Cancers: American Society of Clinical Oncology Clinical Practice Guideline. J Clin Oncol. Sep 20 2016;34(27):3325-3345.
  6. Mao JJ, Liou KT, Baser RE, et al. Effectiveness of Electroacupuncture or Auricular Acupuncture vs Usual Care for Chronic Musculoskeletal Pain Among Cancer Survivors: The PEACE Randomized Clinical Trial. JAMA Oncol. May 1 2021;7(5):720-727.
  7. Yang M, Liou KT, Garland SN, et al. Acupuncture versus cognitive behavioral therapy for pain among cancer survivors with insomnia: an exploratory analysis of a randomized clinical trial. NPJ Breast Cancer. Nov 30 2021;7(1):148.
  8. Bao T, Goloubeva O, Pelser C, et al. A pilot study of acupuncture in treating bortezomib-induced peripheral neuropathy in patients with multiple myeloma. Integr Cancer Ther. Sep 2014;13(5):396-404.
  9. Bao T, Seidman AD, Piulson L, et al. A phase IIA trial of acupuncture to reduce chemotherapy-induced peripheral neuropathy severity during neoadjuvant or adjuvant weekly paclitaxel chemotherapy in breast cancer patients. Eur J Cancer. Sep 2018;101:12-19.
  10. Zhi WI, Ingram E, Li SQ, et al. Acupuncture for Bortezomib-Induced Peripheral Neuropathy: Not Just for Pain. Integr Cancer Ther. Dec 2018;17(4):1079-1086.
  11. Molassiotis A, Suen LKP, Cheng HL, et al. A Randomized Assessor-Blinded Wait-List-Controlled Trial to Assess the Effectiveness of Acupuncture in the Management of Chemotherapy-Induced Peripheral Neuropathy. Integr Cancer Ther. Jan-Dec 2019;18:1534735419836501.
  12. Bao T, Patil S, Chen C, et al. Effect of Acupuncture vs Sham Procedure on Chemotherapy-Induced Peripheral Neuropathy Symptoms: A Randomized Clinical Trial. JAMA Netw Open. Mar 2 2020;3(3):e200681.
  13. Lu W, Giobbie-Hurder A, Freedman RA, et al. Acupuncture for Chemotherapy-Induced Peripheral Neuropathy in Breast Cancer Survivors: A Randomized Controlled Pilot Trial. Oncologist. Apr 2020;25(4):310-318.
  14. Crew KD, Capodice JL, Greenlee H, et al. Randomized, blinded, sham-controlled trial of acupuncture for the management of aromatase inhibitor-associated joint symptoms in women with early-stage breast cancer. J Clin Oncol. Mar 1 2010;28(7):1154-1160.
  15. Mao JJ, Xie SX, Farrar JT, et al. A randomised trial of electro-acupuncture for arthralgia related to aromatase inhibitor use. Eur J Cancer. Jan 2014;50(2):267-276.
  16. Hershman DL, Unger JM, Greenlee H, et al. Effect of Acupuncture vs Sham Acupuncture or Waitlist Control on Joint Pain Related to Aromatase Inhibitors Among Women With Early-Stage Breast Cancer: A Randomized Clinical Trial. JAMA. Jul 10 2018;320(2):167-176.
  17. Hershman DL, Unger JM, Greenlee H, et al. Comparison of Acupuncture vs Sham Acupuncture or Waiting List Control in the Treatment of Aromatase Inhibitor-Related Joint Pain: A Randomized Clinical Trial. JAMA Netw Open. Nov 1 2022;5(11):e2241720.
  18. Vickers AJ, Vertosick EA, Lewith G, et al. Acupuncture for Chronic Pain: Update of an Individual Patient Data Meta-Analysis. J Pain. May 2018;19(5):455-474.
  19. Molassiotis A, Bardy J, Finnegan-John J, et al. Acupuncture for cancer-related fatigue in patients with breast cancer: a pragmatic randomized controlled trial. J Clin Oncol. Dec 20 2012;30(36):4470-4476.
  20. Mao JJ, Farrar JT, Bruner D, et al. Electroacupuncture for fatigue, sleep, and psychological distress in breast cancer patients with aromatase inhibitor-related arthralgia: a randomized trial. Cancer. Dec 1 2014;120(23):3744-3751.
  21. Cheng CS, Chen LY, Ning ZY, et al. Acupuncture for cancer-related fatigue in lung cancer patients: a randomized, double blind, placebo-controlled pilot trial. Support Care Cancer. Dec 2017;25(12):3807-3814.
  22. Deng G, Giralt S, Chung DJ, et al. Acupuncture for reduction of symptom burden in multiple myeloma patients undergoing autologous hematopoietic stem cell transplantation: a randomized sham-controlled trial. Support Care Cancer. Feb 2018;26(2):657-665.
