MONDAY, Dec. 23, 2013 (HealthDay News) -- When it comes to
easing the side effects of certain breast cancer drugs, acupuncture
may work no better than a "sham" version of the technique, a small
Breast cancer drugs known as aromatase inhibitors often cause
side effects such as muscle and joint pain, as well as hot flashes
and other menopause-like symptoms. And in the new study,
researchers found that women who received either real acupuncture
or a sham variation saw a similar improvement in those side effects
over eight weeks.
"That suggests that any benefit from the real acupuncture sessions resulted from a placebo effect," said Dr. Patricia Ganz, a cancer specialist at the University of California, Los Angeles School of Medicine who was not involved in the study.
The placebo effect, which is seen in treatment studies of all
kinds, refers to the phenomenon where some people on an inactive
"therapy" get better.
However, it's difficult to know what to make of the current
findings, in part because the study was so small, said Ganz, who
studies quality-of-life issues in cancer patients.
"I just don't think you can come to any conclusions," she said.
Practitioners of acupuncture insert thin needles into specific
points in the body to bring about therapeutic effects such as pain
relief. According to traditional Chinese medicine, acupuncture
works by stimulating certain points on the skin believed to affect
the flow of energy, or "qi" (pronounced "chee"), through the
The study, published online Dec. 23 in the journal
Cancer, included 47 women who were on aromatase inhibitors
for early-stage breast cancer. Aromatase inhibitors include the
drugs anastrozole (Arimidex), letrozole (Femara) and exemestane
(Aromasin). They help lower the body's level of estrogen, which
fuels tumor growth in most women with breast cancer.
Half were randomly assigned to a weekly acupuncture session for
eight weeks; the other half had sham acupuncture sessions, which
involved retractable needles.
Overall, women in both groups reported an improvement in certain
drug side effects, such as hot flash severity. But there were no
clear differences between the two groups. And in an earlier study,
the researchers found the same pattern when they focused on the
side effect of muscle and joint pain.
Dr. Ting Bao, who led the study, agreed that "you could conclude
that it's a placebo effect."
On the other hand, it's also difficult to design a placebo
version of acupuncture, said Bao, an assistant professor of
medicine at the University of Maryland School of Medicine in
During the sham procedure, the needles did not penetrate the
skin, and they were placed on areas of the skin that are not
considered traditional acupuncture points. But the stimulation may
have some physiological effect, Bao explained.
"It might not be completely inert," she said.
Many studies have suggested that acupuncture can help ease
various types of pain, such as migraines and back aches, as well as
treat nausea and vomiting from surgery or chemotherapy.
Some recent research suggests that the needle stimulation
triggers the release of pain- and inflammation-fighting chemicals
in the body.
The current study was mainly designed to look at one side effect
from aromatase inhibitors -- muscle and joint pain, which all of
the participants had suffered from since starting the drugs. Bao's
team looked at hot flashes, sleep problems and other menopause-like
symptoms as "secondary outcomes."
That's another limitation, Ganz said, because the study was
simply not set up to test those particular effects. Eleven of the
47 women, for example, had no hot flashes when they entered the
Larger studies are still needed, said Bao. And they should also
include a patient group that receives no acupuncture -- to see
whether the procedure is better than doing nothing.
Still, Bao said that because acupuncture carries a low risk of
side effects, women could give it a shot -- even if any benefits
come from a placebo effect.
"The data are not definitive," she said. "But I think it's OK to explore this as an option because it's low-risk."
There are other options for managing aromatase inhibitor side
effects. For hot flashes, certain antidepressants and the
anti-seizure drug gabapentin are often effective, Ganz said.
For muscle and joint pain, Bao said there's evidence that
exercise helps -- if a woman can manage that. In some cases, the
side effect clears up if a woman switches to a different aromatase
inhibitor, Bao noted.
While acupuncture may be low risk, there is the issue of cost.
Prices vary, but a typical session runs around $100, and insurance
may not cover it.
The American Cancer Society has more on
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