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What acupuncture is

Acupuncture treats certain medical conditions by putting fine needles just under the skin at particular points on the body. 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.

Traditional Chinese acupuncture is based on the theory that vital energy called Qi (pronounced chee) circulates around the body along channels called meridians. Blockages in the flow of Qi are thought to cause ill health. Blockages may occur when we are

  • Anxious or stressed
  • Angry
  • Frightened
  • Not eating properly
  • Suffering from an infection
  • In poor health due to illness or disease
  • Exposed to substances that might harm our health

Traditional acupuncture aims to correct the flow of Qi. In traditional Chinese medicine acupuncture is used alongside diet, herbal medicines and other health practices.

Western medical acupuncture is a modern interpretation of acupuncture based on scientific theory. Treatments are given alongside conventional medical treatments and are based on usual medical diagnosis. Acupuncture is used to treat a wide range of conditions, including pain and addiction (for example, smoking). Many medical doctors are trained in acupuncture and some health professionals are also trained to use acupuncture alongside cancer treatment.

 

How acupuncture works

Medical research has shown that acupuncture works by stimulating nerves to release the body’s own natural chemicals. The chemicals help to relieve symptoms. For example, a number of our own natural morphine like substances (endorphins) are released in the spinal cord and brain to relieve pain. Serotonin can be released by acupuncture to help make you feel more relaxed and give a feeling of well being.

Traditional Chinese acupuncturists believe that Qi flows through the body along channels, called meridians. The therapist puts acupuncture needles into certain points along the meridians to free the flow of Qi. This is thought to stimulate the body to heal itself.

 

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. Seabands (acubands) are bracelets that apply pressure to acupuncture points on the wrist and can help to reduce sickness due to chemotherapy or travel.

Acupuncture is used in hospitals, hospices and clinics to relieve pain or other symptoms or to reduce side effects of cancer treatment. Some people like to use it because it helps them to sleep better and feel generally more healthy. It can reduce anxiety, which can also help to reduce pain.

Some people use acupuncture to reduce hot flushes caused by cancer or its treatment.

We have general information about why people with cancer use complementary therapies in our about complementary therapy section.

 

What acupuncture involves

On your first visit the acupuncturist will ask general questions about your health, lifestyle and medical history. This can include sleep patterns, diet, and how you feel emotionally. You will be asked about any symptoms you have or side effects of your cancer treatment, and about any medicines you are taking. A traditional acupuncturist may also look at your tongue and feel your wrists to help them to decide where to put the needles.

Always tell your acupuncturist about any health problems or medicines you take. Acupuncture may not be suitable for you or your acupuncturist may need to avoid certain acupuncture points.

How many treatments you need will vary. Discuss this with your acupuncturist 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 5 to 6 sessions. If you have a chronic condition, you might need to go back every few weeks for a top up treatment.

You have fine, stainless steel needles put into pressure points just below your skin. Most acupuncturists use between 4 and 10 points during a session. They use new, sterile needles for every patient.

The needles shouldn’t cause pain but you might feel a tingling sensation. They are usually left in place for about 20 to 30 minutes. The acupuncturist may turn or flick the needles while they are in place to help the treatment to work.

Many acupuncturists now use a technique called electro acupuncture. They attach a very weak electrical current to the needles once they are in. This small amount of electricity moves the needles so they don’t have to be moved by hand.

There is a particular type of acupuncture called ear acupuncture, or auricular acupuncture, where the needles may be left in place for a few days. Another type of acupuncture called acupressure uses pressure on acupuncture points.

 

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

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. 

A small study has shown that acupuncture can help to reduce joint pain caused by hormone treatment for breast cancer. Joint pain is sometimes a side effect of a type of hormone treatment called aromatase inhibitors, which include anastrozole, exemestane and letrozole.

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

In one study, acupuncture was used to try to reduce numbness, tingling and sensation changes in the hands and feet after chemotherapy treatment. These symptoms are known as peripheral neuropathy. 21 patients had acupuncture therapy according to classical Chinese Medicine, while 26 patients had the best medical care but no specific treatment for peripheral neuropathy. 

In the study 16 patients (76%) in the acupuncture group had an improvement of their symptoms, while only 4 patients in the control group (15%) did so. 3 patients in the acupuncture group (14%) showed no change and 2 patients' symptoms got worse (10%). In the group that had no acupuncture 7 showed no change (27%) and 15 got worse (58%). The researchers suggest that acupuncture can have a positive effect on peripheral neuropathy symptoms.

Acupuncture for hot flushes

A 2005 study of 194 patients with breast or prostate cancer who had hot flushes due to their treatment seemed to show that acupuncture or self acupuncture did reduce the hot flushes. 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 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 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 improve 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

Research has looked acupuncture for 

  • A dry mouth (xerostomia) in people having radiotherapy for head and neck cancers
  • A dry mouth after radiotherapy to the head and neck.
  • Pain and dry mouth after neck surgery
  • A dry mouth in people with advanced cancer

Although some trials seemed to suggest that acupuncture could help, a review of trials in 2013 said that the trials were small and some were at risk of bias. So there is currently no strong evidence that acupuncture can relieve a dry mouth caused by cancer treatment.

Acupuncture for breathlessness

Several 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.

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. For example, the benefits might 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 given by professionally qualified therapists is generally very safe and doesn’t usually have side effects. One large Japanese study showed that of 65,000 people having treatments, very few had any problems. Sometimes people faint or feel dizzy. This is most common with your first treatment. 

It is best not to do anything too energetic straight after a treatment. It is important not to be left alone during treatment and not to drive immediately afterwards. If you carry on feeling dizzy, contact your acupuncturist for advice.

You may have

  • Pain or bleeding at the needle sites but this is rare
  • Bruising around the punctured point

Very rarely, acupuncture can have a serious side effect, such as infection or heart damage. These effects are generally the result of poor practice.

 

Who shouldn’t have acupuncture?

Acupuncture is not recommended if you

  • Have a low number of platelets in your blood because your risk of bleeding is higher
  • Have a low white blood cell count because your risk of infection is higher
  • Have heart valve problems
  • Are pregnant because some acupuncture points can make the womb contract
  • Have lymphoedema because putting needles into areas that have poor lymph drainage increases the risk of infection
  • Wear a pacemaker or have a heart murmur

Always check with your doctor before you start using any type of complementary or alternative treatment. Look in our complementary therapy section for more information about telling your doctor if you are using CAM therapy. Always make sure your acupuncturist 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 7,000 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 5,500 traditional acupuncturists practicing throughout the UK.

There is information about finding an acupuncturist further down this page. If you go for private treatment, your first consultation will usually be longer than normal 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 do.

 

Finding an acupuncturist

Acupuncture is widely used in many cancer hospitals and clinics, hospices and GP practices, so it is worth asking if it is available on the NHS. It's vital that the person who treats you is properly trained. They should also be qualified to use acupuncture for people with cancer. It is best not to go for treatment at acupuncturists on the high street because these practitioners 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 acupuncturist in the UK is to

  • Contact one of the acupuncture organisations listed below and ask them for a list of acupuncturists 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 have treated many people with cancer before
  • Ask if they have indemnity insurance (in case of negligence)

There is no single professional UK organisation that regulates acupuncturists. 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. 

For more information about finding a reliable therapist, and the questions you should ask, look in our complementary therapies section.

 

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.

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
 

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: admin@medical-acupuncture.org.uk
Website: www.medical-acupuncture.co.uk
 

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
 

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: 12 February 2013