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What acupuncture is

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 in addition to the original theories.

Western medical acupuncture is a modern interpretation of acupuncture based on scientific research. Treatments are given following a medical diagnosis and 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 are trained in Western medical acupuncture. Other qualified health professionals are also often trained to use acupuncture alongside anticancer treatments.

 

How acupuncture works

Medical research has shown that acupuncture works by stimulating nerves to release substances that can reduce symptoms. The substances can also change some of the bodies functions, such as muscle tension. A number of our own natural morphine like substances (endorphins) are released in the spinal cord and brain to relieve pain. Serotonin is also released by acupuncture. Serotonin is a pain reliever and can promote a feeling of wellbeing.

The ancient theories of Chinese medicine suggest that Qi (a vital force or energy) flows through the body along channels called meridians. Acupuncture can alter this flow to restore or optimise good health.

 

Why people with cancer use acupuncture

People who use acupuncture often say that it helps them to feel relaxed and improves their overall feeling of wellbeing. 

One of the main reasons people with cancer use acupuncture is to help relieve sickness (nausea) caused by chemotherapy or other cancer drugs. Seabands (acubands) are bracelets that apply pressure to acupuncture points on the wrist and can help to reduce sickness due to chemotherapy or following surgery.

Acupuncture is widely available in hospitals, hospices and clinics. People are often referred because they have pain or other symptoms such as 

  • Tiredness and weakness (fatigue)
  • A dry mouth
  • Breathlessness
  • Hot flushes due to anti cancer treatments

Some people find that they feel a greater sense of wellbeing as well as symptom relief. 

 

What acupuncture involves

On your first visit the acupuncture practitioner will ask general questions about your health, lifestyle and medical history. This can include sleep patterns, diet, and how you feel emotionally. They will also ask you about any symptoms you have or side effects of your cancer treatment, and about any medicines you are taking. 

Always tell your practitioner about any health problems that you have or medicines you take. Occasionally, they may need to change an acupuncture treatment due to other treatments or other medical conditions. 

How many treatments you need will vary. You can discuss this with your practitioner before you start your treatment. They may recommend that you have treatments once or twice a week at first. If acupuncture is going to help you, you are likely to see an improvement in about 3 to 6 sessions. If you have a chronic condition, you might need to go back every few weeks for a top up treatment.

Having the treatment

The practitioner puts fine, stainless steel, disposable needles in through your skin. Often, treatment starts with only a few needles but this may change depending on your response and the number of symptoms that you have. The needles shouldn’t cause pain but you might feel a tingling sensation. They are usually left in place for between 10 to 30 minutes. 

The practitioner may gently flick or turn the needles to stimulate them. Or they may attach a very weak electrical current to the needles once they are in. Using the electrical current is called electro acupuncture. 

In some situations the practitioner leaves a special type of very small needle in the skin to give ongoing symptom relief.

Occasionally people are taught a specific type of acupuncture technique they can use themselves at home.

There is a particular type of acupuncture called ear acupuncture, or auricular acupuncture. The practitioner puts needles or small beads (called acupressure beads) onto the outer part of the ear. They may leave them in place for a few days.

 

Research into acupuncture for cancer

There is no evidence to show that acupuncture helps in any way with treating or curing cancer. But research suggests that it is helpful in relieving some symptoms of cancer or the side effects of cancer treatment. The main areas of research into acupuncture for cancer are chemotherapy related sickness, tiredness and cancer pain. 

For any symptom where there is evidence that acupuncture may help, we need to compare it with standard treatment to get an overall view of how it can help alongside current conventional treatment options. Most studies show acupuncture to be better than no treatment and as good as, or better than, current standard treatment. 

Here, you can read about research into acupuncture for symptoms of cancer or the side effects of treatment. 

Acupuncture and pain control

Recent research reviews have shown positive results for acupuncture in controlling pain. However, studies in people with cancer are often small and so it is more difficult to be sure of the results. In 2011 researchers carried out a review of trials looking at using acupuncture to control cancer pain. Due to problems with the trial designs they found that it was not  possible to tell whether acupuncture helped. You can see the review of trials using acupuncture for cancer pain on the Cochrane Library website. A review in 2013 also found that it is not possible to tell whether acupuncture can reduce cancer pain. We need large, well designed studies so that we can find out. 

Joint pain is a common side effect of a type of hormone treatment for breast cancer called aromatase inhibitors, which include anastrozole, exemestane and letrozole. Several small studies have shown that acupuncture can help to reduce joint pain and stiffness caused by these drugs. 

Acupuncture for nausea and vomiting due to chemotherapy

Past and recent research has given us some information about acupuncture and acupressure for nausea and vomiting due to chemotherapy (CINV).

