Acupuncture is used to treat pain and some other symptoms of cancer and the side effects of treatment.
Acupuncture is a treatment that involves putting fine needles into the body at particular points. The needles are left in place for a short time and then removed. Acupuncture can help with some physical problems such as pain and feeling sick. It can also help to reduce symptoms such as anxiety.
Acupuncture first started in traditional East Asian medicine systems. It became an important part of Chinese medicine about 2000 years ago. But we now know how it works in scientific terms as well.
Western medical acupuncture is a modern interpretation of acupuncture based on scientific research. Treatments are given following a medical diagnosis. They can be used alongside conventional cancer treatments such as cancer drugs or radiotherapy.
Acupuncture is used to treat a wide range of pain conditions and some other symptoms. Many doctors train in Western medical acupuncture. Other qualified health professionals also often train to use acupuncture alongside anticancer treatments.
How it works
Ancient theories of Chinese medicine suggest that a vital force or energy called Qi flows through the body along channels called meridians. Acupuncture alters this flow to restore or optimise good health.
Medical research shows that acupuncture works by stimulating nerves. This releases substances that can reduce cancer symptoms.
It releases some of our own natural morphine like substances (endorphins) in the spinal cord and brain which relieves pain. Serotonin is also released by acupuncture. Serotonin is a pain reliever which can promote a feeling of wellbeing.
Why people with cancer use it
One of the main reasons people with cancer have acupuncture is to relieve sickness caused by chemotherapy or other cancer drugs.
Acupuncture is available in most hospitals, hospices and clinics. People are often referred because they have pain or other symptoms such as:
- tiredness and weakness (fatigue)
- a dry mouth
- hot flushes due to anti cancer treatments
Some people also say that acupuncture helps them feel relaxed and improves their feeling of wellbeing.
What it involves
On your first visit, your practitioner will ask you general questions about your health and lifestyle. This can include how you're sleeping, eating, and feeling both physically and emotionally.
Tell your practitioner about any health problems you have and any medicines you take. Tell them about the cancer symptoms or treatment side effects you have. They might need to change the treatment to suit your specific needs.
Discuss how many treatments you will need before you start having it because it will vary.
Your practitioner might recommend that you have treatments once or twice a week at first.
You might need to go back every few weeks for a top up treatment if you have a chronic condition. You are likely to see an improvement in about 3 to 6 sessions if acupuncture is going to help you.
Having the treatment
The practitioner puts fine, stainless steel, disposable needles in through your skin.
Treatment usually starts with only a few needles. This might change depending on your response and the symptoms that you have.
The needles shouldn’t cause pain but you might feel a tingling sensation. They are left in place for between 10 to 30 minutes.
The practitioner might gently flick or turn the needles to stimulate your nerves. Or, they might attach a very weak electrical current to the needles once they are in. This is called electro acupuncture.
In some situations, the practitioner will leave a special type of very small needle in the skin to give ongoing symptom relief.
For ear (auricular) acupuncture, the practitioner will put needles or small beads (acupressure beads) onto the outer part of the ear. They might leave them in place for a few days.
Sometimes people are taught a specific type of acupuncture technique to use themselves at home.
Possible side effects
Acupuncture is generally safe and gives very few side effects if it is done by a professional and qualified practitioner. The most common side effect is minor bleeding and bruising which occurs in up to 3 in 100 people (3%).
Some people have a temporary short term increase in pain symptoms but this is followed by a decrease in pain.
Sometimes people feel dizzy or faint. Fainting occurs in about 1 in 100 treatments (1%). This does not happen often if you lie down to have the treatment.
Acupuncture can have a serious side effect such as a punctured lung or serious infection. But this is very rare and happens in fewer than 1 in 200,000 treatments.
Research into acupuncture for cancer
There is no evidence to show that acupuncture can help treat or cure cancer. But, research suggests that it can help relieve some cancer symptoms and cancer treatment side effects.
Research into acupuncture for cancer focuses on treating chemotherapy related sickness, tiredness and pain.
