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    Acupuncture (PDQ): Complementary and alternative medicine - Patient Information [NCI]

    Acupuncture (PDQ): Complementary and alternative medicine - Patient Information [NCI]

    This information is produced and provided by the National Cancer Institute (NCI). The information in this topic may have changed since it was written. For the most current information, contact the National Cancer Institute via the Internet web site at http://cancer.gov or call 1-800-4-CANCER.

    Acupuncture

    Overview

    • Acupuncture applies needles, heat, pressure, and other treatments to one or more places on the skin known as acupuncture points (see Question 1).
    • Acupuncture has been used in China and other Asian countries for thousands of years as part of traditional Chinese medicine (see Question 2).
    • Acupuncture has been used in the United States for about 200 years (see Question 2).
    • Acupuncture is used to treat many illnesses and ailments and in cancer patients is usually used to relieve pain and other symptoms and improve quality of life. (see Question 2).
    • There is strong evidence from clinical trials that acupuncture relieves nausea and vomiting caused by chemotherapy (see Question 8).
    • Acupuncture may work by causing physical responses in nerve cells, the pituitary gland, and parts of the brain (see Question 4).
    • Laboratory and animal studies of acupuncture for cancer treatment suggest acupuncture can reduce vomiting caused by chemotherapy (see Question 7).
    • Most acupuncture research with cancer patients studies the use of acupuncture to relieve symptoms caused by cancer treatment (see Question 8).
    • It is important that acupuncture treatment be given by a qualified practitioner who uses a new set of disposable (single-use) needles for each patient (see Question 9).

    Questions and Answers About Acupuncture

    What is acupuncture?

    Acupuncture applies needles, heat, pressure, and other treatments to certain places on the skin to cause a change in the physical functions of the body. The use of acupuncture is part of traditional Chinese medicine (TCM). TCM is a medical system that has been used for thousands of years to prevent, diagnose, and treat disease.

    Acupuncture is based on the belief that qi (vital energy) flows through the body along a network of paths, called meridians. Qi is said to affect a person's spiritual, emotional, mental, and physical condition. According to TCM, qi has two forces, yin and yang. Yin and yang are opposite forces that work together to form a whole. The forces of yin and yang depend on each other and are made from each other in an unending cycle, such as hot and cold, day and night, and health and disease. Nothing is ever all yin or all yang, both exist in all things, including people. Many of the major organs of the body are believed to be yin-yang pairs that must be in balance to be healthy. When a person's yin and yang are not in balance, qi can become blocked. Blocked qi causes pain, illness, or other health problems. TCM uses acupuncture, diet, herbal therapy, meditation, physical exercise, and massage to restore health by unblocking qi and correcting the balance of yin and yang within the person.

    Most acupuncturists in the United States practice acupuncture according to the traditions of Chinese medicine. However, there are other types of acupuncture, including some used for medical treatment, that have different theories about meridians and acupoint locations.

    What is the history of the discovery and use of acupuncture as a complementary and alternative treatment for cancer?

    The oldest medical book known, written in China 4000 years ago, describes the use of acupuncture to treat medical problems. The use of the treatment spread to other Asian countries and to other regions of the world, including to Europe by the 1700s. In the United States, acupuncture has been used for about 200 years.

    Research on acupuncture began in the United States in 1976. Twenty years later, the US Food and Drug Administration (FDA) approved the acupuncture needle as a medical device. Many illnesses are treated with acupuncture. In cancer treatment, its main use is to control symptoms, including the following:

    • Pain.
    • Fatigue.
    • Nausea and vomiting caused by chemotherapy.
    • Weight loss.
    • Anxiety.
    • Depression.
    • Insomnia.
    • Poor appetite.
    • Dry mouth.
    • Hot flashes.
    • Nerve problems.
    • Constipation and diarrhea.

    Acupuncture is usually used as an addition to conventional (standard) therapy for cancer patients.

    What is the theory behind the claim that acupuncture is useful in treating cancer?

    According to TCM, qi can be unblocked by using acupuncture at certain places on the skin, called acupoints. Acupoints are places where the meridians come to the surface of the body. There are more than 360 acupoints on the human body, with specific acupoints for each condition being treated.

    What physical effects may acupuncture have when used in cancer patients?

    Acupuncture may cause physical responses in nerve cells, the pituitary gland, and parts of the brain. These responses can cause the body to release proteins, hormones, and brain chemicals that control a number of body functions. It is proposed that, in this way, acupuncture affects blood pressure and body temperature, boosts immune system activity, and causes the body's natural painkillers, such as endorphins, to be released.

