How can acupuncture help me? What the research says

This ancient therapy originating in China involves inserting very thin needles into the body surface at specific points; it is effective in treating many cancer symptoms and side effects.

How can acupuncture help me? What the research says

We summarize the clinical evidence for each medical benefit here. We begin with our assessment of the strength of evidence within each category, followed by a brief summary of individual studies or reviews of several studies. In assessing the strength of evidence, we consider the study design, number of participants, and the size of the treatment effect (how much outcomes changed with treatment).

Our assessments of evidence for each medical benefit fall into one of these categories:

Strong evidence: consistent, significant effects in several large (or at least one very large) well designed clinical studies or at least two meta-analysesa statistical analysis that combines the results of two or more research studies; the results of smaller research studies addressing the same or similar questions can be analyzed as though they are one bigger, more powerful study of clinical studies of moderate or better quality (or one large meta-analysis) finding similar results
Good evidence: significant effects in one large or several mid-sized and well-designed clinical studies ( randomized controlled trialsa study design in which people are randomly assigned to either an experimental group or a control group to compare the outcomes from different treatments; an RCT is considered a strong design for determining a therapy’s effects with an appropriate placebo or other strong comparison control or observational studies that control for confounds)
Modest evidence: significant effects in at least three small but well-designed randomized controlled trials (RCTs), or one or more well-designed, mid-sized clinical studies of reasonably good quality (RCTs or observationala type of study in which individuals are observed or certain outcomes are measured, but no attempt is made to affect the outcome (for example, no treatment is given); an example is a study that records people’s diets, but doesn’t try to alter their diets, and looks for patterns of disease or other outcomes related to different foods studies), or several small studies aggregated into a meta-analysis
Preliminary evidence: significant effects in small or poorly designed clinical studies OR conflicting results in adequate studies but a preponderance of evidence of an effect
Weak evidence: one or more case studies, supported by animal evidence OR small treatment effects of limited clinical significance OR studies with no controls OR weak trends of effects
Insufficient evidence: preclinical evidence only OR clinical studies with such poor or unclear methodology that no conclusion can be drawn OR conflicting findings across clinical studies with no preponderance of evidence in one direction; conflicting evidence occurs when studies find conflicting effects (positive effect vs no effect or negative effect) with the same treatment and the same general study population (same cancer type, for example)

How We Rate Therapies

Learn more about how we research and rate therapies and practices.

Optimizing your body terrain

Does acupuncture promote an environment within your body that is less supportive of cancer development, growth, or spread? We present the evidence.

Hormone imbalance

Preliminary evidencesignificant effects in small or poorly designed clinical studies OR conflicting results in adequate studies but a preponderance of evidence of an effect (this is the CancerChoices definition; other researchers and studies may define this differently) of better hormone balance during chemotherapy among people with gastrointestinal cancer with cachexiaweakness and wasting of the body due to severe chronic illness treated with acupuncture

Immune function

Preliminary evidence of increased markers of immune function without regard to treatment phase among people treated with acupuncture and moxibustion

Modest evidencesignificant effects in at least three small but well-designed randomized controlled trials (RCTs), or one or more well-designed, mid-sized clinical studies of reasonably good quality (RCTs or observational studies), or several small studies aggregated into a meta-analysis (this is the CancerChoices definition; other researchers and studies may define this differently) of better markers of immune function during cancer treatment among people with lung cancer treated with acupoint stimulation

No evidence of effectsoverall, one or more studies did not demonstrate that a treatment or intervention led to an expected outcome; this does not always mean that there is no effect in clinical practice, but that the studies may have been underpowered (too few participants) or poorly designed. Larger, well-designed studies provide more confidence in making assessments. on immune function during hormone therapy among people with breast cancer treated with acupuncture in a combined analysis of studies

Preliminary evidence of better immune function after surgery among people treated with warm needle acupuncture and moxibustion

Without regard to treatment phase: preliminary evidence of increased markers of immune function among people treated with acupuncture and moxibustion

Increased markers of immune function (CD3+T, CD4+T, CD8+T cells and B cells) among people with non-small cell lung cancer with fatigue treated with acupuncture and moxibustion compared to conventional Chinese and Western medicine in a small RCTrandomized controlled trial, a study design in which people are randomly assigned to either an experimental group or a control group to compare the outcomes from different treatments; an RCT is considered a strong design for determining a therapy’s effects³Li WT, Liu YH, Pet al. [Effects of “Tiaoyi Sanjiao” acupuncture and moxibustion on cancer-induced fatigue and immune function in patients with advanced non-small cell lung cancer]. Zhen Ci Yan Jiu. 2020 Dec 25;45(12):1000-5.

During cancer treatment: modest evidence of better markers of immune function during cancer treatment among people with lung cancer treated with acupoint stimulation

Increased markers of immune function during cancer treatment among people with lung cancer treated with acupoint stimulation compared to controls in a meta-analysisa statistical analysis that combines the results of two or more research studies; the results of smaller research studies addressing the same or similar questions can be analyzed as though they are one bigger, more powerful study of 31 controlled trialsa study design in which people are assigned to either an experimental group or a control group to compare the outcomes from different treatment; assignment is not random, and so this is not as strong a study design as a randomized controlled trial, but still stronger than an uncontrolled trial; study authors’ note: “Acupoint stimulation varies from needle insertion, pressure, plaster application, and moxibustion to herbal extraction on the acupoints”⁴Chen HY, Li SG, Cho WC, Zhang ZJ. The role of acupoint stimulation as an adjunct therapy for lung cancer: a systematic review and meta-analysis. BMC Complementary and Alternative Medicine. 2013 Dec 17;13:362.