Most studies show that acupuncture is better than no treatment at all. And that it is as good as, or better than, standard treatment for these symptoms and side effects.
But, because studies in people with cancer are often small, it is difficult to be completely sure of the results.
Whenever there is evidence that acupuncture might help treat a symptom, we must compare it with standard treatment to understand how it can help alongside conventional treatment.
We need large, well designed studies so that we can learn more.
Recent research reviews show positive results for acupuncture in controlling pain.
Several small studies have shown that acupuncture can help to reduce joint pain and stiffness caused by cancer drugs. Joint pain is a common side effect of aromatase inhibitors. These are a type of hormone treatment for breast cancer.
In 2011 and 2013, researchers reviewed trials that looked into using acupuncture to control cancer pain. They found that it was not possible to tell if acupuncture had definitely helped because of problems with the trial designs.
A recent study found that acupressure does not help relieve sickness due to chemotherapy. The research team were able to analyse the results of 372 out of the 500 people who took part.
Everyone who took part continued having standard care for sickness relief. Some people wore an acupressure or dummy (placebo) wrist band. Acupressure wrist bands (acubands) apply pressure to acupuncture points on the wrist.
Those who wore either type of wrist band felt less sick than those who didn't wear one. But the difference between the groups could be due to chance as the results were not statistically significant.
The researchers found no difference between how either groups rated their quality of life.
The researchers were not able to recommend using acubands to help with sickness after chemotherapy but they felt that some people might benefit from them. They recommended looking at this in other trials.
Other research that has been done includes:
- a 2013 review found that acupuncture can help reduce nausea and vomiting from chemotherapy
- a 2007 UK study of 36 participants found that the people who wore wrist bands had significantly less nausea, retching, and distress compared to the people who didn’t
- a 2007 US study of 160 women found that acupressure wrist bands can help to reduce delayed nausea and vomiting due to breast cancer chemotherapy
- a 2006 review of trials showed that electro acupuncture reduced vomiting in the first day after chemotherapy
Several small studies have looked at using acupuncture to reduce symptoms of peripheral neuropathy. Symptoms include numbness, tingling and sensation changes in the hands and feet after chemotherapy.
Some studies seem to show very positive results but others do not.
The ACUFOCIN trial is looking at acupuncture for people with breast cancer or myeloma and have peripheral neuropathy caused by chemotherapy.
Find out more about the ACUFOCIN trial
Hot flushes and sweats are common in people having treatment for breast, prostate or womb cancers.
- A 2005 study of 194 people with breast or prostate cancer showed that 8 out of 10 people having acupuncture or self acupuncture had half the number of hot flushes
- A very small Swedish study of 38 women in 2006 found that besides reducing the number and intensity of hot flushes, the women also felt better psychologically
- A Korean review of 281 people across 6 trials in 2009 concluded that they failed to prove that acupuncture can control hot flushes
- A 2013 review of acupuncture trials with 281 people found that there is not enough evidence and concluded that we need more research
Lymphoedema is swelling caused by a build up of lymph fluid. It can be a side effect of surgery or radiotherapy treatment if the lymph nodes which usually drain the fluid are removed, or damaged.
Lymphoedema can cause discomfort, pain and difficulty moving. There is no cure for lymphoedema, but treatments can relieve symptoms.
A small trial called the AMWELL-SL trial looked at acupuncture and moxibustion for lymphoedema.
Moxibustion uses a dried herb called mugwort that is rolled into a stick. The moxibustion practitioner holds the glowing end of the lit stick over acupuncture points to warm them.
The trial team found that acupuncture and moxibustion was safe for people with lymphoedema, especially when the needles are not put in the area of lymphoedema.
The people taking part reported some improvement in their symptoms. The team suggested that we need more research.
Tiredness (fatigue) after chemotherapy is a difficult symptom to manage and has a big effect on patient's lives. It can sometimes last for years.
The ACU.FATIGUE trial is a big study of 302 patients from 2012. It looked at whether acupuncture can help women with severe tiredness after chemotherapy treatment for breast cancer.
