By: M. Kay Garcia, DrPH, MSN, RN, LAc, Advanced Practice Nurse, Integrative Medicine Program*
It's important to have realistic expectations about acupuncture. People either don't expect it to work at all, or they expect it to be a "magic bullet" and completely resolve all their health problems. Acupuncture isn't a "magic bullet" and certainly doesn't work for everyone. Most people do get some benefit. Some get a lot of benefit with only a few treatments, while others get a little benefit even after multiple treatments.
What should I use acupuncture for?
Acupuncture has been shown to be effective for nausea/vomiting and some types of pain. There also is a growing body of evidence for xerostomia (dry mouth) and hot flashes. Although it may help for other symptoms such as constipation, loss of appetite, fatigue, insomnia, anxiety, depression, peripheral neuropathy and delayed wound healing, not enough rigorous clinical trials have been conducted to draw meaningful conclusions. That being said, as a safe, inexpensive treatment, there's no reason not to try it if you're interested.
So in a nutshell, it's always a good idea to recommend acupuncture when the patient is:
* Experiencing uncontrolled nausea, vomiting or pain.
* Experiencing side effects from treatment or medications.
* Has failed conventional treatment for symptom control.
As a clinician, I often see a synergistic effect when acupuncture is added to a patient's treatment plan. For example, adding it to a comprehensive pain management regimen often allows patients to reduce the amount of medications they're taking and thereby reduce unpleasant or debilitating side effects. Dr. Moshe Frenkel, medical director of our Integrative Medicine Program, always says, "Can't hurt, might help, why not!"
Is it safe?
Acupuncture has been shown to be extremely safe when given by a qualified and licensed acupuncturist. Risks include fainting, mild discomfort, bruising and possible infection. As for the latter two, because these are tiny, solid stainless steel needles, the risk of either bleeding or infection is lower with acupuncture than with venipuncture. Even for patients taking low molecular weight heparins, aspirin or NSAIDS, the risk of excess bleeding with acupuncture is very low.
Why does acupuncture research often show mixed results?
I think there are many reasons. Sometimes it's because of poor study design. Sometimes researchers ask the wrong questions, and sometimes it's because we don't have a clear understanding of how acupuncture works. Recent data from Germany show that although acupuncture points are indeed areas on the skin with reduced bioelectric resistance, this characteristic varies over time; thus, timing of the treatment may be key to its effectiveness. To date, very little research has evaluated this aspect of acupuncture, even though it's an important concept in traditional Chinese medicine theory.
Putative mechanisms of acupuncture are multiple, and although there's certainly a large placebo effect, fMRI and animal studies clearly indicate there's a physiologic response above and beyond placebo. Let's face it, if it works on lab rats, there's something more than the "power of suggestion" at work. In terms of pain, for example, animal studies have shown the effects of acupuncture are reversed with Naloxone, a powerful opioid antagonist. For other symptoms such as xerostomia, mechanisms are a little harder to explain, but studies are under way to explore these questions.
Needless to say, we still have a lot to learn about the mechanisms and efficacy of acupuncture. However, a growing body of evidence indicates that it can be an important adjunct in the care and treatment of cancer patients
NCI on acupuncture
American Cancer Society on acupuncture
Place of ... wellness at M. D. Anderson
* Byline correction made on 08/11/09