Lymphedema and AcupunctureWhat Do the Experts Say?
To many Westerners, the very notion of acupuncture for relief from serious medical conditions is laughable. But the ancient Eastern art has many proponents, who claim the practice offers some benefits that are not easily explained by conventional medicine. Lymphedema is a chronic condition, and people diagnosed with lymphedema deserve to have all potential treatments investigated objectively.
That was the impetus behind a study conducted at Memorial Sloan Kettering’s Integrative Medicine Service in 2013. A pilot study there indicated that acupuncture as a treatment for lymphedema is safe and well tolerated, and “potentially useful”. Subjects were breast cancer patients who had experienced chronic arm swelling for six months to five years.
What Exactly is Acupuncture?
Acupuncture is a traditional Chinese medicine technique practiced for at least two thousand years. It involves the careful insertion of thin, sterile needles at various points on the surface of the body. According to ancient beliefs, these points are located along “meridians,” or pathways for “qi,” also known as life-force energy. They are located throughout the body.
The needles are thought to modify the flow of this energy to achieve pain relief and other benefits. Needles are inserted no deeper than about one centimeter, which is less than one-half inch. There is no documented scientific evidence for the existence of these qi pathways, and Western medicine remains unable to explain how this technique actually works.
Clinical trials have yielded conflicting results. Various experts have attempted to review studies of acupuncture, and have failed to reach a consensus regarding its effectiveness. Nevertheless, some patients report experiencing significant relief, and Western medicine has increasingly embraced acupuncture as a viable form of alternative and complementary medicine. As such, it should only be considered as a complement to—not a substitute for—any treatments your healthcare provider may have recommended.
Current and Emerging Research
In one third of lymphedema patients who participated in a pilot study, there was a 30% or greater reduction in arm size after eight acupuncture sessions. For some, these improvements lasted up to four months after completion of the trial. Investigators concluded: “Acupuncture treatment appears to work safely and effectively in the hands of acupuncturists who are properly trained to treat patients with cancer.”
The notion of improving arm lymphedema symptoms among breast cancer survivors is intriguing enough that scientists in Australia and New Zealand have also launched a pilot clinical trial. So far, these investigators have only demonstrated that 12 weeks of acupuncture treatment is well tolerated. The study did not document significant improvements in arm circumference (a measure of the degree of lymphedema), but speculated that acupuncture “may stabilize symptoms.” The results warrant further investigation, researchers concluded.
Promising But Not Proven
Yet another pilot study, conducted in Korea, reported encouraging results recently, in the journal Medical Acupuncture. The sample size was exceptionally small, however, at just nine patients, who received acupuncture three times per week, for six weeks. “Acupuncture reduced severity of lymphedema significantly,” investigators concluded. “The Saam acupuncture method appeared to provide reduction of lymphedema among women after they had undergone surgery for breast cancer.”
At Memorial Sloan Kettering, Dr. Barrie R. Cassileth is Chief of the Integrative Medicine Service. She is presently overseeing a larger, randomized clinical trial designed to delve further into the potential benefits of acupuncture among breast cancer patients with lymphedema of the arm(s).
The results of the Memorial Sloan Kettering pilot study are encouraging. A significant number of patients experienced significant reductions in arm swelling after multiple acupuncture sessions. But the results of pending controlled trials will be necessary before we can draw any firm conclusions. In essence, the jury is still out,
Cassileth BR, Van Zee KJ, Yeung KS, et al. Acupuncture in the Treatment of Upper-Limb Lymphedema: Results of a Pilot Study. Cancer. 2013;119(13):2455-2461. doi:10.1002/cncr.28093.
Garcia MK, McQuade J, Haddad R, et al. Systematic Review of Acupuncture in Cancer Care: A Synthesis of the Evidence. Journal of Clinical Oncology. 2013;31(7):952-960. doi:10.1200/JCO.2012.43.5818.
Javdan B, Cassileth B. Acupuncture Research at Memorial Sloan Kettering Cancer Center. J Acupunct Meridian Stud. 2015 Jun;8(3):115-21. doi: 10.1016/j.jams.2015.03.005. Epub 2015 Apr 1.
Smith CA, Pirotta M, Kilbreath S. A feasibility study to examine the role of acupuncture to reduce symptoms of lymphoedema after breast cancer: a randomised controlled trial. Acupunct Med. 2014 Oct;32(5):387-93. doi: 10.1136/acupmed-2014-010593. Epub 2014 Jul 2.