  23. He Y, Guo X, May BH, et al. Clinical Evidence for Association of Acupuncture and Acupressure With Improved Cancer Pain: A Systematic Review and Meta-Analysis. JAMA Oncol. Feb 1 2020;6(2):271-278.
  24. Deng G, Giralt S, Chung DJ, et al. Reduction of Opioid Use by Acupuncture in Patients Undergoing Hematopoietic Stem Cell Transplantation: Secondary Analysis of a Randomized, Sham-Controlled Trial. Pain Med. Mar 1 2020;21(3):636-642.
  25. Garland SN, Xie SX, Li Q, et al. Comparative effectiveness of electro-acupuncture versus gabapentin for sleep disturbances in breast cancer survivors with hot flashes: a randomized trial. Menopause. May 2017;24(5):517-523.
  26. Garland SN, Xie SX, DuHamel K, et al. Acupuncture Versus Cognitive Behavioral Therapy for Insomnia in Cancer Survivors: A Randomized Clinical Trial. J Natl Cancer Inst. Dec 1 2019;111(12):1323-1331.
  27. Zhang J, Zhang Z, Huang S, et al. Acupuncture for cancer-related insomnia: A systematic review and meta-analysis. Phytomedicine. Jul 20 2022;102:154160.
  28. Liou KT, Root JC, Garland SN, et al. Effects of acupuncture versus cognitive behavioral therapy on cognitive function in cancer survivors with insomnia: A secondary analysis of a randomized clinical trial. Cancer. Jul 1 2020;126(13):3042-3052.
  29. Zhu YJ, Wu XY, Wang W, et al. Acupuncture for Quality of Life in Gastric Cancer Patients Undergoing Adjuvant Chemotherapy. J Pain Symptom Manage. Feb 2022;63(2):210-220.
  30. Rithirangsriroj K, Manchana T, Akkayagorn L. Efficacy of acupuncture in prevention of delayed chemotherapy induced nausea and vomiting in gynecologic cancer patients. Gynecol Oncol. Jan 2015;136(1):82-86.
  31. Lee A, Fan LT. Stimulation of the wrist acupuncture point P6 for preventing postoperative nausea and vomiting. Cochrane Database Syst Rev. Apr 15 2009(2):Cd003281.
  32. Garcia MK, McQuade J, Haddad R, et al. Systematic review of acupuncture in cancer care: a synthesis of the evidence. J Clin Oncol. Mar 1 2013;31(7):952-960.
  33. Walker EM, Rodriguez AI, Kohn B, et al. Acupuncture versus venlafaxine for the management of vasomotor symptoms in patients with hormone receptor-positive breast cancer: a randomized controlled trial. J Clin Oncol. Feb 1 2010;28(4):634-640.
  34. Beer TM, Benavides M, Emmons SL, et al. Acupuncture for hot flashes in patients with prostate cancer. Urology. Nov 2010;76(5):1182-1188.
  35. Mao JJ, Bowman MA, Xie SX, et al. Electroacupuncture Versus Gabapentin for Hot Flashes Among Breast Cancer Survivors: A Randomized Placebo-Controlled Trial. J Clin Oncol. Nov 1 2015;33(31):3615-3620.
  36. Lesi G, Razzini G, Musti MA, et al. Acupuncture As an Integrative Approach for the Treatment of Hot Flashes in Women With Breast Cancer: A Prospective Multicenter Randomized Controlled Trial (AcCliMaT). J Clin Oncol. May 20 2016;34(15):1795-1802.
  37. Meng Z, Garcia MK, Hu C, et al. Randomized controlled trial of acupuncture for prevention of radiation-induced xerostomia among patients with nasopharyngeal carcinoma. Cancer. Jul 1 2012;118(13):3337-3344.
  38. Garcia MK, Chiang JS, Cohen L, et al. Acupuncture for radiation-induced xerostomia in patients with cancer: a pilot study. Head Neck. Oct 2009;31(10):1360-1368.
  39. Wong RK, James JL, Sagar S, et al. Phase 2 results from Radiation Therapy Oncology Group Study 0537: a phase 2/3 study comparing acupuncture-like transcutaneous electrical nerve stimulation versus pilocarpine in treating early radiation-induced xerostomia. Cancer. Sep 1 2012;118(17):4244-4252.
  40. Simcock R, Fallowfield L, Monson K, et al. ARIX: a randomised trial of acupuncture v oral care sessions in patients with chronic xerostomia following treatment of head and neck cancer. Ann Oncol. Mar 2013;24(3):776-783.
  41. 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: A Randomized Clinical Trial. JAMA Netw Open. Dec 2 2019;2(12):e1916910.
