Finding ways to minimize the pain caused by ovarian cancer can have a major impact on maximizing the quality of life for those dealing with this illness.
Acupuncture is one technique tried by some patients to help manage both the discomfort caused by the disease itself, as well as the side effects of the standard treatments given for ovarian cancer. Of course, it’s always advised that treatment decisions be made in consultation with a medical professional. Licensed acupuncturist and herbalist Donnielle James gave her insights on commonly asked questions about this complementary therapy during our 2021 National Conference.
Acupuncture is defined by the National Center for Complementary and Integrative Health (NCCIH) as a practice used in traditional Chinese medicine in which thin needles are inserted into the skin to trigger strategic points on the body. “To put it simply, we’re working with stimulating the energy flow (referred to as qi in traditional Chinese medicine) through the body by activating specific points,” Donnielle says. She explains that there are approximately 365 primary points on the body that are targeted in acupuncture for different purposes, including 130 on the ear, several on the scalp, and various on the abdomen, feet, ankles, and hands. “When we’re using those points, we’re able to keep qi and kind of everything balancing and we look at it as life energy.”
According to the Mayo Clinic, practitioners trained in Western medicine may describe acupuncture points slightly differently, typically viewing them as “places to stimulate nerves, muscles and connective tissue.” As the Mayo Clinic website notes, “Some believe that this stimulation boosts your body’s natural painkillers.”
Alternatives to needles can also be used for acupuncture treatment, such as magnets, tiny seeds held in place with adhesive, or simply manual pressure applied via fingertip. These other options offer a potential way for patients with a low platelet or white blood cell count to still undergo acupuncture, as Donnielle explains. “This is a way to receive treatment, especially if you are having issues with thrombocytopenia (low level of platelets in the blood) or neutropenia (low level of neutrophils in the blood) during your chemotherapy — because some doctors may advise reducing infection risks or bleeding.” Switching out needles for one of the other alternatives is also suggested for those who have experienced blood clots, either from the cancer itself or the medications being used to treat it, according to Donnielle.
For those who do choose to have needles used, Donnielle emphasizes that they are single-use, sterile, and very thin. For comparison, the width of a standard butterfly needle used to draw blood is equivalent to the combined width of 25 acupuncture needles. “They just slide under the skin. We take a lot of caution to avoid veins so there is very little bleeding associated with it,” Donnielle notes.
Adverse effects have reportedly been relatively few, according to the NCCIH, which attributes any serious complications — such as punctured organs or infections — to either improper delivery of the treatment or dirty needles. The U.S. Food and Drug Administration (FDA) does classify acupuncture needles as medical devices for use by licensed practitioners only. As such, they must be manufactured in accordance with strict regulations such as being sterile and non-toxic.
According to the American Academy of Medical Acupuncture, the treatment should not cause pain. Patients should not feel any major discomfort, particularly since the needles are not inserted deeply into the skin, but they may experience a sensation of heat, heaviness, numbness or tingling in the spots where the needles are placed. Possible side effects listed by the Mayo Clinic include soreness and minor bruising or bleeding in the areas where the needles were inserted. Other reported reactions noted by the National Cancer Institute (NCI) include feeling lightheaded or sleepy.
Donnielle does acknowledge that cancer patients, in particular, may experience “needle fatigue” due to all the blood draws and other procedures that are typically done as part of their overall medical treatments. “It’s really good to talk to your practitioner about that and the alternatives to make it gentler, such as using the least number of needles possible,” she says.
As a means of managing pain, acupuncture has a major advantage of being much less invasive than a surgical intervention. It does not require the use of anesthesia and has relatively few risks associated with it. Additionally, no preparation is needed before undergoing acupuncture, nor is there typically a recovery period needed after the treatment is completed. Acupuncture also compares favorably to opioids and other pain medications since it carries no danger of addiction, nor does it involve side effects such as constipation and nausea that are associated with some analgesics.
Though considered safe if carried out by a licensed practitioner using sterile needles, acupuncture does have the disadvantage of not being suitable for every patient. As mentioned by Donnielle, patients at risk for clots or bleeding disorders may be advised by a doctor to skip the needles. According to the Mayo Clinic, other patients who may be at risk of complications from acupuncture include those with a pacemaker and those who are pregnant. It is important that you consult with your medical team if considering acupuncture treatment.
Though the full effects of acupuncture are still not yet understood by researchers, studies do point to its success as a pain management tool for some patients. “Acupuncture appears to be a reasonable option for people with chronic pain to consider,” according to the NCCIH. The agency also notes that acupuncture has been useful in managing some side effects caused by cancer treatments.
No reliable research has yet to be reported that links the use of acupuncture to a decrease in the size of cancer tumors. As noted by Memorial Sloan Kettering Cancer Center (MSKCC), “there is no scientific evidence to show that acupuncture can be used to treat cancer or to shrink tumors.” MSKCC, however, echoes the NCCIH’s findings that acupuncture can be useful in alleviating the symptoms caused by cancer and its accompanying treatments.
Acupuncture is used to manage a whole host of symptoms and treatment side effects experienced by cancer patients, with the NCI noting its role in relieving pain, easing neuropathy symptoms, and controlling nausea and vomiting. Cancer patients may also undergo acupuncture to help with anxiety, depression, fatigue, sleep disturbance, hot flashes and dry mouth, according to the NCI.
When dealing with nausea as a side effect of cancer treatment, Donnielle recommends a technique that uses manual pressure and can be tried by patients themselves. “You can do this when you leave after a chemotherapy session if you’re not able to get to an acupuncturist right away,” she says. This self-acupressure technique involves pressing on the acupuncture point known as Pericardium 6, which is located on the inside of the wrist. “Even some of the pain doctors are familiar with this point,” Donnielle says. “In fact, I had a pain doctor ask me about this point specifically because she had heard that it was really helpful for use in reducing anesthesia side effects.”
Another self-acupressure technique that’s used to cope with the side effects of cancer treatment targets peripheral neuropathy specifically. “I know that’s a really common thing that people look for support with, especially because it’s cumulative from the chemo parts of the treatment and some of the other medications,” Donnielle notes. She advises pressing down on acupressure points located between your fingers, as well as using your fingernail to press on the tips of your fingers. “It can help relieve the sensations caused by neuropathy and get the energy flowing in the area.”
To see a demonstration of Donnielle’s recommended self-acupressure techniques and hear more from her on how acupuncture and traditional Chinese medicine can help manage ovarian cancer symptoms, visit our online video collection. You can access Donnielle’s full presentation, which is included in the session Acupuncture and Physical Therapy to Manage Side Effects and Pelvic Pain.