Thinking Out Loud - HVC Blog

The journal Oncology Nurse Advisor is a resource dedicated to evidence-based guidance for oncology nurses. Last week they published a nice review of the use of acupuncture for cancer related fatigue. Fatigue is a major side effect of many cancer related treatments. This article by Bette Kaplan is really well referenced from sources including: the Journal Cancer, the National Comprehensive Cancer Network, and BMC Complement Alternative Medicine Journal.

"Fatigue was reduced by 66% among the study participants in the treatment group"

Rather than flat out reporting numbers the author puts this 66% number in context. In this case the treatment included acupuncture and patient education. At Healing Village Collective we believe patient education is essential to all health issues.

It is great to see this information getting to oncology nurses.

This autumn we have seen a lot of skin rashes at Healing Village Collective. Acupuncture and Naturopathic modalities can be highly useful for treating a variety of skin rashes such as psoriasis, shingles, or acne. It was pretty great to find this page devoted to acupuncture and skin conditions over at LIVESTRONG. The page includes this passage:

"According to Dr. Nader Soliman, a specialist in integrated pain medicine and a member of the American Association of Medical Acupuncture, acupuncture may be effective treatment for psoriasis and other skin problems..."

The full interview with Dr. Soliman can be found at this link as well.

Very strange abstract published by the Journal of Cardiopulmonary Rehabilitation and Prevention this week. The research paper titled, Acupuncture as an Adjunct to Pulmonary Rehabilitation looks at a possible role of acupuncture in helping patients with chronic obstructive pulmonary disease (COPD) who undergo pulmonary rehabilitation (PR). It is a pretty fantastic area to research. COPD is typically a fairly serious condition and looking into how acupuncture may help is great.

The published abstract is a bit humorous and curious in its wording.

The Conclusion states [emphasis mine],

"The addition of acupuncture to PR did not add significant benefit in most of the outcomes measured."

There were no benefits to "most" of the outcomes? Were there "some" outcomes that did add a significant benefit?

The Results state [emphasis mine],

"There were no differences in most of the outcome measures between the 2 treatment groups except that subjects who had both acupuncture and PR remained less breathless for a longer period."

"...remained less breathless for a longer period", that means, "experienced less breathlessness", or, "had an easier time breathing for a longer period of time."

The abstract seems to be saying that acupuncture did not help with most of the outcomes being measured; although it did help subjects breathe easier for a longer period of time.

Which seems like a pretty great thing.

To be fair I have not read the full article. I need to get a copy of it from the medical library. It may simply be a poor choice of wording and acupuncture showed no meaningful benefits at all. If the breathlessness mentioned was not statistically significant the result would be meaningless. However it is unusual to mention a benefit in an abstract like this when it is not statistically significant. The way it is written now, the abstract comes across as a backhanded compliment.

The Journal of Fertility & Sterility published a prospective study on the effects of electro-acupuncture on women under going embryo transfers. The study published in the October 2011 issue is titled, "Increase of success rate for women undergoing embryo transfer by transcutaneous electrical acupoint stimulation: a prospective randomized placebo-controlled study".

The study compares live birth rates of three groups of women: receiving acupuncture before before transfers, after transfers, and before and after transfers. The results showed higher pregnancy rates for the group receiving acupuncture both before and after embryo transfers.

"Transcutaneous electrical acupoint stimulation, especially double TEAS, significantly improved the clinical outcome of ET [embryo transfers]."

Generally published abstracts such as this provide more information than this study currently does. I will track down the full paper in the coming weeks.

The British Journal of Medicine published a great study this month titled, "Acupuncture: a treatment for breakthrough pain in cancer?". The study was a review of previously published studies to determine if acupuncture is useful for patients with cancer experiencing breakthrough pain.

The authors, based in the UK, begin with the premise that there has been very little research done about the effectiveness of acupuncture in the area of pain management for people diagnosed with cancer. Although the authors state, "...the available physiological evidence provides a convincing rationale and one which warrants research."

My personal experience working with clients diagnosed with cancer leads me to the same (albeit subjective) conclusion. Acupuncture helps decrease pain in many cancer related situations.

The abstract from the BJM goes on to state that for break through pain

"...[Acupuncture] represents a possible adjunctive treatment, and consideration should be given to administering acupuncture alongside ‘rescue’ doses of medication to ‘kick-start’ the analgesic response before the medication takes effect."

There are a variety of programs around the U.S.A. that work to combine standard cancer care with acupuncture. It is great to see the British Journal of Medicine open to the idea.