Acupuncture may be effective at reducing the hormonal side effects of endocrine therapy in women with breast cancer, according to a recent study published by Lu et al in Cancer.
Background
Although endocrine therapy—which is capable of blocking the hormone signaling that drive some types of breast cancer—can be a life-saving treatment, up to 80% of patients who receive it experience hot flashes and other hormonal side effects. Many patients who experience these side effects discontinue endocrine therapy, thereby increasing their risk of cancer progression and mortality.
Other therapies can reduce hot flashes; however, they come with their own side effects. Previous studies have evaluated the impact of acupuncture on hot flashes in women with early breast cancer undergoing endocrine therapy but have encountered mixed results.
Study Methods and Results
Researchers conducted a coordinated, multinational project consisting of three independent randomized controlled trials in the United States, China, and South Korea. They randomly assigned 158 women with stage 0 to III breast cancer to receive either immediate acupuncture or delayed acupuncture control. Those in the immediate acupuncture group received acupuncture twice weekly for 10 weeks and were followed-up for an additional 10 weeks without acupuncture, whereas those in the delayed acupuncture control group received usual care for 10 weeks followed by acupuncture with a reduced intensity once weekly for 10 weeks. All of the trials used the same eligibility criteria, acupuncture protocol, and study measures. The researchers then used standardized clinical questionnaires to assess hormonal side effects—including hot flashes, night sweats, vaginal dryness, and joint pain—as well as quality of life related to physical well-being, functional well-being, emotional well-being, and social or family well-being.
After 10 weeks from the start of the trials, the researchers found that the questionnaire scores of the patients who received immediate acupuncture reflected significant lessening of their hormonal side effects compared with the scores of the patients who received delayed acupuncture control. The responses indicated that 64% of the patients in the immediate acupuncture group reported improvements in the number and severity of their hot flashes vs 18% among those in the delayed acupuncture control group. The patients who received immediate acupuncture also experienced greater improvements in their quality of life.
Between weeks 10 and 20, the questionnaire scores didn’t change significantly among the patients in the immediate acupuncture group, whereas those in the delayed acupuncture group who received weekly acupuncture experienced improvements in their hormonal side effects scores relative to week 10. The researchers observed no acupuncture-related side effects during the trials.
Conclusions
“By managing side effects, our approach makes it easier for patients to continue their prescribed [therapy], which has the potential to reduce the risk of cancer recurrence and improve long-term outcomes for breast cancer survivors,” underscored lead study author Weidong Lu, MB, MPH, PhD, of the Dana-Farber Cancer Institute. “In practice, patients interested in using acupuncture for this purpose might begin with a short trial period to assess their response to the treatment, particularly in terms of reduction in hot flashes and other [side effects]. If the trial period yields positive results, patients may then engage in a long-term program, receiving regular acupuncture sessions throughout the duration of their antihormonal [therapy] regimen,” he concluded.
Disclosure: For full disclosures of the study authors, visit acsjournals.onlinelibrary.wiley.com.