During hormone therapy: no evidence of effects on immune function during hormone therapy among people with breast cancer treated with acupuncture in a combined analysis of studies

No change in a marker of immune function during hormone therapy among people with breast cancer treated with acupuncture compared to control or placebo in a meta-analysis of 20 RCTs of moderate quality; all studies used full-body or ear (auricular) needles, some studies included electroacupuncture⁵Yuanqing P, Yong T et al. Acupuncture for hormone therapy-related side effects in breast cancer patients: a grade-assessed systematic review and updated meta-analysis. Integrative Cancer Therapies. 2020 Jan-Dec;19:1534735420940394.

After surgery: preliminary evidence of better immune function after surgery among people treated with warm needle acupuncture and moxibustion

Markers of better immune function after radical resection of colorectal cancer among people treated with conventional medication plus warm-needle acupuncture and moxibustion stimulation compared to conventional medication alone in a small RCT⁶Sun H, Zhang B, Qian HH, Chen ZC. [Effect of warm-needle moxibustion intervention on immune function and intestinal flora in patients after colorectal cancer radical operation]. Zhen Ci Yan Jiu. 2021 Jul 25;46(7):592-7. Chinese.

Inflammation

Insufficient evidencepreclinical evidence only OR clinical studies with such poor or unclear methodology that no conclusion can be drawn OR conflicting findings across clinical studies with no preponderance of evidence in one direction; conflicting evidence occurs when studies find conflicting effects (positive effect vs no effect or negative effect) with the same treatment and the same general study population (same cancer type, for example) (this is the CancerChoices definition; other researchers and studies may define this differently) of effects on inflammation among people with cancer-related depression taking sertraline hydrochloride after 6 weeks of acupuncture without regard to treatment phase

Preliminary evidence of a higher marker of inflammatory response during chemotherapy among people with cachexia treated with acupuncture

No evidence of an effect on inflammation during hormone therapy among people treated with acupuncture in a combined analysis of studies

Preliminary evidence of lower inflammation after radical resection of colorectal cancer among people treated with warm needle acupuncture and moxibustion

Without regard to treatment phase: insufficient evidence of effects on inflammation among people with cancer-related depression taking sertraline hydrochloride after 6 weeks of acupuncture

Some lower and some increased markers of inflammation among people with cancer-related depression taking sertraline hydrochloride after 6 weeks of Tiadu Jieyu acupuncture compared to sertraline hydrochloride alone in a small RCTrandomized controlled trial, a study design in which people are randomly assigned to either an experimental group or a control group to compare the outcomes from different treatments; an RCT is considered a strong design for determining a therapy’s effects⁷Lian JL, Wu XM, Sun X, Wang YJ, Li YH. [Effect of Tiaodu Jieyu acupuncture on cancer-related depression: a randomized controlled trial]. Zhongguo Zhen Jiu. 2021 Apr 12;41(4):381-5. Chinese.

During chemotherapy: preliminary evidence of a higher marker of inflammatory response during chemotherapy among people with cachexia treated with acupuncture

A higher marker of a proinflammatory signaling cytokine (TNF-α) among people with gastrointestinal cancer with cachexia undergoing chemotherapy treated with 8 weekly sessions of targeted acupuncture compared to modified sham (nontargeted) acupuncture in a small RCT;⁸Grundmann O, Yoon SL, Williams JJ, Gordan L, George TJ Jr. Augmentation of cancer cachexia components with targeted acupuncture in patients with gastrointestinal cancers: a randomized controlled pilot study. Integrative Cancer Therapies. 2019 Jan-Dec;18:1534735418823269. elevated levels of circulating TNF-α are linked to cachexia associated with terminal cancer, but it may also contribute to killing cancer cells

During hormone therapy: no evidence of an effect on inflammation during hormone therapy among people treated with acupuncture in a combined analysis of studies

No change in a marker of inflammation during hormone therapy among people with breast cancer treated with acupuncture compared to control or placebo in a meta-analysisa statistical analysis that combines the results of two or more research studies; the results of smaller research studies addressing the same or similar questions can be analyzed as though they are one bigger, more powerful study of 20 RCTs of moderate quality⁹Yuanqing P, Yong T et al. Acupuncture for hormone therapy-related side effects in breast cancer patients: a grade-assessed systematic review and updated meta-analysis. Integrative Cancer Therapies. 2020 Jan-Dec;19:1534735420940394.
Comparable improvements in a marker of inflammation among postmenopausal women with early stage breast cancer experiencing aromatase inhibitor-associated musculoskeletal symptoms treated with either acupuncture or sham in a small RCT¹⁰Bao T, Cai L et al. A dual-center randomized controlled double blind trial assessing the effect of acupuncture in reducing musculoskeletal symptoms in breast cancer patients taking aromatase inhibitors. Breast Cancer Research and Treatment. 2013 Feb;138(1):167-74.

