Patients— and Physiotherapists— Belief in and Use of Acupuncture for Cancer-Related Symptoms
Anna Enblom
First Published December 12, 2018 Other Find in PubMed
https://doi.org/10.1136/acupmed-2015-011007
Abstract
Background
It is important to investigate attitudes to acupuncture, because therapists’ and patients’ expectations may affect the treatment outcome.
Aim
To explore the use of and belief in acupuncture among oncological physiotherapists and to explore patients’ interest in receiving acupuncture during cancer therapy and their belief in its effectiveness.
Methods
522 patients (80% female, mean age 67 years) reported on their interest in receiving acupuncture for nausea during radiotherapy treatment; a subgroup (n=198) additionally disclosed their belief in the effectiveness of acupuncture. 117 Swedish oncological physiotherapists (96% female, mean age 48 years) answered a questionnaire regarding their use of and belief in acupuncture.
Results
Of the patients initiating cancer therapy, 359 (69%) were interested in receiving acupuncture. The patients believed acupuncture to be effective for pain (79%), nausea (79%) and vasomotor symptoms (48%). Of the 117 physiotherapists, 66 (56%) practised acupuncture. Physiotherapists generally believed in the effectiveness of acupuncture. For pain, 89% believed that acupuncture was effective and 42% of them practised it. Similar responses were noted for chemotherapy-induced nausea (86% and 38%, respectively) and vasomotor symptoms (80% and 28%, respectively). Younger physiotherapists and patients were more likely to believe in the effectiveness of acupuncture compared with older ones.
Conclusions
More than two thirds of patients with cancer were interested in receiving acupuncture during therapy. Patients and oncological physiotherapists believed that acupuncture was effective for cancer pain, nausea and vasomotor symptoms. Further studies of acupuncture for cancer-related symptoms and of the effect of patients’ and clinicians’ therapeutic relationships, including treatment expectations, would be welcome.
Factors Affecting Whether Or Not Cancer Patients Consider Using Acupuncture https://doi.org/10.1136/acupmed-2016-011115
Volume: 35 issue: 2, page(s): 107-113
Article first published online: April 1, 2017; Issue published: April 1, 2017
Byeongsang Oh, , , Thomas Eade, , Andrew Kneebone, , Nick Pavlakis, , Stephen Clarke, , Guy Eslick, Jo River, Michael Back,
1Northern Sydney Cancer Centre, Royal North Shore Hospital, Sydney, New South Wales, Australia
2Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
3Harvard Medical School, Boston, Massachusetts, USA
4Sydney Nursing School, University of Sydney, Camperdown, New South Wales, Australia
Corresponding Author:
Professor Byeongsang Oh, Sydney Medical School, University of Sydney, Northern Sydney Cancer Centre, Royal North Shore Hospital, NSW 2065, Australia; byeong.oh@sydney.edu.au
Abstract
Objective
To explore the factors associated with utilisation of an acupuncture service in a tertiary oncology setting in an Australian public hospital.
Method
Cancer patients attending oncology clinics at a university teaching hospital were invited to participate in the evaluation of acupuncture services from June 2014 to May 2015. Patients had a prior diagnosis of cancer (albeit at different stages) and were planning to receive, or were already receiving, systemic and/or radiation cancer treatment.
Results
The majority (81%) of participants indicated that they would consider the use of acupuncture during their cancer treatment. The most common reasons given for not considering acupuncture included adequate control of symptoms already with medical treatment, inconvenient clinic timing, and needle phobia. The main reasons given for considering acupuncture use included its perceived capability of reducing fatigue, boosting energy levels, improving immune function, and reducing pain and anxiety. Patients considering acupuncture use also demonstrated significantly higher levels of stress (p<0.001), anxiety and depression (p<0.001), fatigue (p<0.001), and lower global quality of life (p<0.01) compared to those who were not considering acupuncture.
Conclusions
The findings show that demand for acupuncture by cancer patients is high. A substantial proportion of cancer patients intend to use acupuncture to manage cancer and/or cancer treatment-related symptoms. Discussion with patients about acupuncture and other complementary therapies during the consultation may improve cancer care.
Potential role for acupuncture in the treatment of food addiction and obesity
Jason Aaron Chen,1 Justin Albert Chen,2 Sanghoon Lee,3 Gerard Mullin4
1 Department of Medicine, Division of Integrative Medicine, School of Medicine, Johns Hopkins University, Glen Burnie, Maryland, USA 2 Depression Clinical and Research Program, School of Medicine, Massachusetts General Hospital, Harvard University, Boston, Massachusetts, USA 3 Department of Acupuncture and Moxibustion, College of Korean Medicine, Kyung Hee University, Dongdaemun-gu, Seoul, Korea 4 Division of Gastroenterology and Hepatology, Department of Medicine, School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
Correspondence to Dr Jason Aaron Chen, Departments of Medicine and Integrative Medicine, School of Medicine, Johns Hopkins University, Glen Burnie, MD 21218, USA; jason. chen@ alumni. virginia. edu
Accepted 22 October 2017 Published Online First 9 December 2017
Abstract
Addressing the global obesity epidemic requires innovative approaches that are also acceptable to affected individuals. There is growing evidence suggesting that food addiction, one contributor to obesity, bears many similarities to drug and alcohol addiction, presenting a potential role for addiction focused acupuncture as a novel treatment modality. In this perspective article, we begin by briefly reviewing the evidence linking food and drug/alcohol addiction. We then describe the development of an acupuncture-based protocol for treating opioid addiction in Hong Kong in the 1970s and discuss the evidence base for acupuncture’s efficacy in treating a range of substance use disorders. Next, we describe acupuncture’s proposed mechanism of action in attenuating withdrawal and promoting abstinence. Finally, we note the dearth of studies specifically examining the effectiveness of acupuncture in treating food addiction and suggest that more research should focus in this area as part of the effort to combat rising rates of obesity worldwide.
