Cancer Treatment Side Effects & Supportive and Palliative Care
Acupuncture for nausea and vomiting
The effectiveness of acupuncture in the co-management of nausea and vomiting in oncology populations has been widely described in the medical literature. Statistically significant improvements in anti-emesis have been reported by many RCTs involving the use of acupuncture and variations of acupuncture, including acupressure and electrical acupuncture.
For example, a study of chemotherapy-induced emesis showed that electroacupuncture with needling at PC6 (inner wrist) and ST36 (lower leg) points decreased emesis episodes. Statistically significant improvements in anti-emesis have also been reported by other RCTs.
Safety
When delivered by properly trained licensed acupuncturists, acupuncture is a safe practice with a history of very rare adverse events (related to extremely low platelet count, under 20000 per ml).
Recommendation
Acupuncture (and related modalities, such as acupressure and electro-acupuncture) is recommended for the co-management of nausea and vomiting related to chemotherapy in oncology patients.
References - Hide References
- Shen J, Wenger N, Glaspy J, et al. Electroacupuncture for control of myeloablative chemotherapy-induced emesis: A randomized controlled trial. Jama. 2000;284:2755-2761.
- Pearl ML, Fischer M, McCauley DL, Valea FA, Chalas E. Transcutaneous electrical nerve stimulation as an adjunct for controlling chemotherapy-induced nausea and vomiting in gynecologic oncology patients. Cancer Nurs. 1999;22:307-311.
- McMillan C, Dundee JW. The role of transcutaneous electrical stimulation of neiguan anti-emetic acupuncture point in controlling sickness after cancer chemotherapy. Physiotherapy. 1991;77:499-502.
- Streitberger K, Friedrich-Rust M, Bardenheuer H, et al. Effect of acupuncture compared with placebo-acupuncture at P6 as additional antiemetic prophylaxis in high-dose chemotherapy and autologous peripheral blood stem cell transplantation: a randomized controlled single-blind trial. Clin Cancer Res. 2003;9:2538-2544.
- Dundee JW, Ghaly RG, Fitzpatrick KT, Abram WP, Lynch GA. Acupuncture prophylaxis of cancer chemotherapy-induced sickness. J R Soc Med. 1989;82:268-271.
- Dibble SL, Chapman J, Mack KA, Shih AS. Acupressure for nausea: results of a pilot study. Oncol Nurs Forum. 2000;27:41-47.
- Roscoe JA, Morrow GR, Bushunow P, Tian L, Matteson S. Acustimulation wristbands for the relief of chemotherapy-induced nausea. Altern Ther Health Med. 2002;8:56-57, 59-63.
- Treish I, Shord S, Valgus J, et al. Randomized double-blind study of the Reliefband as an adjunct to standard antiemetics in patients receiving moderately-high to highly emetogenic chemotherapy. Support Care Cancer. 2003;11:516-521.
- Roscoe JA, Morrow GR, Hickok JT, et al. The efficacy of acupressure and acustimulation wrist bands for the relief of chemotherapy-induced nausea and vomiting. A University of Rochester Cancer Center Community Clinical Oncology Program multicenter study. J Pain Symptom Manage. 2003;26:731-742.
- Molassiotis A, Helin AM, Dabbour R, Hummerston S. The effects of P6 acupressure in the prophylaxis of chemotherapy-related nausea and vomiting in breast cancer patients. Complement Ther Med. 2007;15:3-12.
- Molassiotis A, Saunders MP, Valle J, et al. A prospective observational study of chemotherapy-related nausea and vomiting in routine practice in a UK cancer centre. Support Care Cancer. 2007.
- McMillan C, Dundee JW, Abram WP. Enhancement of the antiemetic action of ondansetron by transcutaneous electrical stimulation of the P6 antiemetic point, in patients having highly emetic cytotoxic drugs. Br J Cancer. 1991;64:971-972.