After surgery: preliminary evidence of lower inflammation after radical resection of colorectal cancer among people treated with warm needle acupuncture and moxibustion

Lower markers of inflammation and less vein inflammation (phlebitis) among people who underwent radical resection of colorectal cancer with subsequent use of conventional medication plus warm-needle acupuncture moxibustion stimulation compared to conventional medication alone in a small RCT¹¹Sun H, Zhang B, Qian HH, Chen ZC. [Effect of warm-needle moxibustion intervention on immune function and intestinal flora in patients after colorectal cancer radical operation]. Zhen Ci Yan Jiu. 2021 Jul 25;46(7):592-7. Chinese.

Oxidation

Preliminary evidence of less disruption to antioxidanta molecule that can cause a free radical molecule to stabilize and become less reactive; an antioxidant can reduce harmful oxidation from free radicals levels during general anesthesia for radical surgery among people with intestinal cancer treated with acupuncture

Your microbiome

Preliminary evidence of better intestinal bacteria after colorectal resection surgery among people with colorectal cancer treated with warm needle acupuncture and moxibustion

Managing side effects and promoting wellness

Is acupuncture linked to fewer or less severe side effects or symptoms? Is it linked to less toxicity from cancer treatment? Does it support your quality of life or promote general well-being? We present the evidence.

Anxiety

Modest evidencesignificant effects in at least three small but well-designed randomized controlled trials (RCTs), or one or more well-designed, mid-sized clinical studies of reasonably good quality (RCTs or observational studies), or several small studies aggregated into a meta-analysis (this is the CancerChoices definition; other researchers and studies may define this differently) of less anxiety before surgery among people treated with acupuncture

Preliminary evidencesignificant effects in small or poorly designed clinical studies OR conflicting results in adequate studies but a preponderance of evidence of an effect (this is the CancerChoices definition; other researchers and studies may define this differently) of less anxiety or worry, irritation, and tenseness during or after chemotherapy among people treated with acupuncture

No evidence of additional benefitoverall, one or more studies did not demonstrate that a treatment or intervention led to an expected outcome; this does not always mean that there is no effect in clinical practice, but that the studies may have been underpowered (too few participants) or poorly designed. Larger, well-designed studies provide more confidence in making assessments. to massage therapy for anxiety during reconstructive surgery among people with breast cancer treated with acupuncture in a preliminary study

During or after treatment: preliminary evidence of less anxiety or worry, irritation, and tenseness during or after chemotherapy among people treated with acupuncture

Lower anxiety scores after chemotherapy for solid tumors among people treated with either acupuncture or sham acupuncture added to usual care compared to usual care alone in a small RCTrandomized controlled trial, a study design in which people are randomly assigned to either an experimental group or a control group to compare the outcomes from different treatments; an RCT is considered a strong design for determining a therapy’s effects¹⁴Bao T, Baser R et al. Health-related quality of life in cancer survivors with chemotherapy-induced peripheral neuropathy: a randomized clinical trial. Oncologist. 2021 Nov;26(11):e2070-e2078.
Lower levels of worry, irritation, and tenseness during or after chemotherapy for breast cancer among people treated with 2 sessions per week for 8 consecutive weeks of electroacupuncture plus manual acupuncture compared to minimal acupuncture stimulation (MAS) to In a small RCT¹⁵Zhang ZJ, Man SC et al. Electroacupuncture trigeminal nerve stimulation plus body acupuncture for chemotherapy-induced cognitive impairment in breast cancer patients: An assessor-participant blinded, randomized controlled trial. Brain, Behavior, and Immunity. 2020 Aug;88:88-96.

During breast reconstruction: no evidence of additional benefit to massage therapy for anxiety during reconstructive surgery among people with breast cancer treated with acupuncture in a preliminary study

No additional benefit for anxiety among people undergoing autologous tissue breast reconstruction with acupuncture and massage compared to massage alone in a small RCT¹⁶Dilaveri CA, Croghan IT et al. Massage compared with massage plus acupuncture for breast cancer patients undergoing reconstructive surgery. Journal of Alternative and Complementary Medicine. 2020 Jul;26(7):602-609.

With surgery: modest evidence of less anxiety before surgery among people treated with acupuncture

Less anxiety before surgery, mostly for brain tumors, among people treated with acupuncture compared to people with less anxiety in a review of 7 RCTs¹⁷Oteri V, Martinelli A, Crivellaro E, Gigli F. The impact of preoperative anxiety on patients undergoing brain surgery: a systematic review. Neurosurgical Review. 2021 Feb 19.

Blood-related side effects

Modest evidence of less therapy-induced bone marrow suppression during cancer treatment among people with lung cancer treated with acupuncture

Preliminary evidence of better white blood cell counts after radical resection of colorectal cancer among people treated with warm-needle acupuncture and moxibustion

During treatment: modest evidence of less therapy-induced bone marrow suppression during cancer treatment among people with lung cancer treated with acupuncture

Less therapy-induced bone marrow suppression (hemoglobin, platelet, and white blood cell reduction) during cancer treatment among people with lung cancer treated with acupoint stimulation compared to controls in a meta-analysisa statistical analysis that combines the results of two or more research studies; the results of smaller research studies addressing the same or similar questions can be analyzed as though they are one bigger, more powerful study of 31 controlled trialsa study design in which people are assigned to either an experimental group or a control group to compare the outcomes from different treatment; assignment is not random, and so this is not as strong a study design as a randomized controlled trial, but still stronger than an uncontrolled trial; study authors’ note: “Acupoint stimulation varies from needle insertion, pressure, plaster application, and moxibustion to herbal extraction on the acupoints.”¹⁸Chen HY, Li SG, Cho WC, Zhang ZJ. The role of acupoint stimulation as an adjunct therapy for lung cancer: a systematic review and meta-analysis. BMC Complementary and Alternative Medicine. 2013 Dec 17;13:362.

