Acupuncture Helps Control Nausea from Breast Cancer Treatment
(dateline December 13, 2000)

A derivation of a Chinese medicine practice that originated 2,000 to 3,000 years ago may help women with breast cancer. According to a recent study, electroacupuncture,
the application of electrical stimulation through traditional acupuncture needles, relieves nausea in breast cancer patients who undergo high-dose chemotherapy. While there is
no scientific evidence that acupuncture should be used to treat breast cancer, this research suggests that it may be a useful complement to traditional medicine in helping
to ease nausea caused by breast cancer treatment.

In the study, reported in the December 6, 2000 issue of the Journal of the American Medical Association, Joannie Shen, MD of the National Institutes of Health in Bethesda,
Maryland, and her colleagues enrolled 104 women who were undergoing high-dose chemotherapy prior to having bone marrow transplants. All of the women received anti-nausea
drugs. In addition, each of the women received either electroacupuncture once a day for five days, "minimal needling" with no electrical stimulation once a day for five
days, or no additional therapy.

Over the five days, Dr. Shen and her colleagues noted that the women who received electroacupuncture experienced significantly fewer episodes of nausea and vomiting
than the women who did not receive any needling. The women who received minimal needling with no electrical stimulation also experienced fewer episodes of nausea and
vomiting than the women who did not receive needling but more episodes of nausea and vomiting than the women who received electroacupuncture.

Summary of Results: Patients Undergoing High-Dose Chemotherapy
Type of therapy to ease side effects Average incidence of nausea/ vomiting
Electroacupuncture Minimal acupuncture needling

No acupuncture needling
5 episodes of nausea and vomiting 10 episodes of nausea and vomiting
15 episodes of nausea and vomiting

According to Dr. Shen and her colleagues, there is a concern among some members of the medical community about drug interactions from certain chemotherapy regimens and
anti-nausea drugs. Since some women cannot take anti-nausea drugs during chemotherapy, complementary therapies such as acupuncture may be helpful to these
women.

Acupuncture involves using needles to stimulate the body's "acupoints" (pressure points). Acupuncture needles are typically inserted just far enough into the body so that
they cannot fall out and are usually left in place for about a half an hour. According to Chinese medicine theory, acupuncture helps restore balance and a healthy energy flow
to the body. Electroacupunture is an enhanced form of acupuncture and involves pplying weak electrical currents to the needles. a 1.

Acupuncture in Medicine June 2000 VOL 18( 1) Page 28
Does Acupuncture Influence the Vasomotor Symptoms Experienced by Breast Cancer Patients Taking Tamoxifen?
Sara M Cumins and A Murray Brunt
This is the abstract of a paper presented at the BMAS Scientific Meeting at Warwick in April 1998 Introduction
Vasomotor symptoms (hot flushes, night sweats, etc) are a significant problem for breast cancer patients taking tamoxifen. We saw excellent improvement in a handful of patients treated with
traditional Chinese medicine (predominantly acupuncture and dietary changes) and therefore decided to investigate whether acupuncture indeed had a role to play in the treatment of vasomotor symptoms
in breast cancer patients taking tamoxifen. The investigation was designed to be in three phases, the first two of which are presented here.

1. Phase 1 is to identify the age groups of patients, their willingness to try acupuncture, and the frequency of symptoms.
2. Phase 2 is to perform a pilot study using acupuncture, and 3. Phase 3 is to hold a randomised, controlled trial of acupuncture for vasomotor symptoms in
breast cancer patients on tamoxifen.

Phase 1 A survey was made of 50 patients attending the oncologist's (AMB) breast cancer follow-up clinics
during May and June 1996. The results of this survey showed that:

. 72% of the patients had vasomotor symptoms; .
87% of those aged 65 and under had symptoms, . compared to 25% of those over 65,

. and 56% of patients with symptoms expressed an interest in receiving acupuncture treatment.

Phase 2 For the pilot study using acupuncture, patients were assessed for vasomotor symptoms at intervals
during treatment. A standard form was used that allowed analysis of symptoms through the recording of three outcome measurements:

i. Severity of symptoms using a 4 point scale ii. Day time and night time frequency of symptoms
iii. Intensity of symptoms using a visual analogue scale

Five acupuncture points were needled bilaterally: LI. 4, LR. 3, PC. 6, ST. 36 and SP. 6. Needles were left in for 10 minutes at the initial session and for 20 minutes at all subsequent treatments. Needling
sensation was sought and achieved at each point. There were 26 patients entered into the study: 4 did not attend for treatment, one did not come for
follow-up, and 19 out of the remaining 21 patients responded satisfactorily to treatment. We demonstrated that acupuncture has a statistically significant effect in reducing the frequency and
intensity of all vasomotor symptoms, with the exception of night sweats, in this group of patients. Conclusion
Acupuncture thus appears to be of benefit to breast cancer patients taking tamoxifen and suffering with vasomotor symptoms. We are in the process of preparing a randomised, controlled trial comparing
acupuncture with drug treatment. 2.

Sara M Cumins Physiotherapy Department
North Staffordshire City General Hospital Email: rich_ sara@ madasafish. com

A Murray Brunt Oncology Department
North Staffordshire Hospital