Background Chemotherapy induced peripheral neuropathy (CIPN) is a disabling condition resulting from neurotoxicity. Physical symptoms include pain and numbness. These can lead to loss of function, reduced mobility, low mood and reduced quality of life. A growing body of evidence supports the use of acupuncture in the management of pain with relatively few contraindications to treatment. A study by Lu, Giobbie-Hurder, Freedman, Shin, et al (2020. Oncologist. 25(4):310–318) showed improvement in some of the physical symptoms of peripheral neuropathy in breast cancer patients with acupuncture intervention but there is little evidence to support the holistic effect that acupuncture can have in this patient group.
Aims To review the holistic effect of acupuncture for CIPN. The multi case review will investigate changes in physical, social, emotional and functional wellbeing symptoms before and after acupuncture intervention. This study leads on from a single case review in which marked holistic improvements were demonstrated following acupuncture for CIPN. It is hoped that further study will provide evidence to support acupuncture as a treatment option for CIPN.
Methods Patients presenting with symptoms of CIPN can be considered for acupuncture intervention to complement their existing medical management. Acupuncture points are selected based on individual assessment and presenting symptoms. Extra acupuncture points Bafeng (Ex-LE10) and Baxie (Ex-UE9) are included for CIPN where appropriate. Outcomes are measured using a Functional Assessment of Cancer Therapy Neurotoxicity (FACT GOG-NTX) self-assessment questionnaire completed prior to commencing acupuncture and repeated at the end of the treatment course.
Results The single case review demonstrated improvements across all aspects of wellbeing using the FACT/GOG-Ntx questionnaire. The greatest improvement was in physical symptoms with scores increasing 43% from 13/28 before intervention to 25/28 on completion of treatment. Questions on neurotoxicity symptoms saw improvements of 30% from 22/44 prior to receiving acupuncture to 35/44 post treatment. Total FACT/GOG-Ntx score, taking into account physical, social, emotional and functional aspects of wellbeing, improved 15% from 92/152 to 115/152. The FACT/GOG-Ntx questionnaire was an effective and sensitive tool for identifying changes in holistic wellbeing.
Conclusion Acupuncture offers a cheap, safe, non-pharmacological option for managing the symptoms of CIPN. The holistic nature of acupuncture has the benefit of being able to target multiple symptoms from different dimensions of a person’s overall wellbeing. Further study is ongoing to gather more data.
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