    How is acupuncture administered?

    The acupuncture method most well-known uses needles. Disposable, stainless steel needles that are slightly thicker than a human hair are inserted into the skin at acupoints. The acupuncture practitioner determines the correct acupoints to use for the problem being treated. The inserted needles may be twirled, moved up and down at different speeds and depths, heated, or charged with a weak electric current. There are other acupuncture methods that do not use needles.

    Some acupuncture techniques include the following:

    • Electroacupuncture: A procedure in which pulses of weak electrical current are sent through acupuncture needles into acupoints in the skin.
    • Trigger point acupuncture: The placing of acupuncture needles in a place on the skin that is away from the painful part of the body. Trigger points have to do with referred pain, pain that is not felt at the site of injury, but is sent along nerves and felt elsewhere in the body.
    • Laser acupuncture: The use of a weak laser beam instead of an acupuncture needle to stimulate an acupoint.
    • Acupuncture point injection: The use of a syringe and needle to inject drugs, vitamins, herbal extracts, or other fluids into the body at an acupoint.
    • Microwave acupuncture: The use of a microwave device attached to an acupuncture needle to deliver microwave radiation to an acupoint.
    • Acupressure: A type of massage therapy in which the fingers are used to press on an acupoint. In cancer patients, acupressure has been used to control symptoms such as pain or nausea and vomiting.
    • Moxibustion: A type of heat therapy in which an herb is burned above the body to warm a meridian at an acupoint and increase the flow of blood and qi. The herb may be placed directly on the skin, held close to the skin for several minutes, or placed on the tip of an acupuncture needle. Heat lamps may also be used to warm the acupoints.
    • Cupping: A procedure in which a rounded glass cup is warmed and placed upside down over an area of the body, making a vacuum that holds the cup to the skin. Cupping is used to increase the flow of blood and qi. It is believed to open up the skin's pores and allow toxins to leave the body.
    What do patients feel during acupuncture?

    Patients may have a needling feeling during acupuncture, known as de qi sensation, making them feel heaviness, numbness, or tingling.

    Have any preclinical (laboratory or animal) studies been conducted using acupuncture?

    Scientific studies on the use of acupuncture to treat cancer and side effects of cancer began only recently. Laboratory and animal studies suggest that acupuncture can reduce vomiting caused by chemotherapy and may help the immune system be stronger during chemotherapy. Animal studies support the use of electroacupuncture to relieve cancer pain. Laboratory and animal studies have also looked at how acupuncture works for cancer treatment, such as the role of acupuncture in stimulating immune functions, including increasing blood cell count and enhancing lymphocyte and natural killer cell activity.

    Have any clinical trials (research studies with people) of acupuncture been conducted?

    In 1997, the National Institutes of Health (NIH) began evaluating the safety and effectiveness of acupuncture as a complementary and alternative therapy.

    • Studies of the effect of acupuncture on the immune system

      Human studies on the effect of acupuncture on the immune system have been done.

    • Studies of the effect of acupuncture on pain

      In clinical studies, acupuncture reduced the amount of pain in some cancer patients. In one study, most of the patients treated with acupuncture were able to stop taking drugs for pain relief or to take smaller doses. The findings from these studies are not considered strong, however, because of weaknesses in study design and size. Studies using strict scientific methods are needed to prove how acupuncture affects pain.

    • Studies of the effect of acupuncture on muscle and joint pain from aromatase inhibitors

      Aromatase inhibitors, a type of hormone therapy for postmenopausal women who have hormone-dependent breast cancer, may cause muscle and joint pain. A randomized study found that true acupuncture was much more effective in relieving joint pain and stiffness than sham (inactive) acupuncture in patients taking aromatase inhibitors.

    • Studies of the effect of acupuncture on nausea and vomiting caused by cancer therapies

      The strongest evidence of the effect of acupuncture has come from clinical trials on the use of acupuncture to relieve nausea and vomiting. Several types of clinical trials using different acupuncture methods showed acupuncture reduced nausea and vomiting caused by chemotherapy, surgery, and morning sickness. It appears to be more effective in preventing vomiting than in reducing nausea.

      A study of acupuncture, vitamin B6 injections, or both for nausea and vomiting in patients treated with chemotherapy for ovarian cancer found that acupuncture and vitamin B6 together gave more relief from vomiting than acupuncture or vitamin B6 alone.

