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Acupuncture interventions for cancer related fatigue.

Molassiotis A, Bardy J, Finnegan-John J et al. 2012. Acupuncture for cancer-related fatigue in patients with breast cancer: a pragmatic randomized controlled trial. J Clin Oncol 30:36;4470-4476.

Cancer patients often seek adjuvant care from holistic practitioners, including naturopaths, herbalists and nutritionists. Fatigue is one of the most common side effects of cancer treatments and, indeed, of cancer itself, and is often a presenting concern. Up to 99% of cancer patients are said to experience some level of fatigue during their treatment and this may lead to chronic fatigue. Given conflicting advice and studies, it can sometimes be a challenge for complementary therapists to provide the best evidence-based care. A new study published in the Journal of Clinical Oncology provides some guidance on what may be a less controversial referral for herbalists to make in the multi-modality care of a patient with cancer.

This study was a randomised, multi-centre controlled trial which compared the efficacy of acupuncture vs. usual care for treating breast cancer patients (stage I to stage IIIA) who were suffering with fatigue. 302 patients were enrolled in the study and randomised into two groups on a 1:3 (usual care: acupuncture) basis. The usual care group received a booklet with information about fatigue and its management whilst the acupuncture group received 6 weeks of weekly acupuncture treatment (needling 3 pairs of acupoints). The participants in the intervention arm also received the usual care.

The primary outcome measure was general fatigue at 6 weeks assessed with the multidimensional fatigue inventory (MFI), along with the Hospital Anxiety and Depression Scale and Functional Assessment of Cancer therapy--General Quality-of-Life Scale.

After the intervention period, those who had received acupuncture experienced significantly less fatigue, with the difference in general fatigue score between the groups being -3.11 (95% CI: -3.97 to -2.25; P<0.001). Both mental and physical fatigue were improved, along with all other aspects of fatigue measured on the MFI. There were also significant improvements in secondary outcome measures of anxiety and depression and quality of life. Acupuncture participants rated themselves as having much higher levels of physical, functional, emotional and social function well-being in comparison to the self-rating of those receiving the usual treatment.

The conclusion of study authors was that acupuncture was an effective intervention for managing symptoms of cancer-related fatigue and improving quality of life in those suffering from breast cancer. This makes it an intervention to consider in the multi-modality care of a client suffering from cancer-related fatigue, anxiety or depression, or wishing to improve their quality of life.

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Author:Finney-Brown, Tessa
Publication:Australian Journal of Herbal Medicine
Geographic Code:8AUST
Date:Jun 1, 2013
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