Results from a recent study looking at acupressure to help relieve sickness due to chemotherapy found that overall acupressure did not help. The research team were able to analyse the results of 372 out of the 500 people who took part. Everyone who took part had standard care to relieve sickness. Some people also wore an acupressure wrist band or a dummy wrist band (placebo).

The people who wore a wrist band (acupressure or dummy band) felt less sick than those who didn't wear a wrist band. But the difference between the groups could have happened by chance and was not statistically significant. When looking at how many people had been sick or felt anxious and how they rated their quality of life, the researchers found no difference between the groups. Although the researchers couldn't recommend the use of acupressure wrist bands to help with sickness after chemotherapy, they felt that some people may benefit from them. They recommended looking at this in other trials.

An earlier review of acupuncture trials in 2013 found that acupuncture can help to reduce nausea and vomiting from chemotherapy. 

A UK study in 2007 in Manchester of 36 patients looked at whether acupressure bands (Sea bands) could reduce nausea and vomiting after chemotherapy. Patients in one group wore the wristbands for 5 days. In another group, patients did not wear the wristbands. Both groups took the usual anti sickness medicines. In the group wearing Sea bands patients had significantly less nausea, retching, and distress. A US study in 2007 of 160 women also found that acupressure wrist bands can help to reduce delayed nausea and vomiting due to breast cancer chemotherapy.

A previous review of trials in 2006 seemed to show that electro acupuncture reduced vomiting in the first day after chemotherapy. You can see the 2006 review into acupuncture for nausea and vomiting on the Cochrane Library website. 

Acupuncture for nerve changes due to chemotherapy

Several small studies have looked at acupuncture to try to reduce numbness, tingling and sensation changes in the hands and feet after chemotherapy treatment. These symptoms are known as peripheral neuropathy. Some studies seem to show very positive results but others do not. 

Acupuncture for hot flushes

Hot flushes and sweats are common in people having treatment for breast, prostate or womb cancers. 

A 2005 study was carried out into 194 patients with breast or prostate cancer who had hot flushes due to their treatment. It appeared to show that acupuncture or self acupuncture reduced hot flushes by 50% or more in nearly 8 out of 10 people. Several smaller studies also support this finding, including a Swedish study in 2006 of 38 women having hormone therapy for breast cancer. The study found that as well as reducing the number and intensity of the hot flushes, women who had acupuncture felt better psychologically. 

A 2009 Korean study looked at trials that used acupuncture for hot flushes in women with breast cancer. 6 randomised controlled trials were included in the review. 281 people took part in the trials. They included patients with breast cancer who had needle acupuncture with or without electrical stimulation. The authors of this review felt that the trials failed to show that acupuncture works for the treatment of hot flushes. You can read the report about acupuncture for hot flushes on the Database of abstracts and reviews website. 

A review of acupuncture trials in 2013 also found that there is not enough evidence that it can reduce hot flushes and that more research is needed.

Acupuncture and moxibustion to relieve lymphoedema

Lymphoedema is swelling caused by a build up of lymph fluid in the body. It can be a side effect of surgery or radiotherapy treatment if the lymph nodes that 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 looked at acupuncture and moxibustion for lymphoedema. It was called the AMWELL-SL trial. Acupuncture uses fine sterile needles put just under the skin at particular points (acupuncture points) on the body. In this trial, they did not put the acupuncture needles in the area affected by lymphoedema. Moxibustion uses a dried herb called mugwort which 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 suggest that more research is needed to see how much it could help improve symptoms.

Acupuncture for cancer related tiredness

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. A small UK trial of 47 patients in 2007 looked at acupuncture, acupressure and sham acupuncture (fake acupuncture) for moderate to severe chemotherapy related fatigue. The trial showed that acupuncture and acupressure treatments helped people to feel less tired and reduced physical tiredness. It also improved activity. At the end of the treatments, the acupuncture group had a 36% improvement in fatigue levels, while the acupressure group improved by 19% and the sham acupressure by 0.6%.

The ACU.FATIGUE trial is a big study of 302 patients that reported in 2012. It looked at whether acupuncture can help women with severe tiredness (fatigue) after chemotherapy treatment for breast cancer. The women in the trial had acupuncture carried out by a therapist 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 from the study 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 before they can recommend acupuncture for cancer related tiredness. 

A review of acupuncture trials in 2013 also found that there is not enough evidence that it can reduce tiredness and said that we need more research.

Acupuncture for a dry mouth

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.

Acupuncture for breathlessness

Several small studies have used acupuncture or acupressure for cancer related breathlessness. The results are conflicting. Some studies showed that acupuncture or acupressure can reduce breathlessness and other studies showed no benefit. A review in 2011 stated that there is some evidence that acupuncture may help to relieve breathlessness due to advanced cancer or its treatment. You can read the review into breathlessness and cancer on the CAM-Cancer website. But a review in 2013 said that we really need bigger, good quality trials before we will know for sure whether it can help.

