Application of Acupuncture and Moxibustion for Small Animal Cancer
World Small Animal Veterinary Association World Congress Proceedings, 2011
Keum Hwa Choi, DVM, PhD, CVA, OMD, LAC
Complementary & Alternative Medicine, Department of Veterinary Clinical Sciences, Veterinary Medical Center, College of Veterinary Medicine, University of Minnesota, MN, USA

Acupuncture has been used as a preventive and therapeutic medical modality for cancer treatment in Asia. A growing body of literature provides the potential application of acupuncture for the relief of symptoms caused by cancer treatments. Despite the clinical effects of acupuncture being reported, controversial assessment remains skeptical about the genuine value of acupuncture in conventional oncology.6,12,13

Moxibustion is another medical modality in Oriental Medicine and has been applied for cancer treatment in conjunction with acupuncture or by itself.14 However, the lack of scientific evidence has been a drawback for using moxibustion for cancer treatment.16

The practical implementation of acupuncture and moxibustion for cancer patients based on the medical evidence and our clinical data will be discussed in this presentation.

How Does Acupuncture Work For Cancer Therapy?

The effects of acupuncture include

 Analgesic effect15,18

 Antiinflammation1,7

 Mitigation of chemotherapy-related gastrointestinal discomfort including nausea, vomiting, anorexia and diarrhea5

 Alleviation of side effects due to radiation therapy including xerostomia2

Scientific Evidence of Acupuncture and Moxibustion For Cancer Treatment

Acupuncture treatment has been implemented to alleviate clinical symptoms or adverse effects generated from conventional therapies including pain, vomiting, nausea or anorexia. Studies show that acupuncture can significantly alleviate emesis, pain, and lethargy for patients receiving chemotherapy.10,15Electro-acupuncture has also demonstrated benefits for acute vomiting due to chemotherapy5 and for controlling general pain. Zhang et al.17 reported that electroacupuncture attenuates the hyperalgesia associated with cancer pain in rats, in part through inhibiting the expression of interleukin IL-1β in the spinal cord. Acupuncture can activate immune functions by increasing blood cell count and enhancing lymphocyte and NK cell activity.8,11 Although studies show the positive effects of acupuncture treatment for palliative and supportive cancer therapy, qualified scientific evidence on the effect of acupuncture has shown only chemotherapy-induced nausea and vomiting at present.3,5

The Application of Acupuncture For Small Animal Cancer Patients

Acupuncture treatment has been applied for alleviating chemotherapy-related adverse effects from conventional therapy for small animal cancer patients at the Complementary & Alternative Medicine, Veterinary Medical Center, University of Minnesota. The acupuncture treatment has been applied for dogs under conventional therapy, which includes chemotherapy, surgery or radiation therapy for alleviation of pain, gastrointestinal discomfort, and neutropenia. Once the conventional treatment is finished, further acupuncture treatment was generally not provided. Moxibustion has also been used for the alleviation of gastrointestinal discomfort or pain.

1.  The effect of acupuncture for gastrointestinal discomfort: Acupuncture treatment on ST 36, PC6, and LI11 is provided at least 2 hours prior to receiving the chemotherapy. Retrospective studies showed patients receiving acupuncture had reduced diarrhea, vomiting, and anorexia caused by chemotherapy.

2.  The effect of acupuncture for neutropenia: Acupuncture treatment on ST 36, SP6 and GV 4 has been applied for dogs with neutropenia caused by chemotherapy once or twice weekly.

3.  The effect of acupuncture for pain: Dogs with gastrointestinal discomfort or pain caused by conventional therapy or cancer-related pain were treated by acupuncture. The acupuncture points including LI4 and SP21 were selected, in general.

4.  The application of moxibustion for cancer patients: Indirect moxibustion was applied to the site of spinal cancer, thyroid cancer, osteosarcoma, and skin cancer. In addition, moxibustion on ST 36, SP 6, and CV12 provided the cancer patients with Qi and Yang deficiency.