      A study of acupressure for relief of nausea and vomiting was done in women undergoing chemotherapy. The study found that acupressure applied to an acupuncture point with a wristband helped to decrease nausea and vomiting and reduced the amount of medicine the women used for those symptoms.

      A study of acupuncture for relief of nausea and vomiting was done in patients undergoing radiation therapy. Patients who received either true acupuncture or sham acupuncture were compared to patients who received standard care. The study found that patients in both the true and sham acupuncture groups developed less nausea and vomiting than those in the standard care group.

    • Studies of the effect of acupuncture on hot flashes in patients treated for cancer

      Hormone therapy may cause hot flashes in women with breast cancer and men with prostate cancer. Some studies have shown that acupuncture may be effective in relieving hot flashes in these patients.

    • Study of the effect of acupuncture on fatigue in patients treated for cancer

      Randomized studies of patients with cancer-related fatigue found that those who had a series of acupuncture treatments had less fatigue compared to those who had acupressure, sham acupressure, or information about managing fatigue.

    • Studies of the effect of acupuncture on xerostomia (dry mouth) in patients treated for cancer

      Clinical trials have been done to study the effect of acupuncture in the treatment and prevention of xerostomia (dry mouth) caused by radiation therapy given to patients with nasopharyngeal carcinoma and head and neck cancer.

      Two studies compared acupuncture with standard care for preventing xerostomia in patients being treated with radiation therapy. The studies found that patients treated with acupuncture had fewer symptoms and increased saliva flow.

      Compared to standard care, acupuncture markedly improves xerostomia symptoms in patients who have xerostomia after treatment with radiation therapy.

      A study on the long-term effects of acupuncture on xerostomia found that patients had notable differences in salivary flow at 6 months compared to before treatment. Patients who received additional acupuncture had increased saliva flow at 3 years compared to patients who did not continue acupuncture treatment.

    • Studies of the effect of acupuncture on other symptoms of cancer and side effects of cancer treatment

      The aim of most acupuncture clinical observation and clinical trials in cancer patients has been to study the effects of acupuncture on cancer symptoms and side effects caused by cancer treatment, including weight loss, cough, coughing up blood, anxiety, depression, proctitis, speech problems, blocked esophagus, hiccups, and fluid in the arms or legs. Studies have shown that, for many patients, treatment with acupuncture either relieves symptoms or keeps them from getting worse.

    Have any side effects or risks been reported from acupuncture?

    There have been few complications reported. Problems are caused by using needles that are not sterile (free of germs) and from placing the needle in the wrong place, movement of the patient, or a defect in the needle. Problems include soreness and pain during treatment; feeling tired, lightheaded, or sleepy; and infections. Because chemotherapy and radiation therapy weaken the body's immune system, a strict clean needle method must be used when acupuncture treatment is given to cancer patients. It is important to seek treatment from a qualified acupuncture practitioner who uses a new set of disposable (single-use) needles for each patient.

    Is acupuncture approved by the US Food and Drug Administration (FDA) for use as a cancer treatment in the United States?

    The FDA approved acupuncture needles for use by licensed practitioners in 1996. The FDA requires that sterile, nontoxic needles be used and that they be labeled for single use by qualified practitioners only.

    More than 40 states and the District of Columbia have laws regulating acupuncture practice. The National Certification Commission for Acupuncture and Oriental Medicine (www.nccaom.org) certifies practitioners of acupuncture and traditional Chinese medicine (TCM). Most states require this certification.

    Current Clinical Trials

    Check NCI's list of cancer clinical trials for cancer CAM clinical trials on acupuncture therapy, acupuncture-like transcutaneous electrical nerve stimulation, electroacupuncture therapy and acupressure therapy that are actively enrolling patients.

    General information about clinical trials is available from the NCI Web site.

    Changes to This Summary (06/18/2013)

    The PDQ cancer information summaries are reviewed regularly and updated as new information becomes available. This section describes the latest changes made to this summary as of the date above.

    Changes were made to this summary to match those made to the health professional version.

    About This PDQ Summary

    About PDQ

    Physician Data Query (PDQ) is the National Cancer Institute's (NCI's) comprehensive cancer information database. The PDQ database contains summaries of the latest published information on cancer prevention, detection, genetics, treatment, supportive care, and complementary and alternative medicine. Most summaries come in two versions. The health professional versions have detailed information written in technical language. The patient versions are written in easy-to-understand, nontechnical language. Both versions have cancer information that is accurate and up to date and most versions are also available in Spanish.

