ECCO: Acupuncture -- Real or Fake -- Helps Relieve Nausea in Cancer Patients

BARCELONA, Spain, Sept. 27 -- Acupuncture failed to prevent nausea in cancer patients undergoing radiation any better than a sham procedure -- but the vast majority of the patients in both groups thought the needles were effective.
"Both groups of patients reported they believed the treatment has been invasive and effective and they would do it again," Ann Enblom, a physiotherapist and doctoral student at Sweden's Linkoping University, told attendees at the European CanCer Organisation meeting here.
Previous studies have shown that about 63% of patients who undergo cancer radiotherapy suffer from nausea. Compared with that figure, both real and sham acupuncture showed results.
"We found that 37% of our patients who actually had the needles placed in the acupuncture sessions experienced nausea compared with 31% of the patients who had the sham needle procedure," Enblom said, noting that there was no statistically significant difference between those figures.
Enblom and colleagues recruited 237 cancer patients who were undergoing radiation therapy, a procedure that often results in nausea and vomiting that can continue through the course of treatment and beyond. She reported on 110 patients who received acupuncture and 105 patients who received the sham procedure close to, but not at the actual acupuncture site.
The actual acupuncture needles were placed in the wrist, a few centimeters below the palm in the traditional P6 location that Chinese traditional medicine sites as the place the thin needles need to be inserted to prevent nausea.
The sham procedure used a device that causes the needle to retract into the tube once it touches the skin -- much the way trick knives push backwards into the hilt of the knife when someone is "stabbed" on stage. Enblom said almost all the patients receiving the sham procedure thought they had actually been properly needled.
The patients underwent the needling process for 30 minutes two to three times a week for the five-week course of radiotherapy.
The number of days on which patients had nausea did not differ statistically between the groups. Those getting acupuncture had 19 days of nausea during the treatment; those getting the sham treatment had 17 days of nausea.
Similarly, about 28% of the acupuncture patients experienced vomiting during the study period compared with 24% of those getting the sham treatment -- again, a non-significant difference, Enblom reported.
When patients were asked about the treatment:
93% of the actual acupuncture patients reported that they believed the procedure had "moderate" to "much" effectiveness for them.
96% of the sham acupuncture patients reported they believed the procedure had "moderate" to "much" effectiveness for them.
89% of both groups expressed "moderate" to "much" interest in using acupuncture again.

Alexander Eggermont, M.D., Ph.D., Erasmus University Medical School, Rotterdam
"There have been people -- especially in the alternative and complementary medicine field -- who have said these types of well-designed studies can't be done for treatments such as acupuncture," said Alexander Edgemont, M.D., of Erasmus University in Rotterdam, the Netherlands, who acted as moderator at the session. The Swedish study showed that such studies can be accomplished, he said.
While the study clearly shows that acupuncture is no more successful than non-acupuncture in controlling nausea, he noted that the big difference between Enblom's patients and those who have undergone radiation treatment without acupuncture indicates the potent "placebo" effect that can occur in clinical trials.
"I think this study underscores why it is necessary in clinical trials that we have control groups," he said.
"Our study may indicate that attitudes and expectations play a major role in the experience of the effect of the treatment," Enblom said.
A similar study comparing acupuncture, a sham procedure, and conventional treatment for low-back pain was reported in the Sept. 24 issue of Archives of Internal Medicine. That study, too, found sham acupuncture worked just as well as the real thing. (See: Acupuncture Tops Conventional Therapy for Low-Back Pain) Primary source: European Journal of Cancer SupplementsSource reference: S. Borjeson et al, "Invasive acupuncture for radiotherapy-induced nausea and vomiting is not more effective than placebo acupuncture, Abstract P#1103", European Journal of Cancer Supplements, Vol 5 No 4, Page 142