The National Center for Complementary and Alternative Medicine (NCCAM) has launched a clinical trial of electroacupuncture to determine if it reduces the delayed nausea experienced by cancer patients following chemotherapy.
Electroacupuncture, which has been in use for decades, is a variation of traditional acupuncture. In this process, acupuncture needles are placed at selected points and then pulsed with an electric current to stimulate the acupuncture points. Electroacupuncture has been studied for a variety of health conditions including treatment of pain and relief of acute nausea following chemotherapy. Acute nausea occurs within the first 24 hours after chemotherapy, whereas delayed nausea occurs 24 hours to 5 days after chemotherapy.
Studies of both acupuncture and electroacupuncture show that the techniques can be effective for treatment of chemotherapy-induced acute nausea and produce few or no side effects. However, evidence supporting their effectiveness in treating delayed chemo-related nausea is lacking.
"The scientific evidence supporting use of electroacupuncture for relief of acute nausea following chemotherapy is very encouraging," said Marc Blackman, M.D., Director of NCCAM's Division of Intramural Research. "Now we need to look at its potential utility for treating delayed post-chemotherapy nausea, a problem for many cancer patients that needs to be investigated."
The randomized trial will enroll 52 patients, aged 16 to 35 years, who will be divided into two groups-a treatment group that receives electroacupuncture and a control group that receives sham needling. Sham needling involves the placement of acupuncture needles near acupuncture points, but in sites that are considered to have no treatment effect on nausea or emesis (vomiting). Both patient groups will receive standard anti-nausea drugs for treatment of acute nausea and vomiting.
Trial participants will receive electroacupuncture or sham needling for 7 days (twice daily on days 1 and 2 and once daily on days 3 through 7) starting with the first day of chemotherapy. This will be repeated for a second cycle of chemotherapy. The researchers will follow up with patients after two additional cycles of chemotherapy.
Two particular acupuncture points, known as P6 (near the wrist) and St36 (near the knee), have been tested in previous trials for nausea relief and will be employed in this trial. Both patient groups will also have an additional needle placed at a sham point common to both groups to serve as an added control. In addition to determining the effectiveness of electroacupuncture as an approach to treating delayed nausea, the researchers also hope to verify that the specific acupuncture points P6 and St36 are effective for treating delayed nausea.
"At present, we can treat the acute nausea that accompanies chemotherapy with conventional medications, but delayed nausea is tough to manage," said principal investigator Patrick Mansky, M.D. "We hope that this trial will help reveal the value of electroacupuncture in managing delayed chemotherapy-induced nausea as well as other possible benefits."
Unlike acute chemotherapy-induced nausea, delayed nausea does not respond well to medications. To manage delayed nausea, cancer patients are often prescribed glucocorticoids, a type of steroids, which can lead to unwanted side effects, such as weight gain, retarding of growth, or susceptibility to infection. It also appears that delayed nausea may contribute to stress in patients and the negative effects that stress can induce. Therefore, finding an effective alternative may help patients avoid the potential side effects of glucocorticoids and stress.
"If electroacupuncture does reduce delayed nausea following chemotherapy, oncologists will have a treatment option that may spare patients from negative side effects associated with certain medications," said Stephen E. Straus, M.D., NCCAM Director.
SOURCE:
National Center for Complementary and Alternative Medicine, National Institutes of Health (http://www.nccam.nih.gov)