With surgery: preliminary evidence of better white blood cell counts after radical resection of colorectal cancer among people treated with warm-needle acupuncture and moxibustion

Lower leukopenia after radical resection of colorectal cancer among people treated with warm-needle acupuncture and moxibustion stimulation and conventional medication compared to conventional medication alone in a small RCTrandomized controlled trial, a study design in which people are randomly assigned to either an experimental group or a control group to compare the outcomes from different treatments; an RCT is considered a strong design for determining a therapy’s effects¹⁹Sun H, Zhang B, Qian HH, Chen ZC. [Effect of warm-needle moxibustion intervention on immune function and intestinal flora in patients after colorectal cancer radical operation]. Zhen Ci Yan Jiu. 2021 Jul 25;46(7):592-7. Chinese.

Body composition and cachexia

Weak evidenceone or more case studies, supported by animal evidence OR small treatment effects of limited clinical significance OR studies with no controls OR weak trends of effects (this is the CancerChoices definition; other researchers and studies may define this differently) of weight gain and less muscle loss during chemotherapy among people with gastrointestinal cancer treated with acupuncture

Breathlessness

Modest evidence of less breathlessness among people with advanced diseases including cancer treated with acupuncture

Changes in appetite

Weak evidence of better appetite among people with gastrointestinal cancer treated with acupuncture

Cognitive difficulties

Preliminary evidence of better cognitive function due to less sleep disturbance among people with cancer treated with acupuncture

Depression or mood disturbance

No evidence of an effectoverall, one or more studies did not demonstrate that a treatment or intervention led to an expected outcome; this does not always mean that there is no effect in clinical practice, but that the studies may have been underpowered (too few participants) or poorly designed. Larger, well-designed studies provide more confidence in making assessments. on mood distress among people with cancer treated with acupuncture in combined analysis of studies

Preliminary evidence of less depression among people with cancer treated with acupuncture

No evidence of additional benefit to massage therapy for mood during autologous tissue breast reconstruction among people treated with acupuncture in a preliminary study

Without regard to treatment phase

No evidence of an effect on mood distress among people with cancer treated with acupuncture in combined analysis of studies

Preliminary evidence of less depression among people with cancer treated with acupuncture

No evidence of an effect on mood distress among people with cancer treated with acupuncture compared to controls in a meta-analysisa statistical analysis that combines the results of two or more research studies; the results of smaller research studies addressing the same or similar questions can be analyzed as though they are one bigger, more powerful study of 67 RCTsrandomized controlled trial, a study design in which people are randomly assigned to either an experimental group or a control group to compare the outcomes from different treatments; an RCT is considered a strong design for determining a therapy’s effects of low to moderate quality²⁴Tao WW, Jiang H et al. Effects of acupuncture, tuina, tai chi, qigong, and traditional Chinese medicine Five-Element Music Therapy on symptom management and quality of life for cancer patients: a meta-analysis. Journal of Pain and Symptom Management. 2016 Apr;51(4):728-747.
Less depression among people with breast cancer treated with acupuncture compared to usual care or waitlist controls in a meta-analysis of 20 RCTs²⁵Li H, Schlaeger JM et al. Acupuncture improves multiple treatment-related symptoms in breast cancer survivors: a systematic review and meta-analysis. Journal of Alternative and Complementary Medicine. 2021 Dec;27(12):1084-1097.
Lower depression scores among people with cancer-related depression treated with sertraline hydrochloride and Tiaodu Jieyu acupuncture for 6 weeks compared to sertraline hydrochloride alone in a small RCT²⁶Lian JL, Wu XM, Sun X, Wang YJ, Li YH. [Effect of Tiaodu Jieyu acupuncture on cancer-related depression: a randomized controlled trial]. Zhongguo Zhen Jiu. 2021 Apr 12;41(4):381-5. Chinese.

During treatment: no evidence of additional benefit to massage therapy for mood during autologous tissue breast reconstruction among people treated with acupuncture in a preliminary study

No additive benefit for mood among people undergoing autologous tissue breast reconstruction treated with acupuncture and massage compared to massage alone in a small RCT²⁷Dilaveri CA, Croghan IT et al. Massage compared with massage plus acupuncture for breast cancer patients undergoing reconstructive surgery. Journal of Alternative and Complementary Medicine. 2020 Jul;26(7):602-609.

Fatigue

Modest evidence of less cancer-related fatigue without regard to treatment phase among people treated with acupuncture

Good evidencesignificant effects in one large or several mid-sized and well-designed clinical studies (randomized controlled trials (RCTs) with an appropriate placebo or other strong comparison control or observational studies that control for confounds) (this is the CancerChoices definition; other researchers and studies may define this differently) of less fatigue during or after cancer treatment among people treated with acupuncture

No evidence of additional benefit to massage therapy for fatigue during autologous tissue breast reconstruction among people treated with acupuncture in a preliminary study

Gastrointestinal symptoms, including nausea and vomiting

Preliminary evidence of less nausea and vomiting among people treated with acupuncture without regard to treatment phase

Modest evidence of less chemotherapy-induced diarrhea or nausea and vomiting among people treated with acupuncture

No evidence of an effect on gastrointestinal symptoms among people treated with acupuncture in a combined analysis of studies