  42. Bao T, Iris Zhi W, Vertosick EA, et al. Acupuncture for breast cancer-related lymphedema: a randomized controlled trial. Breast Cancer Res Treat. Jul 2018;170(1):77-87.
  43. Cassileth BR, Van Zee KJ, Yeung KS, et al. Acupuncture in the treatment of upper-limb lymphedema: results of a pilot study. Cancer. Jul 1 2013;119(13):2455-2461.
  44. Deng G, Wong WD, Guillem J, et al. A phase II, randomized, controlled trial of acupuncture for reduction of Postcolectomy Ileus. Ann Surg Oncol. Apr 2013;20(4):1164-1169.
  45. Ng SSM, Leung WW, Mak TWC, et al. Electroacupuncture reduces duration of postoperative ileus after laparoscopic surgery for colorectal cancer. Gastroenterology. Feb 2013;144(2):307-313.e301.
  46. Meng X, Zhang Y, Li A, et al. The effects of opioid receptor antagonists on electroacupuncture-produced anti-allodynia/hyperalgesia in rats with paclitaxel-evoked peripheral neuropathy. Brain Res. Sep 26 2011;1414:58-65.
  47. Pomeranz B, Warma N. Electroacupuncture suppression of a nociceptive reflex is potentiated by two repeated electroacupuncture treatments: the first opioid effect potentiates a second non-opioid effect. Brain Res. Jun 14 1988;452(1-2):232-236.
  48. Peets JM, Pomeranz B. CXBK mice deficient in opiate receptors show poor electroacupuncture analgesia. Nature. Jun 22 1978;273(5664):675-676.
  49. Liou KT, Garland SN, Li QS, et al. Effects of acupuncture versus cognitive behavioral therapy on brain-derived neurotrophic factor in cancer survivors with insomnia: an exploratory analysis. Acupunct Med. Dec 2021;39(6):637-645.
  50. Harris RE, Zubieta JK, Scott DJ, et al. Traditional Chinese acupuncture and placebo (sham) acupuncture are differentiated by their effects on mu-opioid receptors (MORs). Neuroimage. Sep 2009;47(3):1077-1085.
  51. Schröder S, Liepert J, Remppis A, et al. Acupuncture treatment improves nerve conduction in peripheral neuropathy. Eur J Neurol. Mar 2007;14(3):276-281.
  52. Yoo SS, Teh EK, Blinder RA, et al. Modulation of cerebellar activities by acupuncture stimulation: evidence from fMRI study. Neuroimage. Jun 2004;22(2):932-940.
  53. Deng G, Hou BL, Holodny AI, et al. Functional magnetic resonance imaging (fMRI) changes and saliva production associated with acupuncture at LI-2 acupuncture point: a randomized controlled study. BMC Complement Altern Med. Jul 7 2008;8:37.
  54. Huang W, Pach D, Napadow V, et al. Characterizing acupuncture stimuli using brain imaging with FMRI—a systematic review and meta-analysis of the literature. PLoS One. 2012;7(4):e32960.
  55. Romero SAD, Li QS, Orlow I, et al. Genetic predictors to acupuncture response for hot flashes: an exploratory study of breast cancer survivors. Menopause. Aug 2020;27(8):913-917.
  56. Witt CM, Vertosick EA, Foster NE, et al. The Effect of Patient Characteristics on Acupuncture Treatment Outcomes: An Individual Patient Data Meta-Analysis of 20,827 Chronic Pain Patients in Randomized Controlled Trials. Clin J Pain. May 2019;35(5):428-434.
  57. Höxtermann MD, Haller H, Aboudamaah S, et al. Safety of acupuncture in oncology: A systematic review and meta-analysis of randomized controlled trials. Cancer. Jun 1 2022;128(11):2159-2173.
  58. Melchart D, Weidenhammer W, Streng A, et al. Prospective investigation of adverse effects of acupuncture in 97 733 patients. Arch Intern Med. Jan 12 2004;164(1):104-105.
  59. He W, Zhao X, Li Y, et al. Adverse events following acupuncture: a systematic review of the Chinese literature for the years 1956-2010. J Altern Complement Med. Oct 2012;18(10):892-901.
  60. Carlson LE, Ismaila N, Addington EL, et al. Integrative Oncology Care of Symptoms of Anxiety and Depression in Adults With Cancer: Society for Integrative Oncology-ASCO Guideline. J Clin Oncol. 2023 Aug 15:JCO2300857.
  61. Epstein AS, Liou KT, Romero SAD, et al. Acupuncture vs Massage for Pain in Patients Living With Advanced Cancer: The IMPACT Randomized Clinical Trial.  JAMA Netw Open. 2023 Nov 1;6(11):e2342482.
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