Acupuncture

What is acupuncture?

In acupuncture, sterile, hair-thin needles are inserted into specific points on the skin, called "acupuncture points," and then gently moved. Researchers propose that acupuncture stimulates the nervous system to release natural painkillers and immune system cells. They then travel to weakened areas of the body and relieve symptoms.

Studies show that acupuncture may:

• help relieve fatigue
• control hot flashes
• help decrease nausea
• reduce vomiting
• lessen pain

Along with practices such as tai chi, acupuncture is a central part of traditional Chinese medicine (TCM), an ancient system of medicine. In Chinese medicine, it is believed that vital energy, called "qi" (pronounced "chee"), flows through 20 pathways, or "meridians," which are connected by acupuncture points. According to TCM, if qi is blocked, the body can't function at its peak. The goal of acupuncture is to open certain points on these pathways and release blocked qi.

What to expect in a typical acupuncture session

At an acupuncture session, you can expect the following:

• The practitioner will ask you questions about your health and lifestyle. At your first acupuncture session, you'll answer questions to let the practitioner know about any medications you're taking, including herbal supplements, and any symptoms you have. Your treatment will be tailored to your individual lifestyle and health issues.
• The practitioner will insert needles into acupuncture points on your skin. Your practitioner will insert needles into the most appropriate acupuncture points for your condition. Acupuncturists use very thin, solid, stainless steel needles, and most people feel slight or no pain as needles are inserted. Needles are only inserted into the top layer of skin and are never inserted directly into any organs. Once the needles are in place, there is no pain.

The effects of acupuncture can feel different from person to person — you may feel relaxed, or you may feel energized. Directly after the first treatment, some people feel slightly disoriented, but this is usually brief. After treatment, avoid activities that require you to be extra alert, such as driving, mowing the lawn, or cooking.

In the days following treatment, symptoms may worsen for a day or two, or you may notice changes in your appetite, sleep, or mood before you begin to feel improvement. If this happens, it lasts only a short while and passes with rest.

Acupuncture practitioner requirements

It's becoming more common for medical doctors, such as anesthesiologists and neurologists, to be trained in acupuncture. There are also numerous accredited training programs in the United States for certified acupuncturists who aren't medical doctors.

• Training requirements for medical doctors: In most states, medical doctors must have 200 to 300 hours of acupuncture training in a program approved by the American Board of Medical Acupuncture (ABMA). For a list of board-certified physicians who practice acupuncture in the United States, visit the ABMA Web site.
• Training requirements for certified acupuncturists who are not medical doctors:
  • Training. In the United States, an acupuncturist should complete between 2,000 and 3,000 hours of training in a master's degree program accredited by the Accreditation Commission for Acupuncture and Oriental Medicine.
  • Certification. For U.S. certification, an acupuncturist must pass board exams given by the National Certification Commission of Acupuncture and Oriental Medicine (NCCAOM). Check the NCCAOM website's searchable practitioner directory to find a certified acupuncturist in your area.

If you've had breast cancer and want to try acupuncture, be sure that your practitioner has treated people with breast cancer.

Research on acupuncture in people with breast cancer and other types of cancer

Much research is being done on how acupuncture can help relieve some of the symptoms of cancer and side effects of cancer treatment. Acupuncture has been shown to help relieve fatigue, hot flashes, nausea, vomiting, and pain.

The most thorough study of acupuncture in breast cancer patients was published in Journal of the American Medical Association in 2000. In the study, 104 women undergoing high-dose chemotherapy were given traditional anti-nausea medication. In addition to taking the medication, the women were randomly chosen to receive 5 days of electroacupuncture (acupuncture in which needles are stimulated with a mild electrical current), acupuncture without an electrical current, or no acupuncture. The women who had acupuncture had significantly fewer nausea episodes than those who didn't.

Another study, completed at Duke University and published in 2002, compared the use of acupuncture to the use of Zofran (chemical name: ondansetron), an anti-nausea medication, before breast cancer surgery to reduce the nausea that can occur after surgery. The acupuncture treatment was found to work better than Zofran at controlling nausea.

In a French study published in 2003, acupuncture was examined in the treatment of cancer-related pain. Patients treated with acupuncture had a 36% reduction in pain after 2 months of acupuncture treatments, compared with a 2% reduction in pain in the patients receiving a placebo type of acupuncture.

In one very preliminary 2004 study at Memorial Sloan-Kettering Cancer Center, acupuncture was shown to reduce post-chemotherapy fatigue by 31% in people with various types of cancer. In 2005, another preliminary study of breast cancer patients in Sweden showed that acupuncture reduced hot flashes by half. While doctors find these results encouraging, they are still very early results and require further study.

Important things to consider before trying acupuncture

Millions of people are treated with acupuncture every year. Still, as with all therapies, acupuncture carries certain risks.

• Risk of lymphedema: Anyone who has had lymph nodes removed from under the arm should not have needles inserted into that arm. If acupuncture is used on an arm, there is a risk of lymphedema, or swelling caused by an excess of fluid in the arm. Talk to the acupuncturist about other treatments that could be used on that arm, such as aromatherapy.
• Risk of infection: It is standard practice to use disposable, single-use, sterile needles and to swab acupuncture areas with alcohol or a similar disinfectant before using needles. Infection is always a risk, but the risk is higher if the acupuncturist does not follow this process. People who have low white blood cell counts are at an increased risk of infection during acupuncture. This is because the low white blood cell count weakens their immune systems.
• Risk of bleeding for certain people: Because of the risk of bleeding, acupuncture should not be received by people who:
  • have bleeding disorders
  • have low white blood cell counts
  • take blood thinners
• Risk of reducing chemotherapy effectiveness because of using herbal supplements: Although acupuncture sometimes incorporates the use of herbal supplements, you should NOT take herbal supplements during a course of chemotherapy. Herbal supplements can reduce the effectiveness of chemotherapy.

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