    PDQ is a service of the NCI. The NCI is part of the National Institutes of Health (NIH). NIH is the federal government's center of biomedical research. The PDQ summaries are based on an independent review of the medical literature. They are not policy statements of the NCI or the NIH.

    Purpose of This Summary

    This PDQ cancer information summary has current information about the use of acupuncture in the treatment of people with cancer. It is meant to inform and help patients, families, and caregivers. It does not give formal guidelines or recommendations for making decisions about health care.

    Reviewers and Updates

    Editorial Boards write the PDQ cancer information summaries and keep them up to date. These Boards are made up of experts in cancer treatment and other specialties related to cancer. The summaries are reviewed regularly and changes are made when there is new information. The date on each summary ("Date Last Modified") is the date of the most recent change.

    The information in this patient summary was taken from the health professional version, which is reviewed regularly and updated as needed, by the PDQ Cancer Complementary and Alternative Medicine Editorial Board.

    Clinical Trial Information

    A clinical trial is a study to answer a scientific question, such as whether one treatment is better than another. Trials are based on past studies and what has been learned in the laboratory. Each trial answers certain scientific questions in order to find new and better ways to help cancer patients. During treatment clinical trials, information is collected about the effects of a new treatment and how well it works. If a clinical trial shows that a new treatment is better than one currently being used, the new treatment may become "standard." Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment.

    Clinical trials are listed in PDQ and can be found online at NCI's Web site. Many cancer doctors who take part in clinical trials are also listed in PDQ. For more information, call the Cancer Information Service 1-800-4-CANCER (1-800-422-6237).

    Permission to Use This Summary

    PDQ is a registered trademark. The content of PDQ documents can be used freely as text. It cannot be identified as an NCI PDQ cancer information summary unless the whole summary is shown and it is updated regularly. However, a user would be allowed to write a sentence such as "NCI's PDQ cancer information summary about breast cancer prevention states the risks in the following way: [include excerpt from the summary]."

    The best way to cite this PDQ summary is:

    National Cancer Institute: PDQ Acupuncture. Bethesda, MD: National Cancer Institute. Date last modified <MM/DD/YYYY>. Available at: http://www.cancer.gov/cancertopics/pdq/cam/acupuncture/patient. Accessed <MM/DD/YYYY>.

    Images in this summary are used with permission of the author(s), artist, and/or publisher for use in the PDQ summaries only. If you want to use an image from a PDQ summary and you are not using the whole summary, you must get permission from the owner. It cannot be given by the National Cancer Institute. Information about using the images in this summary, along with many other images related to cancer can be found in Visuals Online. Visuals Online is a collection of more than 2,000 scientific images.

    Disclaimer

    The information in these summaries should not be used to make decisions about insurance reimbursement. More information on insurance coverage is available on Cancer.gov on the Coping with Cancer: Financial, Insurance, and Legal Information page.

    Contact Us

    More information about contacting us or receiving help with the Cancer.gov Web site can be found on our Contact Us for Help page. Questions can also be submitted to Cancer.gov through the Web site's Contact Form.

    General CAM Information

    Complementary and alternative medicine (CAM)?also referred to as integrative medicine?includes a broad range of healing philosophies, approaches, and therapies. A therapy is generally called complementary when it is used in addition to conventional treatments; it is often called alternative when it is used instead of conventional treatment. (Conventional treatments are those that are widely accepted and practiced by the mainstream medical community.) Depending on how they are used, some therapies can be considered either complementary or alternative. Complementary and alternative therapies are used in an effort to prevent illness, reduce stress, prevent or reduce side effects and symptoms, or control or cure disease.

    Unlike conventional treatments for cancer, complementary and alternative therapies are often not covered by insurance companies. Patients should check with their insurance provider to find out about coverage for complementary and alternative therapies.

    Cancer patients considering complementary and alternative therapies should discuss this decision with their doctor, nurse, or pharmacist as they would any therapeutic approach, because some complementary and alternative therapies may interfere with their standard treatment or may be harmful when used with conventional treatment.

    Evaluation of CAM Approaches

    It is important that the same rigorous scientific evaluation used to assess conventional approaches be used to evaluate CAM therapies. The National Cancer Institute (NCI) and the National Center for Complementary and Alternative Medicine (NCCAM) are sponsoring a number of clinical trials (research studies) at medical centers to evaluate CAM therapies for cancer.

