Written by Karen Pilkington, Edzard Ernst and the CAM-Cancer Consortium.
Updated August 13, 2015

Acupuncture in cancer pain

Does it work ?

Systematic reviews

Several systematic reviews of acupuncture in cancer pain have been published; results of the most recent and most reliable reviews published since 2011 are summarised here.

A Cochrane review in 2011 identified 3 RCTs with a total of 204 participants.10 One study comparing auricular acupuncture with auricular acupuncture at 'placebo' points and with non-invasive vaccaria ear seeds (Semen vaccariae) attached at 'placebo' points was assessed to be of high quality. Participants in the true acupuncture group reported lower pain scores at two months than those in the other groups but there was a question over whether blinding was maintained, which may have biased the results. Of the remaining two studies, one compared acupuncture with medication and the other compared acupuncture with medication and with point-injection. Both reported positive results favouring acupuncture but the reliability of the results is uncertain due to methodological limitations, small sample sizes, poor reporting and inadequate analysis.

A 2012 systematic review included 15 RCTs with a total of 1,157 participants.11 Most used TCM-based acupuncture. Two used non-penetrating sham acupuncture as the control and 12 compared acupuncture against conventional medication while one compared acupuncture with chemotherapy or radiotherapy. Interventions and types of cancer varied. Few details of the methods were reported leading to the trials being assessed as at high risk of bias. Most trials reported positive results including better effects with a combination of acupuncture and medication compared with medication alone but the quality and quantity of evidence was too low for this to be confirmed.

Two systematic reviews examined the evidence on acupuncture for a range of symptoms in cancer patients. The first, on palliative care in cancer patients, did not find any more recent studies on pain than those in the previous reviews.12 The second review13 identified a total of 11 RCTs, including two more recent trials not included in the above reviews. The first trial of acupuncture versus sham acupuncture for aromatase-inhibitor-associated joint pain reported positive results but the study was of high risk of bias. The second trial compared acupuncture with usual care in 58 patients with chronic pain or dysfunction attributed to neck dissection. It reported positive results for neck pain and function as well as xerostomia but again was of high risk of bias.

Narrative reviews

Other recent reviews on this subject arrived at similar conclusions regarding lack of conclusive evidence.14,15

Randomised controlled trials

One RCT in 2013 compared electroacupuncture with a sham control in 60 patients with pancreatic cancer pain.16 A statistically significant difference in pain reduction was reported after 3 treatments and the methods appear rigorous although allocation concealment could not be assessed.  

Several trials have been published on the use of acupuncture after procedures undergone by cancer patients e.g. post-operatively or post-procedure, but no further trials specifically on cancer pain have been identified.

Collectively, the evidence to suggest that acupuncture is effective in reducing cancer pain is not conclusive.

Citation Karen Pilkington, Edzard Ernst, CAM-Cancer Consortium. Acupuncture for cancer pain [online document]. http://ws.cam-cancer.org/The-Summaries/Mind-body-interventions/Acupuncture-for-cancer-pain. August 13, 2015.


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