When your wellbeing is affected by head and neck cancer (HNC), dysphasia is a common adverse effect of chemoradiation therapy. Previous reports suggest that complementary wellness techniques, such as acupuncture, may help to provide some relief from dysphasia, but a new study has found this is not the case. The research, which was presented at the 10th International Conference of the Society for Integrative Oncology (SIO), found that active acupuncture provides no more of an improvement to your wellness than sham acupuncture, or a placebo.
The study was presented by lead author Weidong Lu, MB, PhD, MPH, an instructor in the Department of Medicine at Harvard Medical School and a staff acupuncturist at the Zakim Center for Integrative Therapies, Dana-Farber Cancer Institute, in Boston. Lu commented that while some improvements were shown, there wasn’t enough of an improvement for the results to be statistically significant. ‘Acupuncture is a safe intervention, and it is feasible for head and neck cancer patients,’ he said. ‘Improvements were observed in both arms of the study, and more studies are needed to establish the clinical benefit of acupuncture in head and neck cancer.’
The cohort involved 42 patients diagnosed with stage III or IV HNC who had no evidence of distant metastasis and who were receiving curative-intent chemoradiation. For the study, the patients were given 12 sessions of active or sham acupuncture. The sessions were undergone once a fortnight, starting, during and continuing until 20 weeks after chemoradiation. A total of 35 patients (83%) received at least eight sessions of acupuncture, and 28 (67%) received all 12. Lu noted that HNC patients might require more frequent or a longer duration of treatment in order for researchers to more thoroughly investigate the efficacy of acupuncture in this setting. He explained that the biweekly nature of the sessions ‘is among the weaknesses of the study,’ but the researchers needed to make this modification during the recruitment phase of the study because prospective participants ‘did not like needles.’ The researchers changed the timing so that participants would sign up for the study, but Lu asserted that ‘in the next phase, it should be once a week in order to get better results.’
According to Richard Lee, MD, assistant professor of general oncology at the University of Texas M.D. Anderson Cancer Centre in Houston, even though the results of the study were negative, that is not to say that there wasn’t a benefit with acupuncture. Lee explained, ‘It may be the style of acupuncture — manual or electrostimulation — or the point selection. These different factors could modify response. It’s the same with medicines, even within one category; you can have different response rates with different medicines. With acupuncture, everyone is using different points and different techniques, so that can account for the differences that are seen in studies. It may very well be that for dysphasia, there is not a specific effect, but it requires more research to determine whether that really is the case.’
In randomised trials, sham acupuncture is used as a placebo, meaning that the researchers either insert the needles superficially or else they do not penetrate the skin. In theory, this means that the sham acupuncture should not achieve the same impact as active acupuncture, and so the wellness experts are speculating as to why patients who received sham acupuncture showed similar improvement. Lee surmised, ‘With acupuncture, there are “non-specific effects” or placebo effects. I suspect that part of that placebo response is related to the care and attention from the practitioner. That is why you get some response with sham acupuncture.’