Acupuncture Offers Quality-of-Life Benefits for Patients Taking AIs

Jun Mao, MD, MSCE

A new study led by researchers at the Perelman School of Medicine at the University of Pennsylvania has shown that electroacupuncture produces significant improvements in fatigue, anxiety, and depression in as little as 8 weeks for early-stage breast cancer patients experiencing joint pain related to the use of aromatase inhibitors (AIs).

The study, published online this week in the journal Cancer, is the first demonstration of electroacupuncture’s efficacy for both joint pain relief, as well as these other common symptoms.

“Since many patients experience pain, fatigue, anxiety, and depression simultaneously, our results provide an opportunity to offer patients one treatment that may target multiple symptoms,” lead author Jun Mao, MD, MSCE, associate professor of Family Medicine and Community Health in Penn’s Perelman School of Medicine, said in a statement.

“We see patients every day who are looking for ways to combat some of the side effects of their treatment. What is particularly significant about these new results is that we can now offer more evidence-based treatment and management solutions for these women,” Mao, who also directs the Integrative Oncology program at the Abramson Cancer Center, continued.

These results build upon earlier findings reported in November 2013, showing that electroacupuncture—a form of acupuncture where a small electric current is passed between pairs of acupuncture needles—can decrease the joint pain reported by roughly 50% of breast cancer patients taking aromatase inhibitors.

Although AIs are extremely effective in preventing disease recurrence among postmenopausal women with early-stage, hormone receptor—positive breast cancer, the joint pain associated with the use of these agents often leads to fatigue, anxiety, depression, and sleep disturbances for these patients.

Previous studies have shown that nearly half of women taking AIs do not complete their recommended course of treatment due to side effects. Those patients who stop taking the drugs or don’t take them as prescribed have a higher chance of dying of both breast cancer and other causes.

All participants in the 8-week trial were receiving AI therapy. They were randomly assigned to receive electroacupuncture, sham acupuncture (a nonelectric, placebo acupuncture where the needles are not actually inserted into the skin) or usual care.

Patient-reported experiences of fatigue and psychological distress were measured prior to the study and periodically throughout it, with additional follow-up 4 weeks after treatment.

The study showed that compared with usual care, patients receiving electroacupuncture had a greater reduction in the fatigue score at week 8 and the effect was maintained at week 12.

Researchers also found that by week 12, patients receiving electroacupuncture reported a significant improvement in their anxiety score, whereas patients receiving the sham acupuncture did not.

Patients who received both the electroacupuncture and sham acupuncture demonstrated a significant improvement in scores on the Hospital and Depression Scale compared with the usual care group by week 8, and these effects were maintained for both groups at week 12, researchers said.

“Our study provides a novel understanding of how fatigue, sleep, and psychological distress relate to pain in patients with AI-related joint pain. More importantly, we found that acupuncture helped reduce these symptoms and the effects persisted for at least 4 weeks following treatment,” said Mao.

“There is a small but growing body of literature showing that acupuncture is effective for the management of pain, fatigue, anxiety, and depression. However, studies with larger sample sizes and longer follow-up periods are needed to provide more in-depth knowledge about how these treatments, combined with usual care, are improving quality of life for our patients,” he concluded.