September 27, 2007 (Barcelona) — Acupuncture does not reduce radiotherapy-induced nausea, concludes a 215-patient trial reported here at the 14th European Cancer Conference. The controlled trial compared acupuncture with a sham procedure and found that both had a similar effect on radiation-induced nausea in patients with various types of cancer, doctoral student Anna Enblom, from Linkoping University, in Sweden, told the meeting. However, she added, “Both groups of patients reported that they believed the treatment had been invasive and effective in reducing nausea.”
There is widespread belief among cancer patients and among healthcare professionals that acupuncture helps to relieve nausea resulting from cancer treatments, Ms. Enblom commented, and also that it helps to relieve pain. She noted that between 2% and 30% of cancer patients have reported using acupuncture for various kinds of symptoms.
“It has proven efficacy in pain related to, for example, osteoarthritis, but the evidence for its effect in cancer patients is lacking,” Ms. Enblom said. “In this study, the question of whether invasive acupuncture is more effective than nonpenetrating placebo needles for the reduction of radiotherapy-related nausea is answered.”
In this study, acupuncture was given 2 to 3 times per week during the whole period of radiotherapy, which is how it is commonly administered. One group of patients had active acupuncture, while the sham group was treated with needles that looked and felt identical, but which retracted into the handle upon contact with skin. The intervention was administered to the forearm.
Patient diary records showed that 68% of patients in the active group experienced nausea for an average of 19 days during radiotherapy, while 61% of patients in the sham group had nausea for an average of 17 days. In addition, 24% of patients in the active group and 28% in the sham group reported vomiting.
A small proportion of the participants, 58/215 patients, received chemotherapy in addition to radiotherapy. Among this small subgroup, 82% in the active group and 80% in the sham group reported nausea.
“There was no statistically significant difference between the groups in the number of days with nausea or vomiting or in the intensity of the nausea, either in the patients receiving radiotherapy alone or in those receiving a combination of chemotherapy and radiotherapy,” Ms. Enblom reported.
“Our study may indicate that attitudes and expectations play a major role in the experience of the effect of treatment.”
Ms. Enblom speculated that the fact that patients were receiving extra attention by participating in a clinical trial might have had a placebo effect. The amount of nausea reported by patients in this trial (in both groups) was about half that seen in previous trials with no intervention, so it appeared that something about participating in the study was reducing the adverse effect.
“This study illustrates how powerful the placebo effect can be,” commented Alexander Eggermont, MD, PhD, from Erasmus University, in Rotterdam, the Netherlands, who was chairing a press conference at which the study was highlighted. “It also shows why it is essential to carry out controlled clinical trials — if it weren’t for the sham arm in this study, we could have compared the results with historical controls and concluded that acupuncture halves the amount of nausea experienced with radiotherapy,” he said, adding, “Unfortunately, that is often what happens with these alternative therapies.”
14th European Cancer Conference: Abstract 1103. Presented September 26, 2007.
Medscape Medical News © 2007 Medscape
Cite this: Zosia Chustecka. Acupuncture Does Not Reduce Radiotherapy-Induced Nausea - Medscape - Sep 27, 2007.