Acupuncture for Cancer Side Effect Management

Who would have thought needles could bring relief?! (well, the Chinese did more than 2000 years ago…) But more recently, acupuncture has gained popularity, with increasing recognition of the power of these small needles in the Western world. Acupuncture is a modality that has limited side effects, minimal interactions with medications, and has promise for improving lives of those undergoing active cancer treatment and post-treatment side-effect management. Here are some of the symptoms/ side-effects that acupuncture has been shown to help with:

Fatigue

Cancer-related fatigue (CRF) can be debilitating emotionally, physically, and cognitively, resulting in a significant decline in quality of life. It is difficult to manage because currently, the availability of medications that can effectively address this symptom is lacking. The use of acupuncture is slowly becoming more popular to address CRF as research builds on this topic. In a meta-analysis that pooled the results of over 1300 individuals, acupuncture has been shown to improve cancer-related fatigue from a variety of cancer types including lung, liver, ovarian, cervical, breast, and pancreatic and in palliative cancer care cases compared to those doing conventional treatment alone. This is so incredibly powerful because it shows that acupuncture consistently improves CRF and ultimately, quality of life.

Menopausal Symptoms

Any sort of hormone therapy (yup, the ER/PR+ or the triple positive tumours) will likely induce some sort of menopausal symptoms, and these symptoms can be distressing and quality-of-life-reducing. Fortunately (and unfortunately), these side effects really demonstrate the power of aromatase inhibitors or SERMs (i.e. tamoxifen). Studies have found that acupuncture significantly reduces the frequencies of hot flashes and the severity of menopause-related symptoms of those taking aromatase inhibitors or tamoxifen. Another study looked at comparing the efficacy of acupuncture for sleep disturbances due to hot flashes and medication (gabapentin) and the results showed that there was no difference between the two groups.

Chemotherapy-induced Peripheral Neuropathy and Nausea/ Vomiting

Peripheral neuropathy refers to a range of symptoms that include tingling, numbness and/or pain at fingers and toes. This is especially common in those who are receiving taxane chemotherapy (i.e. Paclitaxel or Docetaxel). There is currently a lack of adequate management for this symptom and is often the dose-limiting factor – meaning if the peripheral neuropathy gets bad enough, there is no other way to reduce it other than reducing the dose of chemotherapy, which is not ideal in terms of efficacy. Luckily, acupuncture is becoming a more accepted therapy to address these concerns. Two of the biggest benefits of using acupuncture in this setting are that there are no interactions with the chemotherapy and that it works. Studies have shown that acupuncture reduces the incidence of high-grade neuropathy, pain, and improved sensory function for those on taxane chemotherapy. Interestingly, acupressure and auricular (ear) acupuncture has been shown to decrease the frequency and intensity of nausea and vomiting episodes. Since nausea and vomiting are usually well-managed with medication, the application for acupuncture and acupressure should be limited to those who are not adequately managed with medication alone.

Anxiety and Depression

This isn’t necessarily a specific side effect of cancer treatment but these are concerns that are just as important to manage for individuals undergoing cancer treatment and also during survivorship. Emotional and mental health are often under-discussed within the talks of cancer-defeating/ controlling treatments. From a holistic perspective, it is important to address concerns of anxiety and depression throughout the cancer journey. Acupuncture has shown to help reduce general anxiety and mitigate depressive symptoms when performed on a regular basis.

Safety of Acupuncture

In general, acupuncture has few side effects aside from the obvious inserting-a-needle-into-skin aspect of the treatment. Even though there is minimal pain associated with this treatment (because the needles are so thin), some individuals can still be sensitive to the insertion of the needles and cause discomfort and anxiety, especially if there is a fear of needles, to begin with. No one likes getting poked, that is simply a fact of life. Since there are still needles that get inserted into the skin, an obvious side effect is bleeding/ bruising at the insertion site. This poses a caution for anyone who uses anticoagulants (such as warfarin) or anyone with bleeding/clotting disorders. Always talk to your healthcare provider prior to getting treatment.

It is important to emphasize that complementary therapies are meant to be used adjunctively with conventional medication, where available. Acupuncture is a powerful tool and should be utilized to minimize side effects from treatment or cancer itself. 

Dr. Vivian Liang is a naturopathic doctor at Nova Health. She is passionate about the role of naturopathic medicine in integrative cancer care. She is heavily invested in an evidence-based approach to individualized naturopathic care. She has been involved in, co-authored, and presented integrative oncology research throughout her education. She strongly believes in empowering individuals with high-quality evidence to better support their cancer treatment and journey by optimizing quality of life, minimizing side effects from conventional treatments, increase overall survival, and prolong disease-free survival. Dr. Vivian has an open communication policy and believes that as much as she is a doctor, she is also a patient advocate; she strives to improve the individual’s medical experience by communicating with their health care teams.