Written by Karen Pilkington, Vinjar Fønnebø and the CAM-Cancer Consortium.
Updated April 27, 2016

Acupuncture for chemotherapy-associated nausea and vomiting

Is it safe?

Adverse events

In about 8-10% of all patients, acupuncture causes mild, transient adverse effects such as pain, haematoma or bleeding at the site of needling. (25,26) In addition, in rare cases complications due to tissue trauma, pneumothorax, cardiac tamponade or infection are on record.(27) Risk of cross-infection of blood borne disease, particularly hepatitis B, is minimised by the use of sterile disposable needles, and immunisation of acupuncturists. Rare cases of fatalities after acupuncture treatment have been reported although causality was not confirmed in many of these reports.(28)

Contraindications

Professional bodies for acupuncture vary somewhat in defining contraindications, particularly in relation to pregnancy.(1,29). Bleeding abnormalities and anticoagulant treatment, oedema, epilepsy, pregnancy and needle phobia are among those conditions that have been suggested as relative, or in some cases absolute, contra-indications. Some points are considered ‘forbidden’ or not to be used for acupuncture needling.

Interactions

None known, except for electro-acupuncture where the electrical current might interfere with pacemakers and is used with caution in epilepsy.(29)

Warnings

Strict asepsis and use of sterile disposable needles are mandatory to avoid infections. Some patients faint during acupuncture and should thus be treated lying down.

Citation Karen Pilkington, Vinjar Fønnebø, CAM-Cancer Consortium. Acupuncture for chemotherapy-associated nausea and vomiting [online document]. http://ws.cam-cancer.org/The-Summaries/Mind-body-interventions/Acupuncture-for-chemotherapy-associated-nausea-and-vomiting. April 27, 2016.

