Acupuncture reduces pain in head and neck cancer patients

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June 1, 2008  
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CM NEWS – Acupuncture has been found to significantly reduce pain dysfunction, and dry mouth in head and neck cancer patients after neck dissection.

The study was led by David Pfister, MD, Chief of the Head and Neck Medical Oncology Service, and Barrie Cassileth, PhD, Chief of the Integrative Medicine Service, at Memorial Sloan-Kettering Cancer Centre (MSKCC). Dr Pfister presented the findings at the annual meeting of the American Society for Clinical Oncology.

Neck dissection is a common procedure for treatment of head and neck cancer. There are different types of neck dissection, which vary based on which structures are removed and the anticipated side effects. One type – the radical neck dissection – involves complete removal of lymph nodes from one side of the neck, the muscle that helps turn the head, a major vein, and a nerve that is critical to full range of motion for the arm and shoulder.

“Chronic pain and shoulder mobility problems are common after such surgery, adversely affecting quality of life as well as employability for certain occupations,” said Dr Pfister.

Nerve-sparing and other modified radical techniques that preserve certain structures without compromising disease control reduce the incidence of these problems but do not eliminate them entirely.

Dr Pfister adds, “Unfortunately, available conventional methods of treatment for pain and dysfunction following neck surgery often have limited benefits, leaving much room for improvement.”

Seventy patients participated in the study and were randomized to receive either acupuncture or usual care, which includes recommendations of physical therapy exercises and the use of anti-inflammatory drugs. For all of the patients, at least three months had elapsed since their surgery and radiation treatments. The treatment group received four sessions of acupuncture over the course of approximately four weeks. Both groups were evaluated using the Constant-Murley scale, a composite measure of pain, function, and activities of daily living.

Pain and mobility improved in 39% of the patients receiving acupuncture, compared to a 7% improvement in the group that received usual care. An added benefit of acupuncture was significant reduction of reported xerostomia, or extreme dry mouth. This distressing problem, common among cancer patients following radiotherapy in the head and neck, is addressed with only limited success by mainstream means.

“Like any other treatment, acupuncture does not work for everyone, but it can be extraordinarily helpful for many,” said Dr Cassileth. “It does not treat illness, but acupuncture can control a number of distressing symptoms, such as shortness of breath, anxiety and depression, chronic fatigue, pain, neuropathy, and osteoarthritis.”

Acupuncture for cancer pain

In another study done in Beijing, it was found that acupuncture offered good analgesic effects for patients of late cancer with pain.

In that study by the Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, 66 cases of late cancer with pain were divided into 3 different degrees of pain, mild, moderate and severe. The patients with pain of each same degree were randomly divided into an acupuncture group treated by acupuncture at 3-5 of the most severe tender points, and a medication group treated with oral administration according to the WHO Three Step Administration Principle, i.e. the patients with mild pain took aspirin, moderate pain took codeine and severe pain took morphine.

The results showed that both methods could effectively control cancer pain. The total effective rate of 94.1% in the acupuncture group was significantly better than 87.5% in the medication group. The researchers concluded that the analgesic effect of acupuncture treatment is better than that of the Three Step Administration, with no adverse effect and addiction of analgesics.

[Zhongguo Zhen Jiu. 2008 Apr;28(4):251-3.]

Acupuncture, a component of Traditional Chinese Medicine, originated more than 2,000 years ago. Treatment involves stimulation of one or more predetermined points on the body with needles, heat, pressure, or electricity for therapeutic effect. A report published by the Centres for Disease Control (CDC) indicated that more than 8 million Americans use acupuncture to treat different ailments. Acupuncture is being used in the palliative care of cancer to alleviate pain and chronic fatigue and to reduce postoperative chemotherapy-induced nausea and vomiting.