ACUPUNCTURE significantly reduces side effects of endocrine therapy, including hot flashes, in patients with breast cancer. Endocrine therapy can cause several hormonal side effects, including night sweats, vaginal dryness, joint pain and hot flashes. Whilst drug treatments can reduce the occurrence and severity of hot flashes, they are associated with further side effects. Therefore, researchers investigated the clinical applicability of acupuncture to reduce hot flashes and other endocrine therapy side effects in patients with breast cancer.
Across three parallel, randomised clinical trials in the United States, China, and South Korea, 158 women with stage 0–III breast cancer were randomised to immediate acupuncture (IA) or delayed acupuncture control (DAC). IA participants received acupuncture twice a week for the first 10 weeks, completing 20 sessions in total. Whereas, DAC participants received usual care for 10 weeks, then 10 sessions of acupuncture at a reduced intensity (one session per week rather than twice per week). Hormonal symptoms associated with endocrine therapy were assessed at baseline and week 10 using the endocrine symptom subscale of the Functional Assessment of Cancer Therapy (FACT)-Endocrine Symptoms, the hot flash score and the FACT-Breast score.
After 10 weeks of acupuncture, patients in the IA group reported significantly greater improvements in symptoms, compared with DAC participants, with larger reductions in the endocrine symptom subscale score (mean change ± standard error: 5.1 ± 0.9 versus 0.2 ± 1.0; p=.0003), the hot flash score (−5.3 ± 0.9 versus−1.4 ± 0.9; p<.003), and the FACT-Breast total score (8.0 ± 1.6 versus −0.01 ± 1.6; p=.0005). Notably, the effect of the acupuncture intervention differed by site (p=.005), indicating that further research should be carried out to elucidate the findings.
The results of the study highlight that hot flashes, and other hormone-related side effects, in patients undergoing endocrine therapy for breast cancer can be reduced using acupuncture. Thus, acupuncture may be a promising non-pharmacological therapy, with fewer additional side effects, for this patient group. Future research should focus on understanding site-specific differences and optimising acupuncture protocols to enhance its clinical applicability and efficacy for managing hormonal symptoms in diverse patient populations.
Katrina Thornber, EMJ
Reference
Lu W et al. Acupuncture for hot flashes in hormone receptor-positive breast cancer: A pooled analysis of individual patient data from parallel randomized trials. Cancer. 2024;DOI:10.1002/cncr.35374.
