Comparing Two Effective Approaches to Cancer Pain – Ear Acupuncture and Electroacupuncture – with Standard Pain Treatment

60% of patients with cancer experience pain at some point during their illness, and approximately 50% of these people do not receive adequate pain treatment. Although many options are available to address pain, insufficient attention to cancer pain is a worldwide problem. In addition to existing barriers, the opioid crisis in the United States (misuse of narcotic painkillers) has increased the search for non-drug approaches to pain treatment. Acupuncture is an obvious candidate: evidence of its effectiveness for chronic pain unrelated to the tumor itself and for aromatase-inhibitor-related joint pain, together with moderate evidence that it reduces pain and analgesic burden in cancer, has been central to its growing prominence.

ASCO 2020 Virtual Congress featured a notable study comparing electroacupuncture and ear acupuncture with standard pain treatment in patients who had completed cancer treatment and had chronic musculoskeletal pain.

Regardless of cancer type, the study enrolled patients who had completed treatment at least 1 month earlier, had experienced musculoskeletal pain for more than 3 months and had a pain score of ≥4 (0-10) during the preceding 1 week. Patients requiring treatment for inflammatory arthritis, those with phantom limb pain and those with an implanted battery-powered device were excluded. Treatment responses were assessed after 12 weeks using the 11-part Brief Pain Inventory. The PROMIS scale was used to assess mental and physical health.

Of the 360 patients enrolled, 145 were assigned to electroacupuncture (137 completed 12 weeks), 143 to ear acupuncture (135 completed 12 weeks) and 72 to the control group (68 completed 12 weeks).

Results

• The time since pain onset was 5.3 ± 6.5 years (mean ± standard deviation), and the time since cancer diagnosis was 6.2 ± 6.7 years.
• 70% of patients were women and 30% were men; 46% had breast cancer, 14% lymphoma, 12% more than one type of cancer, 11% prostate cancer and 17% other cancers.
• Pain severity decreased by 1.9 points with electroacupuncture and 1.6 points with ear acupuncture, and these changes were statistically significant. Ear acupuncture was not found to be less effective in reducing pain.
• Electroacupuncture and ear acupuncture also produced significant improvements in functional, physical and mental status compared with the control group.
• Treatment side effects were mild in both of the 2 groups. Treatment discontinuation was lowest in the electroacupuncture group, with only 1 person stopping. In the ear acupuncture group, the discontinuation rate was 11.2%, mainly because of discomfort in the ear.

What Does This Study Mean for Us?

The study's limitations are that it was conducted at a single center and the procedures were performed by experienced acupuncturists. Its strength is that it is the largest oncology acupuncture study involving different patient groups.

In conclusion, this study showed that both electroacupuncture and ear acupuncture effectively reduced pain in cancer survivors with chronic musculoskeletal pain, and that electroacupuncture was superior in terms of adverse effects and the ability to continue treatment. Based on these results, acupuncture may be recommended for oncology patients whose pain is not adequately relieved.