Conclusion and Discussion

Acupuncture is an effective treatment as a complementary care for cancer patients. Recently, acupuncture and Oriental Medicine have been gradually embraced by conventional oncologists, academic health centers, and integrative medicine cancer centers. Although acupuncture is safe with minimal side-effects and is clinically effective for alleviating gastrointestinal discomfort as well as immune-suppression caused by conventional therapy, the lack of profound scientific evidence to manage the adverse effects from conventional therapy or to manage cancer-related conditions has been apprehended. Although the growing amount of scientific evidence has supported the use of acupuncture for cancer patients, the genuine effect of acupuncture has not been fully elucidated. Therefore, continuing research using a valid methodology is essential. Further basic studies on the physiologic mechanisms of acupuncture and qualified clinical trials of acupuncture for cancer patients will enhance our knowledge and application of acupuncture in integrative medicine oncology.

References

1.  Carneiro ER, Xavier RA, De Castro MA, et al. Electroacupuncture promotes a decrease in inflammatory response associated with Th1/Th2 cytokines, nitric oxide and leukotriene B4 modulation in experimental asthma. Cytokine 2010;50(3):335–340.

2.  Cho JH, Jung HH. Manual acupuncture improved quality of life in cancer patients with radiation-induced xerostomia. J Alternat Compl Med 2008;14:523–526.

3.  Ernst E, Lee MS. Acupuncture for palliative and supportive cancer care: a systematic review of systematic reviews. J Pain Sympt Manag 2010;40(1):e3–5.

4.  Ezzo J, Vickers A, Richardson MA, et al. Acupuncture-point stimulation for chemotherapy-induced nausea and vomiting. J Clin Onco. 2005;23:7188–7198.

5.  Ezzo JM, Richardson MA, Vickers A, et al. Acupuncture-point stimulation for chemotherapy-induced nausea or vomiting. Cochrane Database Syst Rev 2006;(2):CD002285.

6.  Jedel E. Acupuncture in xerostomia - a systematic review. J Oral Rehabil 2005;32:392–396.

7.  Kim HW, Roh DH, Yoon SY, et al. The anti-inflammatory effects of low- and high-frequency electroacupuncture are mediated by peripheral opioids in a mouse air pouch inflammation model. J Alt Complement Med. 2006.;2(1):39–44.

8.  Lai M, Wang SM, Zhang WL, et al. Effects of electroacupuncture on tumor growth and immune function in the Walker-256 model rat. Zhongguo Zhen Jiu 2008;28(8):607–609.

9.  Lee MS, Choi TY, Park JE, et al. Moxibustion for cancer care: a systemic review and meta-analysis. BMC Cancer 2010;7(10):130.

10. Lee H, Schmidt K, Ernst E. Acupuncture for the relief of cancer-related pain - a systematic review. Eur J Pain. 2005;437–444.

11. Lu BW, Hu D, Dean-Clower E, et al. Acupuncture for chemotherapy-induced leukopenia: exploratory meta-analysis of randomized controlled trials. J Soc Integr Oncol 2007;5:1–10.

12. O-Sullivan EM, Higginson IJ. Clinical effectiveness and safety of acupuncture in the treatment of irradiation-induced xerostomia in patients with head and neck cancer: a systematic review. Acupunct Med 2010;28(4):191–199.

13. Paley CA, Johnson MI, Tashani OA, et al. Acupuncture for cancer pain in adults. Cochrane Database Syst Rev 2011;19:(1):CD007753.

14. Pei J, Wei H, Liu ZD, et al. Effects of moxibustion on the expression of IL-1 beta, IL-2, IL-6 mRNA and protein in the cerebral cortex in tumor-bearing mice. Zhen Ci Yan Jiu 2010;35(4):243–249.

15. Vickers AJ, Cronin AM, Maschino AC, et al. Individual patient data meta-analysis of acupuncture for chronic pain: protocol of the Acupuncture Trialists' Collaboration. Trials 2010;28(11):90.

16. Wang WJ, Lu J, Niu CS, et al. Moxibustion for cancer care: a systematic review and meta-analysis. BMC cancer 2010;7(10):130.

17. Zhang RX, Li A, Liu B, et al. Electroacupuncture attenuates bone cancer pain and inhibits spinal interleukin-1 beta expression in a rat model. Anesth Analg 2007;105(5):1482–1488.

18. Zhao ZQ. Neural mechanism underlying acupuncture analgesia. Prog Neurobiol 2008;84:355–375.

 

Speaker Information
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Keum Hwa Choi, DVM, PhD, CVA, OMD, LAC
Complementary & Alternative Medicine, Department of Veterinary Clinical Sciences
Veterinary Medical Center, College of Veterinary Medicine, University of Minnesota
MN, USA


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