Conclusion
Acupuncture has been shown to be beneficial in the treatment of addictions from clinical observation as well as basic research in animals and humans. While acupuncture has been shown to have a positive impact on the treatment of drug and alcohol addiction, preliminary research has begun to shed light on potential mechanisms for the treatment of food addiction with acupuncture. These include reducing the desire for food by reducing the expression of neuropeptide Y, an appetite-inducing factor in the hypothalamus of food-deprived rats,22 and reducing appetite, decreasing hunger and increasing satiety by decreasing insulin and leptin levels and increasing ghrelin and cholecystokinin.23 Additional mechanisms for the therapeutic benefits of acupuncture in the treatment of food addiction are suggested by experimental models of diabetic rats in which electroacupuncture has been demonstrated to regulate blood glucose levels by increasing insulin sensitivity,5 inducing secretion of beta endorphin24 and stimulating cholinergic nerves.25 Moreover, a recent systematic review showed that acupuncture could be
effective for treating obesity and was more effective than placebo or lifestyle modifications in reducing body weight with similar efficacy as anti-obesity medications with fewer reported adverse effects.26 In conclusion, these are exciting findings because acupuncture is an inexpensive, non-pharmacological intervention that could present a useful adjunct or alternative to traditional pharmacotherapeutic approaches. However, much remains to be learnt. In summary, given the similarity between food addiction and drug and alcohol addiction as well as the clinical benefits of treating addictions with acupuncture, we suggest a potential role for acupuncture for the treatment of food addiction and ultimately obesity. In light of increasing interest in the role of food addictions as a substantial factor contributing to the global obesity epidemic, we propose that further investigation in this area is warranted.
Regulation of the Endoplasmic Reticulum Stress Response and Neuroprotective Effects of Acupuncture on Brain Injury Caused by Heroin Addiction
https://doi.org/10.1136/acupmed-2016-011220
Article Information
Volume: 35 issue: 5, page(s): 366-373
Article first published online: December 12, 2018; Issue published: October 1, 2017
Yong-Long Gao, Yang Zhang, Jiang-Peng Cao, Sheng-Bing Wu, Xing-Hui Cai, Yan-Chun Zhang, Rong-Jun Zhang, Xiao-Ge Song, Li-Da Zhang
1Clinical College of Acupuncture-Moxibustion and Orthopedic, Anhui University of Chinese Medicine, Hefei, Anhui Province, China
2Department of Rehabilitation Medicine, Anhui Provincial Hospital, Hefei, Anhui, China
3Key Laboratory of Xin’ an Medicine Constructed by Anhui Province and Chinese Ministry of Education, Anhui University of Chinese Medicine, Hefei, Anhui Province, China
4College of Pharmacy, Anhui University of Chinese Medicine, Hefei, Anhui Province, China
5Clinical College of Chinese and Western Medicine, Anhui University of Chinese Medicine, Hefei, Anhui Province, China
6Institute of Acupuncture and Meridian, Anhui University of Chinese Medicine, Hefei, Anhui Province, China
Corresponding Author:
Xing-Hui Cai, Clinical College of Acupuncture-Moxibustion and Orthopedic, Anhui University of Chinese Medicine, No. 103 Meishan Road Hefei, Anhui Province 230038, China; zhenjiugushang@126.com
Y-LG and YZ contributed equally.
Abstract
Objectives
To evaluate regulation of the endoplasmic reticulum stress (ERS) response by acupuncture and to investigate its neuroprotective effect on brain injury caused by heroin addiction.
Methods
A total of 48 male Sprague-Dawley rats were randomly divided into a healthy control group (Control), an untreated heroin exposed group (Heroin) and a heroin exposed group receiving electroacupuncture (EA) treatment at GV14 and GV20 (Heroin+acupuncture) with n=16 rats per group. A rat model of heroin addiction was established by intramuscular injection of incremental doses of heroin for 8 consecutive days. A rat model of heroin relapse was established according to the exposure (addiction) → detoxification method. Apoptotic changes in nerve cells in the hippocampus and ventral tegmental area (VTA) were evaluated in each group of rats using terminal deoxynucleotidyl transferase dUTP nick end labelling (TUNEL) assay. PERK, eIF2a, CHOP, IRE1 and JNK gene expression and protein expression were measured using quantitative real-time PCR (RT-qPCR) assay and immunohistochemical assay, respectively.
Results
The total number of positive nerve cells in the hippocampus and VTA was significantly lower in the Heroin+acupuncture group than in the Heroin group (p<0.01). Compared with the Heroin group, mRNA and protein expression of PERK, eIF2a, CHOP, IRE1 and JNK in the hippocampus and VTA were significantly downregulated in the Heroin+acupuncture group (p<0.05).
Conclusion
The acupuncture-regulated ERS response appears to mediate the neuroprotective effect of acupuncture in heroin-addicted rats with brain injury. Inhibition of CHOP and JNK upregulation and reduction of nerve cell apoptosis may be the main mechanisms underlying the effects of acupuncture on heroin addiction-induced brain injury.