Preliminary evidence of quicker return of bowel function and less nausea and vomiting after colorectal cancer surgery among people treated with acupuncture

No evidence of additional benefit to massage therapy for nausea during autologous tissue breast reconstruction among people treated with acupuncture in a preliminary study

Without regard to treatment phase: preliminary evidence of less nausea and vomiting among people treated with acupuncture

Less nausea and vomiting among people with cancer treated with acupuncture in a meta-analysisa statistical analysis that combines the results of two or more research studies; the results of smaller research studies addressing the same or similar questions can be analyzed as though they are one bigger, more powerful study of 2 RCTsrandomized controlled trial, a study design in which people are randomly assigned to either an experimental group or a control group to compare the outcomes from different treatments; an RCT is considered a strong design for determining a therapy’s effects of low to moderate quality³⁹Tao WW, Jiang H et al. Effects of acupuncture, tuina, tai chi, qigong, and traditional Chinese medicine Five-Element Music Therapy on symptom management and quality of life for cancer patients: a meta-analysis. Journal of Pain and Symptom Management. 2016 Apr;51(4):728-747.

During chemotherapy: modest evidence of less chemotherapy-induced diarrhea or nausea and vomiting among people treated with acupuncture

Less nausea and vomiting among people with lung cancer undergoing treatment and also treated with acupoint stimulation compared to controls in a meta-analysis of 31 controlled trialsa study design in which people are assigned to either an experimental group or a control group to compare the outcomes from different treatment; assignment is not random, and so this is not as strong a study design as a randomized controlled trial, but still stronger than an uncontrolled trial of moderate quality; study authors’ note: “Acupoint stimulation varies from needle insertion, pressure, plaster application, and moxibustion to herbal extraction on the acupoints”⁴⁰Chen HY, Li SG, Cho WC, Zhang ZJ. The role of acupoint stimulation as an adjunct therapy for lung cancer: a systematic review and meta-analysis. BMC Complementary and Alternative Medicine. 2013 Dec 17;13:362.
Reduced incidence of acute vomiting, but not acute or delayed nausea severity among people undergoing chemotherapy and taking antiemetic medication with acupuncture-point stimulation compared to controls in a systematic review of 11 studies⁴¹Ezzo JM, Richardson MA et al. Acupuncture-point stimulation for chemotherapy-induced nausea or vomiting. Cochrane Database of Systematic Reviews. 2006 Apr 19;(2):CD002285.Our note: acupuncture-point stimulation therapies in this meta-analysis include stimulation with needle, electroacupuncture, and acupressure
Less nausea, vomiting, abdominal distention and diarrhea among people with spleen and stomach deficiency syndrome after colon cancer surgery and receiving hyperthermic intraperitoneal chemotherapy when treated with acupuncture and ondansetron compared to ondansetron alone in a mid-sized RCT⁴²Gu XY, Gao ZQ, Zhang ZJ, Huang ZM, Xie XH. [Influence of warming needling technique on gastrointestinal reaction after hyperthermic intrape-ritoneal chemotherapy in patients with postoperation of colon cancer] [Article in Chinese]. Zhen Ci Yan Jiu. 2020;45(4):315-319.
Fewer incidents of diarrhea among people with breast cancer during or after chemotherapy treated with 2 sessions per week for 8 consecutive weeks of electroacupuncture plus manual acupuncture compared to minimal acupuncture stimulation (MAS) to in a small RCT⁴³Zhang ZJ, Man SC et al. Electroacupuncture trigeminal nerve stimulation plus body acupuncture for chemotherapy-induced cognitive impairment in breast cancer patients: An assessor-participant blinded, randomized controlled trial. Brain, Behavior, and Immunity. 2020 Aug;88:88-96.

During hormone therapy: no evidence of an effect on gastrointestinal symptoms among people treated with acupuncture in a combined analysis of studies

No change in gastrointestinal symptoms among people with breast cancer receiving hormone therapy and treated with acupuncture compared to control or placebo in a meta-analysis of 20 RCTs of moderate quality⁴⁴Yuanqing P, Yong T et al. Acupuncture for hormone therapy-related side effects in breast cancer patients: a grade-assessed systematic review and updated meta-analysis. Integrative Cancer Therapies. 2020 Jan-Dec;19:1534735420940394.

With surgery

Preliminary evidence of quicker return of bowel function and less nausea and vomiting after colorectal cancer surgery among people treated with acupuncture

No evidence of additional benefit to massage therapy for nausea during autologous tissue breast reconstruction among people treated with acupuncture in a preliminary study

Shorter times to passing gas and bowel movement after open or laparoscopic resection for colorectal cancer when receiving simo decoction (SMD, a traditional Chinese medicine) and acupuncture for 5 consecutive days following surgery compared to chewing gum or no intervention in a mid-sized RCT⁴⁵Yang Y, Zuo HQ et al. Comparison of efficacy of simo decoction and acupuncture or chewing gum alone on postoperative ileus in colorectal cancer resection: a randomized trial. Scientific Reports. 2017 Jan 19;7:37826.
Less nausea and vomiting among people who underwent radical resection of colorectal cancer treated with warm-needle acupuncture and moxibustion stimulation and conventional medication compared to conventional medication alone in a small RCT⁴⁶Sun H, Zhang B, Qian HH, Chen ZC. [Effect of warm-needle moxibustion intervention on immune function and intestinal flora in patients after colorectal cancer radical operation]. Zhen Ci Yan Jiu. 2021 Jul 25;46(7):592-7. Chinese.
No additive benefit for nausea during autologous tissue breast reconstruction among people treated with acupuncture and massage compared to massage alone in a small RCT⁴⁷Dilaveri CA, Croghan IT et al. Massage compared with massage plus acupuncture for breast cancer patients undergoing reconstructive surgery. Journal of Alternative and Complementary Medicine. 2020 Jul;26(7):602-609.