Researchers are currently analysing the results of a trial comparing acupuncture to morphine treatment and a combination of the two treatments for people with breathlessness.

Acupuncture for anxiety and mood changes

6 studies have been carried out into whether acupuncture can help to reduce anxiety or mood changes. A review of studies in 2013 found no evidence that it can help but suggested that we need better designed studies to find out.

Acupuncture for sleep problems

3 studies have been carried out into whether acupuncture can help people with cancer to sleep better. A review of studies in 2013 found that there is currently no evidence that it can help but suggested that we need better designed studies to find out.

Sham acupuncture

Some people think that acupuncture may work because of a placebo effect. The placebo effects means that people have a benefit from the treatment because they believe that it will work. The benefits may also be due to the attention of the therapist, being listened to, or just having the chance to lie down and relax. To try to account for the placebo effect, some studies compare true acupuncture with sham acupuncture. Sham acupuncture uses a special needle that does not actually penetrate the skin. Some studies have shown that the real acupuncture worked better than the sham acupuncture for some symptoms. For others, there was no difference.

 

Possible side effects of acupuncture

Acupuncture performed by professionally qualified practitioners is generally very safe and gives very few side effects. The most common 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 faint or feel dizzy and fainting occurs in about 1 in 100 treatments (1%). This does not usually happen if you lie down to have the treatment.

Very rarely, acupuncture can have a serious side effect, such as a punctured lung or serious infection. These effects are thought to happen in fewer than 1 in 200,000 treatments.

 

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. There are more than 8,000 nurses, GPs, physiotherapists and hospital doctors who have training in acupuncture. In fact 1 in 3 GP surgeries are making acupuncture available to their patients. There are also about 3,500 traditional acupuncturists practicing throughout the UK.

There is information about finding a practitioner further down this page. If you go for private treatment, your first consultation will usually be longer than follow up treatment sessions. Roughly you should expect to pay between £40 and £80 for your first consultation and between £30 and £70 for following treatments. If you have private healthcare it is always worth asking the company if they cover acupuncture, because 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. 

It's important that the person who treats you is properly trained. They should also be experienced in using acupuncture for people with cancer. It is best not to go for treatment at shops on the high street because the practitioners there may not be familiar with treating cancer. Many Chinese medicine practitioners use herbs alongside acupuncture and some of the herbs can interact with cancer treatments and stop them working so well.

The best way to find a reliable acupuncture practitioner in the UK is to

  • Contact one of the acupuncture organisations listed below and ask them for a list of practitioners in your area
  • Check if the organisation has a code of practice and ethics and a disciplinary and complaints procedure – the better complementary organisations do
  • Ask the acupuncturist how many years of training they've had and how long they've been practicing
  • Ask them if they are familiar with treating people with cancer
  • Ask if they have indemnity insurance (in case of negligence)

There is no single professional UK organisation that regulates acupuncture practice. There are several associations but there is no law that says acupuncturists have to join them. Most reputable acupuncturists belong to one of the organisations listed below. These organisations are working together and have made proposals to the Government about legal regulation of acupuncturists. 

 

Acupuncture organisations

There are a number of different organisations that acupuncturists can join. These are listed here, with details of how you can contact them.

British Medical Acupuncture Society (BMAS) – London Office
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
Email: bmaslondon@aol.com
 

British Medical Acupuncture Society (BMAS)
(for medical practitioners who practice acupuncture)
BMAS House
3 Winnington Court
Northwich
Cheshire
CW8 1AQ
Phone: 01606 786 782
Fax: 01606 786 783
Email: bmasadmin@aol.com
Website: www.medical-acupuncture.co.uk
 

Acupuncture Association of Chartered Physiotherapists (AACP)
(for physiotherapists who use acupuncture as part of their treatment)
AACP Limited
Southgate House
Southgate Park
Bakewell Road
Orton Southgate
Peterborough
PE2 6YS
Phone: 01733 390007
Email: sec@aacp.uk.com
Website: www.aacp.uk.com
 

British Academy of Western Medical Acupuncture (BAWMA)
(for nurses, doctors and physiotherapists who use acupuncture)
76 Langdale Road
Bebington
Wirral CH63 3AW
Phone: 0151 3439168
Website: www.bawma.co.uk
 

British Acupuncture Council (BAcC)
(practitioners of traditional acupuncture)
63 Jeddo Road
London W12 9HQ
Tel: 020 8735 0400
Fax: 020 8735 0404
Email: info@acupuncture.org.uk
Website: www.acupuncture.org.uk
 

The Federation of Holistic Therapists (FHT)
18 Shakespeare Business Centre
Hathaway Close
Eastleigh
SO50 4SR
Website: findatherapist.fht.org.uk
Phone: 023 8062 4350
Email: info@fht.org.uk

The Federation of Holistic Therapists 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.

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Updated: 4 February 2015