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Acupuncture may ease cancer-related fatigue

By Genevra Pittman

NEW YORK (Reuters Health) - Acupuncture may help relieve fatigue in women who've had breast cancer, a new UK study suggests.

Researchers found that women who attended six weekly acupuncture sessions had greater improvements in fatigue as well as anxiety, depression and quality of life, compared to those who only received educational materials.

But that still doesn't prove it was the needles, themselves, that boosted women's energy levels, they said. And one cancer and alternative medicine researcher not part of the study team said the acupuncture group only showed a "modest improvement in fatigue - it was not a very remarkable, strong effect."

Still, acupuncture could be "well worth a try" for some people, Dr. Amit Sood, from the Mayo Clinic in Rochester, Minnesota, Reuters Health.

"Fatigue is the most common symptom for all cancer patients," said Carol Enderlin, who has studied that topic at the University of Arkansas for Medical Sciences in Little Rock.

She said cancer and cancer treatments can cause chronic pain, psychological stress and anemia - a decrease in healthy red blood cells - all of which contribute to fatigue. In addition, people who are nauseated after chemo might not be getting the most nutritious diet for maintaining energy levels.

Enderlin, who also wasn't involved in the new study, said acupuncture may help as an add-on therapy for women who've had their fatigue checked out by a doctor and tinkered with their physical activity and diet - but are still frequently tired.

Approximately one in eight women will be diagnosed with breast cancer at some point in her life.

For the new research, Alexander Molassiotis from the University of Manchester and his colleagues tracked 227 women with moderate or severe cancer-related fatigue treated with acupuncture and another 75 fatigued women who didn't get acupuncture.

The women had all received chemotherapy for breast cancer in the five years before the study, and most had felt chronically tired for a year or more. Participants were given a booklet about cancer-related fatigue when they started the study.

The researchers found that after six weeks, general fatigue had dropped by almost four points on a 0-20 scale among women who had acupuncture, compared to a less than one-point decline in the comparison group. That is "mild to modest" improvement, according to Sood - not enough to allow someone who is stuck in bed to start walking, but maybe enough to get people who are too tired to exercise to start doing some activity.

Anxiety and depression scores, measured from 0-21, dropped by two additional points post-acupuncture, compared to scores in women given educational materials only. Emotional and physical well-being got a greater boost with acupuncture therapy as well, Molassiotis's team found.

The researchers couldn't tell how much of that benefit might have been due to the "placebo effect" - women who felt better because they expected to benefit from acupuncture.

In an ideal trial, participants would get either real or fake acupuncture, without knowing which. But it's very hard to design a convincing but ineffective fake acupuncture treatment to use for comparison, researchers noted.

According to an editorial published with the study in the Journal of Clinical Oncology, close to one-third of cancer patients have persistent fatigue that may continue for years after treatment. Doctors typically encourage moderate exercise and talk therapy to improve their energy, wrote psychologist Julienne Bower, from the University of California, Los Angeles.

Still, she added, it's unclear how well any therapies work over the long term in people with severe fatigue.

Enderlin said people who've been treated for cancer should make sure they're not at high risk of bleeding or infection before considering acupuncture for fatigue.

But if they're medically cleared, she said the alternative therapy "looks really intriguing."

Enderlin recommended "maintaining activity to tolerance, unless there are other problems with that, good nutrition, getting adequate sleep, and if the fatigue continues, considering there might be an alternative that could complement (those things)."

SOURCE: http://bit.ly/gPtMdm Journal of Clinical Oncology, online October 29, 2012.

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