Hot flashes

Preliminary (conflicting) evidence of fewer hot flashes without regard to treatment phase among people with cancer, mostly with breast cancer, treated with acupuncture

Good evidence of fewer hot flashes during cancer treatment, including hormone therapy, among people with breast cancer treated with acupuncture

Weak evidence of fewer hot flashes after treatment among people with breast cancer treated with acupuncture

Modest evidence of fewer adverse effects among people treated with acupuncture compared to non-hormonal medication for hot flashes

Lymphedema

Weak evidence of fewer symptoms of breast cancer-related lymphedemaswelling caused by a blockage in the lymphatic system, most commonly caused by lymph node removal or damage due to cancer treatment among people treated with acupuncture

Weak evidence of fewer symptoms of cancer-related lymphedemaswelling caused by a blockage in the lymphatic system, most commonly caused by lymph node removal or damage due to cancer treatment among people treated with acupuncture

A weak trend of less breast cancer-related lymphedema swelling among people treated with acupuncture compared to controls in a review of reviews, systematic reviews, and meta-analysisa statistical analysis that combines the results of two or more research studies; the results of smaller research studies addressing the same or similar questions can be analyzed as though they are one bigger, more powerful study⁶¹Marchica P, D’Arpa S et al. Integrated treatment of breast cancer-related lymphedema: a descriptive review of the state of the art. Anticancer Research. 2021 Jul;41(7):3233-3246.
A weak trend towards lower levels of lymphedema among people with breast cancer treated with acupuncture compared to sham acupuncture in a meta-analysis of 20 RCTsrandomized controlled trial, a study design in which people are randomly assigned to either an experimental group or a control group to compare the outcomes from different treatments; an RCT is considered a strong design for determining a therapy’s effects⁶²(Li H, Schlaeger JM et al. Acupuncture Improves Multiple Treatment-Related Symptoms in Breast Cancer Survivors: A Systematic Review and Meta-Analysis. Journal of Alternative and Complementary Medicine. 2021 Dec;27(12):1084-1097.
Higher effective treatment rate for lymphedema but no significant improvements in front flexion or back extension among people with breast cancer-related lymphedema treated with acupuncture compared to controls in a meta-analysis of 8 RCTs of low quality⁶³Yu S, Zhu L, Xie P, Jiang S, Yang Z, He J, Ren Y. Effects of acupuncture on breast cancer-related lymphoedema: a systematic review and meta-analysis. Explore (NY). 2020 Mar-Apr;16(2):97-102.
Smaller arm circumference among people with breast cancer treated with acupuncture compared to controls in a meta-analysis of 2 RCTs⁶⁴Jang S, Ko Y et al. Acupuncture as an adjuvant therapy for management of treatment-related symptoms in breast cancer patients: systematic review and meta-analysis (PRISMA-compliant). Medicine (Baltimore). 2020 Dec 11;99(50):e21820.
No change in arm circumference among people with breast cancer-related lymphedema treated with acupuncture compared to controls in a meta-analysis of 2 RCTs of medium to high quality⁶⁵Chien TJ, Liu CY, Fang CJ. The effect of acupuncture in breast cancer-related lymphoedema (BCRL): a systematic review and meta-analysis. Integrative Cancer Therapies. 2019 Jan-Dec;18:1534735419866910.
Substantial reduction in circumference of elbow joints and effectiveness rate among people with breast cancer-related lymphedema treated with acupuncture compared to usual care in a meta-analysis of 2 RCTs of low to medium quality⁶⁶Zhang X, Wang X, Zhang B, Yang S, Liu D. Effects of acupuncture on breast cancer-related lymphoedema: a systematic review and meta-analysis of randomised controlled trials. Acupuncture in Medicine. 2019 Feb;37(1):16-24.

Neurological symptoms

Good evidence of fewer symptoms and pain related to chemotherapy-induced peripheral neuropathydamage to the peripheral nerves outside the brain and spinal cord among people treated with acupuncture

Oral symptoms

Modest evidence of less effect at least three small but well-designed RCTs, or one or more well-designed, mid-sized clinical studies of reasonably good quality (RCTs or observational studies), or several small studies aggregated into a meta-analysis found less effect (this is the CancerChoices definition; other researchers and studies may define this differently) than cholinergic agonists in relieving symptoms of dry mouth among people treated with acupuncture

Preliminary evidence of fewer dry mouth symptoms among people treated with acupuncture compared to sham acupuncture or controls

Compared to cholinergic agonists: modest evidence of less effect in relieving symptoms of dry mouth among people with head and neck cancer treated with acupuncture

Less relief of symptoms of dry mouth among people with head and neck cancer treated with acupuncture compared to cholinergic agonists in a meta-analysisa statistical analysis that combines the results of two or more research studies; the results of smaller research studies addressing the same or similar questions can be analyzed as though they are one bigger, more powerful study of 8 intervention trials⁶⁹Lovelace TL, Fox NF, Sood AJ, Nguyen SA, Day TA. Management of radiotherapy-induced salivary hypofunction and consequent xerostomia in patients with oral or head and neck cancer: meta-analysis and literature review. Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology. 2014 May;117(5):595-607.