References

  1. BAcC (British Acupuncture Council) website. Ten Top Things to Know. Available at: www.acupuncture.org.uk. Accessed 17th April 2015.
  2. Filshie, J., Cummings, M. Western medical acupuncture. In: Ernst E, White A.  (Eds). Acupuncture: A Scientific Appraisal. 1999. Oxford: Butterworth-Heinemann, 1999. pp 31-59.
  3. White A, Editorial Board of Acupuncture in Medicine. Western medical acupuncture: a definition. Acupunct Med 2009;27:33-5.
  4. White A, Ernst E. Introduction. In: Ernst E, White, A. (Eds). Acupuncture: A Scientific Appraisal. Oxford: Butterworth-Heinemann, 1999. pp1-10.
  5. Birch S, Kaptchuk T. History, nature and current practice of acupuncture: an East Asian perspective. InIn: Ernst E, White, A. (Eds). Acupuncture: A Scientific Appraisal. Oxford: Butterworth-Heinemann, 1999. pp 11-30.
  6. Ahn AC, Colbert AP, Anderson BJ, Martinsen OG, Hammerschlag R, Cina S, Wayne PM, Langevin HM. Electrical properties of acupuncture points and meridians: a systematic review. Bioelectromagnetics 2008;29:245-56.
  7. Zhao ZQ. Neural mechanism underlying acupuncture analgesia. Prog Neurobiol 2008;84:355-375.
  8. Molassiotis A, Browall M, Milovics L, Panteli V, Patiraki E, Fernandez-Ortega P. Complementary and alternative medicine use in patients with gynecological cancers in Europe. Int J Gynecol Cancer. 2006 16 Suppl 1:219-24.
  9. Molassiotis A, Fernadez-Ortega P, Pud D, Ozden G, Scott JA, Panteli V, Margulies A, Browall M, Magri M, Selvekerova S, Madsen E, Milovics L, Bruyns I, Gudmundsdottir G, Hummerston S, Ahmad AM, Platin N, Kearney N, Patiraki E. Use of complementary and alternative medicine in cancer patients: a European survey. Ann Oncol 2005;16:655-63.
  10. Ezzo J, Vickers A, Richardson MA, Allen C, Dibble SL, Issell B et al. Acupuncture-point stimulation for chemotherapy-induced nausea and vomiting. J Clin Oncol 2005;23:7188-98.
  11. Chao LF, Zhang AL, Liu HE, Cheng HM et al. The efficacy of acupoint stimulation for the management of therapy related adverse events in patients with breast cancer: a systematic review. Breast Cancer Res Treat 2009;118:255-267.
  12. Chen HY, Li SG, Cho WC, Zhang ZJ. The role of acupoint stimulation as an adjunct therapy for lung cancer: a systematic review and meta-analysis. BMC Complement Altern Med;2013 13:362.
  13. Garcia MK, McQuade J, Lee R, Haddad R, Spano M, Cohen L. Acupuncture for symptom management in cancer care: an update. Curr Oncol Rep 2014;16:418.
  14. Cheon S, Zhang X, Lee IS, Cho SH, Chae Y, Lee H. harmacopuncture for cancer care: a systematic review. Evid Based Complement Alternat Med 2014;2014:804746.
  15. Song HJ, Seo HJ, Lee H, Son H, Choi SM, Lee S. Effect of self-acupressure for symptom management: a systematic review. Complement Ther Med 2015;23:68-78.
  16. Tan JY, Molassiotis A, Wang T, Suen LK. Current evidence on auricular therapy for chemotherapy-induced nausea and vomiting in cancer patients: a systematic review of randomized controlled trials. Evid Based Complement Alternat Med 2014;2014:430796.
  17. Genc A, Can G, Aydiner A. The efficiency of the acupressure in prevention of the chemotherapy-induced nausea and vomiting. Support Care Cancer 2013;21:253-61.
  18. Molassiotis A, Russel W, Hughes J, Breckons M, Lloyd-Williams M, Richardson J, Hulme C, Brearley S, Campbell M, Garrow A, Ryder W. The effectiveness and cost-effectiveness of acupressure for the control and management of chemotherapy-related acute and delayed nausea: Assessment of Nausea in Chemotherapy Research (ANCHoR), a randomised controlled trial. Health Technol Assess 2013;17: 1-114.
  19. Molassiotis A, Russel W, Hughes J, Breckons M, Lloyd-Williams M, Richardson J, Hulme C, Brearley S, Campbell M, Garrow A, Ryder W. The effectiveness of acupressure for the control and management of chemotherapy-related acute and delayed nausea: a randomized controlled trial. J Pain Symptom Manage 2014;47:12-25.
  20. Suh EE. The effects of P6 acupressure and nurse-provided counseling on chemotherapy-induced nausea and vomiting in patients with breast cancer. Oncol Nurs Forum 2012;39:E1-9.
  21. Liu Y, Sun QS, Dong HJ, Zhai DX, Zhang DY, Shen W, Bai LL, Yu J, Zhou LH, Yu CQ. Wrist-ankle acupuncture and ginger moxibustion for preventing gastrointestinal reactions to chemotherapy: A randomized controlled trial. Chin J Integr Med 2015;21:697-702.
  22. Rithirangsriroj K, Manchana T, Akkayagorn L. Efficacy of acupuncture in prevention of delayed chemotherapy induced nausea and vomiting in gynecologic cancer patients. Gynecol Oncol 2015;136:82-6.
  23. Shen Y, Liu L, Chiang JS, Meng Z, Garcia MK, Chen Z, Peng H, Bei W, Zhao Q, Spelman AR, Cohen L. Randomized, placebo-controlled trial of K1 acupoint acustimulation to prevent cisplatin-induced or oxaliplatin-induced nausea. Cancer 2015; 121: 84-92.
  24. Zhang X, Jin HF, Fan YH, Lu B, Meng LN, Chen JD. Effects and mechanisms of transcutaneous electroacupuncture on chemotherapy-induced nausea and vomiting. Evid Based Complement Alternat Med 2014;2014:860631.
  25. White A, Hayhoe S, Ernst E. Survey of Adverse Events Following Acupuncture Acupunct Med 1997;15:67-70.
  26. Witt CM, Pach D, Brinkhaus B, Wruck K, Tag B, Mank S, Willich SN. Safety of acupuncture: results of a prospective observational study with 229,230 patients and introduction of a medical information and consent form. Forsch Komplementmed 2009;16:91-7.
  27. White A. A cumulative review of the range and incidence of significant adverse events associated with acupuncture. Acupunct Med 2004;22:122-123.
  28. Ernst E. Deaths after acupuncture: a systematic review. Int J Risk Safety 2010;22:131-136.
  29. BMAS (British Medical Acupuncture Society). Code of Practice & Complaints Procedure. Version 9 December 2009. Available at: http://www.medical-acupuncture.co.uk. Accessed 21st July 2015.