Acupuncture reduces hot flashes associated with endocrine therapy for breast cancer

Acupuncture significantly improved hot flashes and other endocrine symptoms in women receiving endocrine therapy for hormone receptor (HR)-positive breast cancer, according to a pooled analysis of randomized trials.

In a study conducted in the United States, China, and South Korea, patients who received immediate acupuncture reported statistically significant improvements in Functional Assessment of Cancer Therapy (FACT) endocrine symptoms subscale scores compared with patients who received delayed acupuncture (mean change 5.1 vs. 0.2; P= 0.0003), reported Weidong Lu, PhD, of the Dana-Farber Cancer Institute in Boston, and his colleagues.

Another significant improvement was seen in the hot flash score, calculated by multiplying the frequency and severity of hot flashes recorded in a daily hot flash diary (mean change -5.3 vs -1.4; P<0.003), FACT-Breast total score measuring breast cancer-related quality of life (mean change 8.0 vs. -0.01, P=0.0005), they write: cancer.

Additionally, 64% of participants in the immediate acupuncture group reported a 50% or greater reduction in their hot flash scores, compared with 18% of women in the delayed acupuncture group.

“Our findings further suggest that the benefits of acupuncture on enrolled patients persisted for at least 10 weeks after the intervention,” Lu et al. wrote.

“By managing side effects, our approach may make it easier for patients to continue taking their prescribed medications, reduce the risk of cancer recurrence, and improve long-term outcomes for breast cancer survivors,” Lu noted in a press release.

“In practice, patients interested in acupuncture for this purpose might begin with a short-term trial period to assess their response to treatment, particularly reduction in hot flashes and other symptoms,” he added. “If the trial period shows positive results, patients would then enter a longer-term program of regular acupuncture treatment for the duration of their antihormonal therapy.”

The analysis included 158 women with stages 0-III breast cancer from three randomized trials: 78 from the United States, 40 from China, and 40 from South Korea. Of these women, 81 were randomly assigned to immediate acupuncture (20 acupuncture treatments over 10 weeks) and 77 to delayed acupuncture (reduced-intensity acupuncture treatments followed by usual treatment).

The median age was 48 years, 53% were Asian and 40% were Caucasian. Nearly all patients (95%) had confirmed HR-positive disease and 61.4% were HER2-negative.

The most commonly used endocrine therapy was tamoxifen (61.4%), 32.9% were treated with aromatase inhibitors, and 15% received ovarian suppression. The mean number of hot flashes per day at baseline was 6.3, with almost two-thirds of patients experiencing 2 to 6 hot flashes per day at baseline.

The primary outcome was the change in score on the FACT endocrine symptoms subscale from baseline to week 10. At baseline, the mean score in the immediate acupuncture group was 50.3, and the mean score in the delayed acupuncture group was 51.6 (on a scale of 0 to 76).

The effect of acupuncture intervention varied by site, with the most significant benefit of acupuncture on the FACT endocrine symptoms subscale observed in Korea.

Lu and her colleagues acknowledged limitations in the studies included in their analysis, such as the lack of use of sham acupuncture as a control, but noted that systematic reviews have suggested that its use should be reconsidered because it is “not a sufficient inert control.”