Compared to usual care or other controls: preliminary evidence of fewer symptoms of dry mouth among people treated with acupuncture

Fewer symptoms but no change in salivary flow rate among people with cancer with radiation-induced dry mouth (xerostomia) treated with acupuncture compared to sham acupuncture, standard oral care, usual care, or no treatment in a meta-analysis of 3 RCTsrandomized controlled trial, a study design in which people are randomly assigned to either an experimental group or a control group to compare the outcomes from different treatments; an RCT is considered a strong design for determining a therapy’s effects of low quality⁷⁰Ni X, Tian T et al. Acupuncture for radiation-induced xerostomia in cancer patients: a systematic review and meta-analysis. Integrative Cancer Therapies. 2020 Jan-Dec;19:1534735420980825.
A very small increase in unstimulated whole saliva and stimulated whole saliva, but no evidence of an effect on symptoms, and also more adverse effects (mild and temporary tiny bruises and tiredness) among people with dry mouth treated with acupuncture compared to controls in a meta-analysis of 9 RCTs of low quality⁷¹Furness S, Bryan G, McMillan R, Worthington HV. Interventions for the management of dry mouth: non-pharmacological interventions. Cochrane Database of Systematic Reviews. 2013 Aug 30;(8):CD009603.
Less dry mouth among people with head and neck cancer treated with acupuncture compared to baseline (all studies) or controls (1 study) in a review of 3 RCTs of low to moderate quality⁷²O’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. Acupuncture in Medicine. 2010 Dec;28(4):191-9.
Insufficient evidence to draw conclusions about effects on dry mouth in a systematic review of 10 RCTs of low quality⁷³Assy Z, Brand HS. A systematic review of the effects of acupuncture on xerostomia and hyposalivation. BMC Complementary and Alternative Medicine. 2018 Feb 13;18(1):57.

Pain

Good evidence of less cancer-related pain without regard to treatment phase among people treated with acupuncture, whether alone or in addition to conventional pain treatments

Preliminary evidence of fewer headaches during or after chemotherapy among people with breast cancer treated with acupuncture

Good evidence of less pain related to surgery among people with cancer treated with acupuncture

Modest evidence of less pain related to aromatase inhibitors among people treated with acupuncture

No evidence of an effect on pain during chemotherapy, radiotherapy, or hormone therapy among people treated with acupuncture in combined analyses of studies

Quality of life and physical function

Modest evidence of better quality of life and physical function without regard to treatment phase among people treated with acupuncture

Modest evidence of better physical performance and quality of life during conventional treatment among people treated with acupuncture

Preliminary evidence of better function during chemotherapy after colon cancer surgery among people treated with acupuncture

Good evidence of less stiffness but no evidence of an effect on quality of life during hormone therapy among people with breast cancer treated with acupuncture

Modest evidence of better quality of life among people with advanced disease treated with acupuncture

Sleep disruption

Modest evidence of less sleep disturbance without regard to treatment phase among people treated with acupuncture

Weak evidence of less sleep disturbance during chemotherapy among people treated with acupuncture

Stress

Weak evidence of less stress without regard to treatment phase among people with cancer treated with acupuncture

No evidence of additional benefit to massage therapy for stress during autologous tissue breast reconstruction among people treated with acupuncture in a preliminary study

Other side effects and symptoms

Preliminary evidence of shorter hospital stays after surgery for colorectal cancer among people treated with acupuncture

Weak evidence of less ringing in ears (tinnitus) among people with breast cancer during or after chemotherapy

Acupuncture as part of combination therapies

Modest evidence of less breast cancer-related lymphedema among people treated with acupuncture combined with drugs or functional exercise

Preliminary evidence of less pain among people with multiple myeloma treated with acupuncture combined with methylcobalamin

Preliminary evidence of shorter hospital stays after open or laparoscopic resection for colorectal cancer among people treated with simo decoction and acupuncture

Acupuncture combined with drugs or functional exercise: modest evidence of less breast cancer-related lymphedema among people treated with acupuncture combined with drugs or functional exercise

Less breast cancer-related lymphedema among people treated with acupuncture combined with drugs or functional exercise compared with controls in a meta-analysisa statistical analysis that combines the results of two or more research studies; the results of smaller research studies addressing the same or similar questions can be analyzed as though they are one bigger, more powerful study of 13 RCTsrandomized controlled trial, a study design in which people are randomly assigned to either an experimental group or a control group to compare the outcomes from different treatments; an RCT is considered a strong design for determining a therapy’s effects of low quality¹¹⁹Hou W, Pei L et al. Acupuncture therapy for breast cancer-related lymphedema: a systematic review and meta-analysis. Journal of Obstetrics and Gynaecology Research. 2019 Dec;45(12):2307-2317.

Acupuncture combined with methylcobalamin (a B vitamin): preliminary evidence of less pain among people with multiple myeloma treated with acupuncture combined with methylcobalamin

Less pain among people with multiple myeloma treated with acupuncture combined with methylcobalamin compared to methylcobalamin alone in a mid-sized RCT¹²⁰Han X, Wang L et al. Acupuncture combined with methylcobalamin for the treatment of chemotherapy-induced peripheral neuropathy in patients with multiple myeloma. BMC Cancer. 2017 Jan 9;17(1):40.

