Complementary Therapy: Using Acupuncture to Help Treat Side Effects

Jennifer Williams, 51, of Catonsville, Maryland, was diagnosed with stage III breast cancer in October 2017. She was reading about ways to manage the side effects of chemotherapy when a friend recommended acupuncture. Jennifer had heard of acupuncture, the practice of inserting very thin, single-use, sterile needles at specific spots on the body to improve quality of life, but she had never done it before. She did her own research that, along with her friend’s recommendation, convinced her to give it a try.

At first she went once a month and noticed the relaxing treatments helped settle her stomach. After the chemotherapy medicine paclitaxel (Taxol) was added to her treatments, Jennifer started going for acupuncture every two weeks. She hoped it might prevent neuropathy, a nerve problem that causes weakness, pain, swelling or tingling in different parts of the body. It’s a common side effect of paclitaxel. She had been feeling tingling and numbness in her fingertips but it went away. “Whatever they’re doing, I don’t have [neuropathy],” she says.

Acupuncture is one form of complementary and integrative medicine, a collection of therapies used along with conventional treatment to help ease side effects from cancer treatments. More people and medical centers are bringing complementary therapies into cancer care. That’s partly because recent research shows some evidence these therapies help relieve side effects. Studies done in the United States and Europe show that acupuncture can help relieve pain and nausea. And in June 2018 the American Society of Clinical Oncology endorsed guidelines on complementary therapies, like acupuncture, made by the Society for Integrative Oncology.

Acupuncture Then and Now

Acupuncture began in China and has been practiced for thousands of years. It is based on the belief that the body contains a system of paths that a life force called qi (pronounced “chee”) travels through. When this energy is blocked, it’s thought to affect spiritual, emotional, mental and physical health. The paths that qi flows through have openings on your body at certain points called acupoints. By inserting very thin needles into these points, practitioners redirect the flow of qi through the body.

Formal research into the benefits of acupuncture began in the U.S. in the late 1970s. Studies like the recent SWOG 1200 trial, led by Dawn Hershman, MD, MS, show acupuncture can help relieve some side effects. Dr. Hershman is leader of the breast cancer program at the Herbert Irving Comprehensive Cancer Center at New York Presbyterian Hospital/Columbia University Medical Center. The study looked at people suffering from joint pain caused by aromatase inhibitors. It compared rates of pain among three groups: people given real acupuncture; those who got “sham” acupuncture, where needles were inserted at random points on the body; and those who received no acupuncture. After 6 weeks, 60 percent of people in the true acupuncture arm reported a major improvement in their pain. In the sham acupuncture group, 33 percent of people reported the same kind of improvement, as did 31 percent of people with no acupuncture.

Dr. Hershman’s study, and others like it, suggests acupuncture can help people with breast cancer manage side effects. “We have pretty good evidence that acupuncture works,” she says.  Doctors are starting to see that practices like acupuncture and other complementary therapies may help people stay on their treatment. The pain some people experience from aromatase inhibitors stops them from finishing the course of therapy, Dr. Hershman says.

What a Session Is Like

When you first visit an acupuncturist, your provider will ask questions to get a basic medical history, says Jennifer. You’ll sit or lie down to receive the treatment. Your provider then inserts very fine needles into specific points on the body.

After putting in the needles, the acupuncturist may leave you alone for 15 to 30 minutes. Like Jennifer, Carol Sherr, 51, of Lake Worth, Florida, had never had acupuncture before her diagnosis of metastatic HER2-positive breast cancer. Her chiropractor connected her with an acupuncturist who worked with people going through treatment for breast cancer. “Sometimes they put an infrared light on, some music. It’s like going in for a massage without a massage,” Carol says.

After that time is up, the acupuncturist will remove the needles. The needles acupuncturists use are sterile and single-use, so they will be thrown out and not used again on you or anyone else. Your acupuncturist may follow up with you after they take out all the needles to help plan your treatment.

Acupuncture should not be painful, says Lorenzo Cohen, PhD, director of the integrative medicine program and professor at the University of Texas MD Anderson Cancer Center in Houston. Sometimes things can go wrong, though. Carol experienced some pain from needles being used near injured areas or tight muscles. That’s why it’s important to communicate with your acupuncturist, Dr. Cohen says, so they can avoid those places.

There are different types of acupuncture available. Electroacupuncture uses a device to send a very small electric current to the needles as a way of increasing the stimulation. This method is typically used to treat pain or other conditions. People who have electrical medical devices, like a pacemaker, will want to avoid electoacupuncture because it can disrupt their function.

In acupressure, practitioners or the patient use their fingers to place pressure on acupoints to stimulate them. Dr. Cohen says it’s commonly seen as less effective than acupuncture, but if used with anti-nausea medications, it may help reduce nausea and vomiting. Acupressure may be useful for people who can’t get regular acupuncture because of a risk of infection or a fear of needles.

Should I Get Acupuncture?

Acupuncture has very few side effects, Dr. Hershman says, making it safe for most people. People who get acupuncture may get some small bruises, though this is uncommon. The bruises will go away after a few days. People with bleeding disorders may want to avoid acupuncture. And those with weakened immune systems, like people with cancer going through chemotherapy, may be at risk for infections. If you’re having chemotherapy, Dr. Cohen says it’s important to talk to your doctor about getting acupuncture. They can check your white blood cell count and platelet count to see if it’s safe for you. However, acupuncture done by a licensed acupuncturist using sterile, single-use needles is as safe as getting your blood drawn.

Some people may also worry about getting acupuncture after breast cancer surgery because of the needles and the risk of lymphedema. Dr. Cohen says there’s no evidence that acupuncture makes lymphedema more likely to occur and there’s research being done on whether it may help treat lymphedema. Overall, because of the low risk of major side effects, it’s a therapy that’s safe to try and could provide relief to those who need it.

You should have a sense if acupuncture is working for you after about four sessions, usually given over about 2 weeks, Dr. Cohen says. Some people may feel relief right away that fades a few hours or days later. For the best outcomes, a typical course of acupuncture is eight sessions delivered over 4 weeks. Getting regular treatments can help with feeling relief longer.

Acupuncture may not work for everyone. After being diagnosed with metastatic breast cancer in 2014, Meshelle Smith, 58, of Gainesville, Florida, tried acupuncture hoping to find relief for fatigue and sleep problems. “I could not tell any difference,” she says. But even though she didn’t find relief, she doesn’t regret her experience. “Some people do get benefits. It’s one of the main reasons I tried. … It’s not painful, it’s very relaxing.”

Jennifer continues to go to acupuncture, even after finishing chemotherapy, because she finds it relaxing. The expense can be a challenge, though. “If my insurance didn’t cover it, I would have to find a way to pay for it. I don’t want to do without it.”

Some insurance plans cover acupuncture, but not all. Sessions average $60 to $70, with more expensive sessions costing up to $150, Dr. Cohen says. These sessions can be private or in a group. Group sessions tend to be less expensive. It’s important to check with your insurance company and the acupuncturist before you get treatment to make sure it’s covered.

Your cancer center may offer free or no-cost complementary therapies, so check if they offer acupuncture. Dr. Hershman says that it’s important to “[Make] sure patients that want it get it.”

If you’re interested in acupuncture, it’s important to find an experienced acupuncturist to give you the best experience possible. It’s best if they have experience helping people with cancer. You can check if your cancer center has any recommendations, or use the searchable database on the National Certification Commission for Acupuncture and Oriental Medicine’s website to find a certified acupuncturist.