Acupuncture for Cancer-Related Pain: An Open Clinical Trial

Background: Among patients with cancer, pain is common and significantly impairs quality of life. The mainstay of treatment, opioids, can increase nausea and fatigue. Acupuncture appears to be efficacious for nonmalignant pain states. Studies of acupuncture for cancer-related pain are mixed, with systematic reviewers calling for further studies. Materials and Methods: Fifty-seven patients receiving treatment at a university oncology center and who had significant pain were seen in an open treatment program. A semistructured acupuncture protocol was designed to target pain, as well as anxiety, depression, fatigue, and nausea. Outcome measures included the Brief Pain Inventory (BPI) as the primary outcome and Edmonton Symptom Assessment System (ESAS) ratings of current symptoms. Patients were offered up to 12 sessions of acupuncture, typically over a 3-month period. Results: Twenty-five patients were considered to be treatment completers, receiving 9 or more sessions of acupuncture, and the analysis examines the response for these patients. Pain severity on the BPI decreased by 32% from baseline to the last session and pain interference decreased by 40%. Current symptoms on the ESAS decreased by similar to 50% for pain, nausea, and fatigue, and by 44% for anxiety. Except for nausea, these change scores were all found to be significant on paired t-tests. Conclusions: This semistructured acupuncture protocol appeared to be effective for reducing cancer-related pain and other symptoms. Further study with a larger sample size, an appropriate control, and adequate follow-up is warranted. It would also be helpful to assess pragmatic outcomes including nausea and pain medication use and hospital admission for pain.