Simo decoction (SMD, a traditional Chinese medicine) and acupuncture: preliminary evidence of Shorter hospital stays after open or laparoscopic resection for colorectal cancer among people treated with simo decoction and acupuncture

Shorter hospital stays after open or laparoscopic resection for colorectal cancer among people treated with simo decoction and acupuncture for 5 consecutive days following surgery compared to chewing gum or no intervention in a mid-sized RCT¹²¹Yang Y, Zuo HQ et al. Comparison of efficacy of simo decoction and acupuncture or chewing gum alone on postoperative ileus in colorectal cancer resection: a randomized trial. Scientific Reports. 2017 Jan 19;7:37826.

Side effects and symptoms not specific to cancer

Good evidence of comparable effects on hot flashes among people treated with acupuncture compared to non-hormonal drugs

Modest evidence of higher frequency of hot flashes among people treated with acupuncture compared to hormonal therapy

Preliminary evidence of less clinical depression among people treated with acupuncture

Good evidence of comparable effects on hot flashes among people treated with acupuncture compared to non-hormonal drugs

Comparably fewer hot flashes among menopausal women treated with acupuncture or non-hormonal drugs including selective serotonin reuptake inhibitors / serotonin-norepinephrine reuptake inhibitors and neuroleptic agents such as gabapentin and escitalopram in a meta-analysisa statistical analysis that combines the results of two or more research studies; the results of smaller research studies addressing the same or similar questions can be analyzed as though they are one bigger, more powerful study of 17 meta-analyses of medium to high quality¹²²Li T, Zhang Y et al. Quantitative study on the efficacy of acupuncture in the treatment of menopausal hot flashes and its comparison with nonhormonal drugs. Menopause. 2021 Mar 15;28(5):564-572.

Modest evidence of higher frequency of hot flashes among people treated with acupuncture compared to hormonal therapy

More hot flashes per day but no difference in severity among menopausal women with acupuncture compared to hormonal therapy in a meta-analysis of 16 RCTsrandomized controlled trial, a study design in which people are randomly assigned to either an experimental group or a control group to compare the outcomes from different treatments; an RCT is considered a strong design for determining a therapy’s effects with low or very low quality evidence¹²³Dodin S, Blanchet C et al. Acupuncture for menopausal hot flushes. Cochrane Database of Systematic Reviews. 2013 Jul 30;2013(7):CD007410.

Preliminary evidence of less clinical depression among people treated with acupuncture

Better depression remission rates among people with clinical depression treated with manual acupuncture compared to antidepressant medications in a meta-analysis of 19 RCTs of low quality¹²⁴Haller H, Anheyer D, Cramer H, Dobos G. Complementary therapies for clinical depression: an overview of systematic reviews. BMJ Open. 2019 Aug 5;9(8):e028527.
Less severe depression among people with clinical depression with manual acupuncture compared to usual care or when added to usual care in a meta-analysis of 4 RCTs of very low quality, but only a weak trend toward less severe depression compared to sham treatment (7 RCTs) or antidepressant medications (19 RCTs) in meta-analyses of RCTs of very low quality¹²⁵Haller H, Anheyer D, Cramer H, Dobos G. Complementary therapies for clinical depression: an overview of systematic reviews. BMJ Open. 2019 Aug 5;9(8):e028527.
No evidence of an effect on depression remission rates among people with clinical depression with manual acupuncture compared to sham treatment (7 RCTs), usual care (4 RCTs), or when added to usual care (8 RCTs) in meta-analyses of RCTs of low quality¹²⁶Haller H, Anheyer D, Cramer H, Dobos G. Complementary therapies for clinical depression: an overview of systematic reviews. BMJ Open. 2019 Aug 5;9(8):e028527.

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Author

Nancy Hepp, MS

Lead Researcher and Program Manager

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Reviewers

Emily Ryan, ND, MSOM, LAc

Research Associate

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Laura Pole, RN, MSN, OCNS

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Janet Spitzer, MD

Integrative physician

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Last update: March 12, 2023

Last full literature review: February 2022

CancerChoices provides information about integrative in cancer care, a patient-centered approach combining the best of conventional care, self care and evidence-informed complementary care in an integrated plan cancer care. We review complementaryin cancer care, complementary care involves the use of therapies intended to enhance or add to standard conventional treatments; examples include supplements, mind-body approaches such as yoga or psychosocial therapy, and acupuncture therapies and self-care lifestyle actions and behaviors that may impact cancer outcomes; examples include eating health-promoting foods, limiting alcohol, increasing physical activity, and managing stress practices to help patients and professionals explore and integrate the best combination of conventionalthe cancer care offered by conventionally trained physicians and most hospitals; examples are chemotherapy, surgery, and radiotherapy and complementary therapies and practices for each person.

Our staff have no financial conflicts of interest to declare. We receive no funds from any manufacturers or retailers gaining financial profit by promoting or discouraging therapies mentioned on this site.

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123	Dodin S, Blanchet C et al. Acupuncture for menopausal hot flushes. Cochrane Database of Systematic Reviews. 2013 Jul 30;2013(7):CD007410.
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Author

Nancy Hepp, MS

Reviewers

Emily Ryan, ND, MSOM, LAc

Laura Pole, RN, MSN, OCNS

Janet Spitzer, MD

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