Acupuncture for Chemotherapy-Induced Nerve Damage in the Hands and Feet (Neuropathy)

Studies increasingly show evidence-based benefits for managing side effects from acupuncture, a complementary treatment commonly used by cancer patients. Some chemotherapies damage nerve sheaths in the extremities as a side effect, causing peripheral neuropathy . We would like to share current data on acupuncture for chemotherapy-induced peripheral neuropathy.

Platinum drugs, taxanes, vinca alkaloids, bortezomib and thalidomide are among chemotherapy drugs that can cause peripheral neuropathy. Signs and complaints associated with peripheral neuropathy include pain, numbness, tingling and burning, which may persist for years and impair quality of life.

A previous placebo -controlled clinical studyrecommended, for patients with chemotherapy-induced peripheral neuropathy, duloxetine . Apart from this drug, of 19 interventions evaluated to prevent or treat peripheral neuropathy in 42 randomized controlled studies, none proved effective. Acupuncture, viewed by many patients as a natural medical option, is among nonpharmacological interventions recommended for cancer patients to relieve symptoms associated with aromatase inhibitors, among breast cancer hormonal therapies, specifically arthralgia(joint pain). Small studies also suggest benefit in peripheral neuropathy, diabetes-associated peripheral neuropathy and acquired immunodeficiency syndrome (AIDS). Acupuncture is therefore considered to deserve further research for these purposes.

Acupuncture studies in peripheral neuropathy

The first study discussed evaluated different acupuncture types in patients with long-term peripheral neuropathy caused by bortezomib or thalidomide and multiple myeloma. In the study, 10 weeks of manual acupuncture significantly benefited patients with moderate peripheral neuropathic pain caused by bortezomib.

Another study found electroacupuncture significantly improved bortezomib- and / or thalidomide-induced neuropathy in 19 patients. Benefit appeared at week 4, peaked on completing 9 weeks of treatment and remained improved at 13 weeks.

In contrast, two randomized controlled electroacupuncture studies produced negative results. A prevention study enrolled 48 patients with breast cancer. Taxane chemotherapy patients received electroacupuncture or sham treatment for 12 weeks, with no difference in outcomes. Those receiving electroacupuncture also had greater neuropathy complaints at week 16. This raised questions about using electricity rather than manual forms to prevent chemotherapy-induced peripheral neuropathy.

In another 4-arm study, improvement did not differ significantly between patients randomized to electroacupuncture, electroacupuncture with hydroelectric baths, high-dose vitamins B1 / B6 or placebo.

Conclusion

Although current evidence is promising, particularly for manual/classical acupuncture, larger studies, placebo controls and further randomized controlled studies using nerve conduction studies or measurable sensory tests are warranted. More research is needed into the mechanisms by which acupuncture helps reduce chemotherapy-induced peripheral neuropathy symptoms.