The women in the trial had acupuncture for 20 minutes, once a week, for 6 weeks. The results showed that it helped to reduce fatigue and improved the women's quality of life.
It is not clear whether this benefit continues in the longer term because the women were only followed up for 18 weeks. The researchers say that we need more research.
Another review of acupuncture trials in 2013 had similar findings and concluded that we need more research.
Acupuncture is widely used for a dry mouth (xerostomia) in people having radiotherapy for head and neck cancers. It is also used for pain and dry mouth after neck surgery and a dry mouth in people with advanced cancer.
Several trials seem to suggest that acupuncture can help.
Several small studies have looked into acupuncture or acupressure for cancer related breathlessness.
A 2011 review found some evidence that acupuncture might help relieve breathlessness due to advanced cancer or its treatment.
Other studies show no benefit.
A 2013 review said that we need bigger, good quality trials before we can know for sure.
Researchers are currently comparing acupuncture, morphine and a combination of the two as a treatment for breathlessness.
6 studies have been carried out to see whether acupuncture can help to reduce anxiety or mood changes. A review of studies in 2013 found no evidence that it can help. It suggested that we need better designed studies to find out.
3 studies have been carried out to see if acupuncture can help people with cancer sleep better. A review of studies in 2013 found that there is currently no evidence that it does but suggested that we need better designed studies to find out.
Some people think that acupuncture works because of a placebo effect. The placebo effect means that people get a benefit from the treatment simply because they believe that it will work.
The benefits might just be due to having the therapist's full attention, the chance to lie down and relax or be listened to.
Some studies compare true acupuncture with sham acupuncture to look into this. Sham acupuncture uses a special needle that does not actually penetrate the skin.
Some studies show that the real acupuncture works better than the sham acupuncture for some symptoms. Others show no difference.
Before having acupuncture
Always check with your doctor before you start using any type of complementary or alternative treatment. Always make sure your acupuncture practitioner knows your full medical and drug history at every visit, especially if anything has changed.
The cost of acupuncture
Most people who have acupuncture have to pay for it themselves. But, acupuncture is being used more and more within the NHS.
You should expect to pay between £40 and £80 for your first consultation if you choose to have private treatment. Your first consultation is usually longer than follow up sessions which you could pay between £30 and £70 for.
If you have private healthcare it is always worth asking the company if they cover acupuncture as some of them do.
Finding an acupuncture practitioner
Acupuncture is widely used in cancer hospitals and clinics, hospices and GP practices, so it is worth asking if it is available to you on the NHS. There are more than 8,000 nurses, GPs, physiotherapists and hospital doctors who have training in acupuncture.
1 in 3 GP surgeries make acupuncture available to their patients. There are also about 3,500 traditional acupuncturists practicing throughout the UK.
It's important that the person who treats you is properly trained. They should be experienced in using acupuncture for people with cancer.
It is best not to go for treatment at shops on the high street. The practitioners there might not be familiar with treating cancer. Many traditional Chinese acupuncturists use herbs alongside acupuncture. Some of the herbs can interact with cancer treatments and stop them from working so well.
The best way to find a reliable acupuncture practitioner in the UK is to contact the British Acupuncture Council. It has high standards for its registered members. It will make sure that you receive treatment from a highly qualified acupuncturist who has undertaken a 3 year BSc honours acupuncture degree.
There are a number of organisations that acupuncturists can join. These are listed here with details of how you can contact them.
Royal London Hospital for Integrated Medicine
(formerly Royal London Homoeopathic Hospital)
60 Great Ormond St
London WC1N 3HR
Tel: 020 7713 9437
Fax: 020 7713 6286
(for physiotherapists who use acupuncture as part of their treatment)
Phone: 01733 390007
(for nurses, doctors and physiotherapists who use acupuncture)
76 Langdale Road
Wirral CH63 3AW
Phone: 0151 3439168
The FHT is the leading professional association for complementary therapists. They have a register of therapists who are qualified, insured, and who follow the FHT strict Code of Conduct and Professional Practice.
18 Shakespeare Business Centre
Phone: 023 8062 4350