Breast cancer patients experience fewer side effects while being treated with a widely used drug called an aromatase inhibitor when they get acupuncture - either the real treatment or a "sham" procedure, according to a new study led by researchers at the University of Maryland Marlene and Stewart Greenebaum Cancer Center. Their findings are published online in Cancer, a peer-reviewed journal of the American Cancer Society.
"We found that patients with early stage, hormone receptor-positive breast cancer taking an aromatase inhibitor showed significant improvement in some symptoms, especially hot flashes, after eight weekly treatments with real acupuncture or sham acupuncture," says lead author Ting Bao, M.D., D.A.B.M.A, M.S., assistant professor of medicine at the University of Maryland School of Medicine and research scientist at the University of Maryland Greenebaum Cancer Center.
"There was no statistically significant difference between the two interventions," Dr. Bao says. She notes that the study sample of 47 women - 23 who received real acupuncture and 24 who had the sham procedure - may not have been large enough to detect a distinction. In addition, sham acupuncture, which is performed using non-penetrating, retractable needles at non-acupuncture points in the body, may have some unexplained physiological effects. "We are not convinced that sham acupuncture is totally inert," she says.
"Importantly, neither type of acupuncture produced any significant side effects, which is good news for patients," Dr. Bao says.
Up to 60 percent of postmenopausal women with breast cancer who take an aromatase inhibitor, which inhibits an enzyme involved in producing estrogen, experience joint and muscle pain and other side effects, such as hot flashes, anxiety and depression. The study findings may lend support to the use of acupuncture to treat these symptoms.
"If we really want to find something that will help patients, acupuncture is a reasonable alternative to drug therapy, which can produce its own set of side effects," Dr. Bao says. For example, antidepressants used to treat hot flashes can cause side effects such as nausea, constipation, dry mouth and drowsiness.
According to Dr. Bao, the research team did not set out to look at racial differences, but in analyzing the data, found that African-American patients benefited more than non-African-Americans from real acupuncture, compared to sham acupuncture, in reducing the severity and frequency of hot flashes. Researchers plan additional studies to investigate this finding.
The patients enrolled in the study were treated at the University of Maryland Greenebaum Cancer Center and the Johns Hopkins Kimmel Cancer Center. Vered Stearns, M.D., professor of oncology at the Johns Hopkins University School of Medicine and co-director of the breast cancer program at the Kimmel Cancer Center, is the study's senior author.
The research was supported by grants from the American Society of Clinical Oncology, Susan G. Komen for the Cure, the Breast Cancer Research Foundation, the Maryland affiliate of Susan G. Komen and the National Cancer Institute (K12 CA126849, R21 CA173263).
E. Albert Reece, M.D., Ph.D., M.B.A., vice president for medical affairs at the University of Maryland and the John Z. and Akiko K. Bowers Distinguished Professor and Dean of the University of Maryland School of Medicine, says, "Aromatase inhibitors are a very important advance in treating postmenopausal women with estrogen receptor-positive breast cancer, but side effects may cause some patients to stop treatment. This study led by Dr. Bao, an oncologist and medical acupuncturist, offers some intriguing evidence that acupuncture - even sham acupuncture - may be helpful in alleviating some side effects. These findings warrant further investigation."
In February 2013, Dr. Bao and her colleagues reported similar findings in the journal Breast Cancer Research and Treatment in regard to joint and muscle pain associated with treatment with aromatase inhibitors. They found that acupuncture and sham acupuncture improved breast cancer patients' symptoms but saw no statistical difference between the two interventions.
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