1. DiGiulio, Sarah

Article Content

For breast cancer survivors, persistent chronic musculoskeletal pain is a common and ongoing problem. Some evidence suggests about 1 in 5 women experience moderate or severe pain as long as 5 years after diagnosis.

acupuncture. acupunc... - Click to enlarge in new windowacupuncture. acupuncture

Acupuncture is one integrative medicine technique that has been found to help reduce chronic musculoskeletal pain in breast cancer survivors. New data presented in a poster presentation at the 2022 San Antonio Breast Cancer Symposium (SABCS) reported multiple types of acupuncture help, including one that can be administered by clinicians without formal acupuncture training.


"Chronic musculoskeletal pain is common and debilitating among breast cancer survivors. We wanted to find out if electroacupuncture and ear acupuncture help reduce pain among those patients," noted Ting Bao, MD, DABMA, MS, Director of Integrative Breast Oncology within the Integrative Medicine and Breast Medicine Services at Memorial Sloan Kettering Cancer Center. "Chronic pain is common among cancer survivors. Integrative medicine approaches such as acupuncture are beneficial to our patients. Clinicians should be aware of these findings."


Study Details

The study was a randomized clinical trial that included 165 breast cancer survivors experiencing chronic musculoskeletal pain for 3 months or greater. The data presented at SABCS was a subgroup analysis; the primary analysis known as the Personalized Electroacupuncture Versus Auricular Acupuncture Comparative Effectiveness (PEACE) trial, showed that both acupuncture methods reduced pain more than usual care in cancer survivors. The primary analysis included survivors of other cancer types, too.


The subgroup analysis focused on breast cancer survivors only and looked at whether electroacupuncture or auricular acupuncture would be more effective to reduce their pain with fewer side effects. Electroacupuncture is a technique of inserting acupuncture needles in specific points in the body with electronic stimulation connected between certain acupoints to obtain a therapeutic effect. Battlefield auricular acupuncture is a specific ear acupuncture protocol. A key difference is that electroacupuncture is body acupuncture, whereas auricular acupuncture is ear acupuncture.


The primary outcome measured was patient-reported pain (primary outcome). Physical functions and co-morbid symptoms (e.g., fatigue, sleep disturbance, anxiety, depression, and post-traumatic stress disorder) were also measured. Patients in the trial received weekly 45-minute acupuncture treatments for 10 weeks.


The data showed that, among the breast cancer survivors, electroacupuncture was more effective than auricular acupuncture when it came to reducing pain severity as reported by the patients. But both acupuncture types similarly improved physical and mental health scores.


The data suggest that patients may want to consider electroacupuncture before auricular acupuncture, but both are valid options, Bao said. A benefit is that auricular acupuncture can be administered by clinicians without formal acupuncture training, and thus may be more accessible to patients.


Non-Pharmacological Approaches

Other integrative medicine doctors say the data is important. "This study expands our evidence base for non-pharmacologic approaches to pain in oncology patients," stated Melinda Ring, MD, Executive Director of the Osher Center for Integrative Health at Northwestern University. "Hopefully work like this will lead to more non-pharmacologic treatment options to improve quality of life for patients.


"The data continues to support the use of acupuncture as a treatment for chronic musculoskeletal pain in cancer survivors, with now some suggestion that electroacupuncture may have benefit over auricular acupuncture. However, benefits were seen with both delivery models, so use of either approach depending on access is reasonable," she said.


Bao noted that both of these types of acupuncture are available to patients and Ring added a few caveats to that point. "Acupuncture is increasingly available in comprehensive cancer centers and in communities," she said. "However, insurance coverage for acupuncture is variable, and it often needs to be supported by philanthropic grants to ensure equitable access to integrative approaches."


Studying how to better implement these pain reduction techniques as part of routine cancer care and make them available to patients is the next step of the team's work, Bao said. "Next, we will conduct dissemination and implementation by leading workshops to share this information and train practitioners to learn the protocol used in this trial."


Sarah DiGiulio is a contributing writer.