    Conventional approaches to cancer treatment have generally been studied for safety and effectiveness through a rigorous scientific process that includes clinical trials with large numbers of patients. Less is known about the safety and effectiveness of complementary and alternative methods. Few CAM therapies have undergone rigorous evaluation. A small number of CAM therapies originally considered to be purely alternative approaches are finding a place in cancer treatment?not as cures, but as complementary therapies that may help patients feel better and recover faster. One example is acupuncture. According to a panel of experts at a National Institutes of Health (NIH) Consensus Conference in November 1997, acupuncture has been found to be effective in the management of chemotherapy-associated nausea and vomiting and in controlling pain associated with surgery. In contrast, some approaches, such as the use of laetrile, have been studied and found ineffective or potentially harmful.

    The NCI Best Case Series Program, which was started in 1991, is one way CAM approaches that are being used in practice are being investigated. The program is overseen by the NCI's Office of Cancer Complementary and Alternative Medicine (OCCAM). Health care professionals who offer alternative cancer therapies submit their patients' medical records and related materials to OCCAM. OCCAM conducts a critical review of the materials and develops follow-up research strategies for approaches deemed to warrant NCI-initiated research.

    Questions to Ask Your Health Care Provider About CAM

    When considering complementary and alternative therapies, patients should ask their health care provider the following questions:

    • What side effects can be expected?
    • What are the risks associated with this therapy?
    • Do the known benefits outweigh the risks?
    • What benefits can be expected from this therapy?
    • Will the therapy interfere with conventional treatment?
    • Is this therapy part of a clinical trial?
    • If so, who is sponsoring the trial?
    • Will the therapy be covered by health insurance?

    To Learn More About CAM

    National Center for Complementary and Alternative Medicine (NCCAM)

    The National Center for Complementary and Alternative Medicine (NCCAM) at the National Institutes of Health (NIH) facilitates research and evaluation of complementary and alternative practices, and provides information about a variety of approaches to health professionals and the public.

    NCCAM Clearinghouse
    Post Office Box 7923 Gaithersburg, MD 20898?7923
    Telephone: 1?888?644?6226 (toll free) 301?519?3153 (for International callers)
    TTY (for deaf and hard of hearing callers): 1?866?464?3615
    Fax: 1?866?464?3616
    E-mail: info@nccam.nih.gov
    Web site: http://nccam.nih.gov

    CAM on PubMed

    NCCAM and the NIH National Library of Medicine (NLM) jointly developed CAM on PubMed, a free and easy-to-use search tool for finding CAM-related journal citations. As a subset of the NLM's PubMed bibliographic database, CAM on PubMed features more than 230,000 references and abstracts for CAM-related articles from scientific journals. This database also provides links to the Web sites of over 1,800 journals, allowing users to view full-text articles. (A subscription or other fee may be required to access full-text articles.) CAM on PubMed is available through the NCCAM Web site. It can also be accessed through NLM PubMed bibliographic database by selecting the "Limits" tab and choosing "Complementary Medicine" as a subset.

    Office of Cancer Complementary and Alternative Medicine

    The NCI Office of Cancer Complementary and Alternative Medicine (OCCAM) coordinates the activities of the NCI in the area of complementary and alternative medicine (CAM). OCCAM supports CAM cancer research and provides information about cancer-related CAM to health providers and the general public via the NCI Web site.

    National Cancer Institute (NCI) Cancer Information Service

    U.S. residents may call the NCI Cancer Information Service toll free at 1-800-4-CANCER (1-800-422-6237) Monday through Friday from 8:00 am to 8:00 pm. A trained Cancer Information Specialist is available to answer your questions.

    Food and Drug Administration

    The Food and Drug Administration (FDA) regulates drugs and medical devices to ensure that they are safe and effective.

    Food and Drug Administration
    5600 Fishers Lane
    Rockville, MD 20857
    Telephone: 1?888?463?6332 (toll free)
    Web site: http://www.fda.gov/

    Federal Trade Commission

    The Federal Trade Commission (FTC) enforces consumer protection laws. Publications available from the FTC include:

    • Who Cares: Sources of Information About Health Care Products and Services
    • Fraudulent Health Claims: Don't Be Fooled
    Consumer Response Center
    Federal Trade Commission
    CRC-240
    Washington, DC 20580
    Telephone: 1-877-FTC-HELP (1-877-382-4357) (toll free)
    TTY (for deaf and hearing impaired callers): 202-326-2502
    Web site: http://www.ftc.gov/

    Last Revised: 2013-06-18


    If you want to know more about cancer and how it is treated, or if you wish to know about clinical trials for your type of cancer, you can call the NCI's Cancer Information Service at 1-800-422-6237, toll free. A trained information specialist can talk with you and answer your questions.


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