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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.

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  • 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.