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Print Posted on 03/27/2017 in Acupuncture

Acupuncture is effective in relieving cancer-related pain

Acupuncture is effective in relieving cancer-related pain

Systematic review and meta-analysis of acupuncture to reduce cancer-related pain.

Acupuncture is effective in relieving cancer-related pain, particularly malignancy-related and surgery-induced pain. Our findings suggest that acupuncture can be adopted as part of a multimodal approach for reducing cancer-related pain.

Abstract
We conducted a systematic review and meta-analysis to evaluate the effects of acupuncture on malignancy-related, chemotherapy (CT)- or radiation therapy (RT)-induced, surgery-induced, and hormone therapy (HT)-induced pain. Randomised controlled trials (RCTs) examining the effects of acupuncture on cancer-related pain were reached from the EMBASE, PubMed, PsycINFO, Cochrane Central Register of Controlled Trials, CINAHL, Airiti library, Taiwan Electrical Periodical Service, Wanfang Data (a Chinese database) and China Knowledge Resource Integrated Database from inception through June 2014. Heterogeneity, moderator analysis, publication bias and risk of bias associated with the included studies were examined. A total of 29 RCTs yielding 36 effect sizes were included. The overall effect of acupuncture on cancer-related pain was −0.45 [95% confidence interval (CI) = −0.63 to −0.26]. The subanalysis indicated that acupuncture relieved malignancy-related and surgery-induced pain [effect size (g) = −0.71, and −0.40; 95% CI = −0.94 to −0.48, and −0.69 to −0.10] but not CT- or RT-induced and HT-induced pain (g = −0.05, and −0.64, 95% CI = −0.33 to 0.24, and −1.55 to 0.27).

INTRODUCTION
Pain is extremely prevalent in cancer patients and survivors. It is estimated that more than half of cancer patients experience pain while undergoing anticancer treatments or during the metastatic, advanced and terminal stages of the disease (Van Den Beuken-Van Everdingen et al. 2007). Causes of cancer pain include underlying cancers (e.g. bones, soft tissue or visceral metastases) and cancer-related treatments [e.g. chemotherapy (CT)-induced mucositis, surgical removal of tumours, musculoskeletal symptoms from hormone therapy, HT] (Grond et al. 1996; Davis & Parala-Metz 2013). Cancer-related pain substantially impairs the quality of life of patients (Kroenke et al. 2010; Oliveira et al. 2014).

Analgesics remain the mainstay of pain management in patients with cancer-related pain; however, adverse effects associated with analgesics, such as nausea and constipation as well as inadequate use, may result in unsuccessful pain management (Cherny et al. 2001). A previous systematic review revealed that more than 50% of patients are undertreated for their cancer pain (Deandrea et al. 2008), suggesting that alternative treatments for cancer related pain are urgently required.

Chiu H.Y., Hsieh Y.J. & Tsai P.S. (2017) European Journal of Cancer Care 26, e12457, doi: 10.1111/ecc.12457 Systematic review and meta-analysis of acupuncture to reduce cancer-related pain




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