Study: Can acupressure be used to treat cancer-related fatigue?
Contents
At a glance | In-depth |
Findings | Limitations |
Clinical trials | Resources |
Questions for your doctor |
STUDY AT A GLANCE
This study is about:
Whether self-administered acupressure can improve persistent cancer-related fatigue in breast cancer survivors.
Why is this study important?
Breast cancer survivors commonly experience fatigue, which can lead to poor sleep and quality of life, yet few treatments are available.
Study findings:
- Some breast cancer survivors who used acupressure had less fatigue over a 10-week period than breast cancer survivors who did not use acupressure.
What does this mean for me?
This study suggests that acupressure, which uses firm finger pressure to stimulate the same sensitivity points used in acupuncture, may be used for treating fatigue in breast cancer survivors. However, not all breast cancer survivors who used acupressure benefited from it. More work needs to be done to determine which patients might benefit most from acupressure, and how long patients should use it. Breast cancer survivors experiencing cancer-related fatigue should talk to their health care providers to see if acupressure is an option they might explore, and to find out what other options are available.
Posted 8/9/16
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References
Zick, SM, Sen A, Wyatt GK, et al. “Investigation of 2 Types of Self-administered Acupressure for Persistent Cancer-Related Fatigue in Breast Cancer Survivors, A .” JAMA Oncology. Published online first on July 16, 2016.
Disclosure
FORCE receives funding from industry sponsors, including companies that manufacture cancer drugs, tests and devices. All XRAYS articles are written independently of any sponsor and are reviewed by members of our Scientific Advisory Board prior to publication to assure scientific integrity.
This article is relevant for:
Breast cancer survivors and people in treatment who are experiencing fatigue
This article is also relevant for:
people with breast cancer
people with ER/PR + cancer
people with Her2-positive cancer
men with breast cancer
people with metastatic or advanced cancer
people with a genetic mutation linked to cancer risk
people with triple negative breast cancer
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IN DEPTH REVIEW OF RESEARCH
Study background:
About one-third of breast cancer survivors report experiencing moderate to severe fatigue after breast cancer treatment. In some cases, this fatigue can last up to 10 years! Finding ways to combat this fatigue is critical, as it affects quality of life. Even though fatigue is a major issue for some breast cancer survivors, few therapeutic options are available.
Suzanna Zick and her colleagues from the University of Michigan published work in the journal JAMA Oncology in July 2016 that examined acupressure as a potential treatment for persistent fatigue in breast cancer survivors.
Researchers of this study wanted to know:
Can relaxing acupressure or stimulating acupressure help breast cancer survivors with their persistent cancer-related fatigue?
Population(s) looked at in the study:
The women in this study were recruited from the Michigan Tumor Registry, with data collected from women who live in Michigan. These women previously had breast cancer between stages 0 to III, completed their cancer treatments 12 months prior to the study, and were currently cancer free. All women in the study scored 4 or higher on the Brief Fatigue Inventory (BFI), which assesses the severity and impact of cancer-related fatigue. Scores on the BFI range from zero (no fatigue) to 10 (as bad [fatigue] as you can imagine). Women who had a cancer diagnosis other than breast or skin cancer in the past 10 years, an untreated major depressive disorder, another diagnosed condition associated with fatigue, or who had previously done acupressure were not included in the study.
Study participants included 270 women, each randomly assigned to one of three groups:
- 94 women received relaxing acupressure
- 90 women received stimulating acupressure
- 86 women received only usual care—any treatment for fatigue that they were already receiving from their health care providers.
The women who received the acupressure treatments were taught by a trained acupressure educator to self-administer the therapy. They were assessed to see how well they performed the acupressure (for example, if they could locate the correct acupoints) at their first visit and at weeks 3 and 6.
Study findings:
- A score of less than 4 on the Brief Fatigue Inventory (BFI) is considered normal for fatigue levels. After doing acupressure or usual care once daily for 6 weeks:
- about 66% of breast cancer survivors who did relaxing acupressure had a BFI score of less than 4
- about 61% of women who did stimulating acupressure had a BFI score of less than 4
- about 30% of women who did usual care had a BFI score of less than 4
- The women stopped doing the acupressure after 6 weeks. Their BFI scores were assessed again at 10 weeks to see if the effects of acupressure remained. At 10 weeks:
- about 56% of breast cancer survivors who did relaxing acupressure had a BFI of less than 4
- about 61% of women who did stimulating acupressure had a BFI of less than 4
- about 30% of women who did usual care had a BFI score of less than 4
- At week 6, women who did relaxing acupressure saw an improvement in their sleep quality compared to women who did usual care. However, that improvement did not persist once acupressure was stopped.
- Women who did stimulating acupressure did not see any improvement in sleep quality.
- At weeks 6 and 10, women who did relaxing acupressure had a better quality of life compared to women who had usual care.
- Women who did stimulating acupressure did not see any improvement in quality of life.
Limitations:
The majority (about 90%) of women who participated in this study were white non-Hispanics; the majority of the minority women were black women. Because this study did not observe how male breast cancer survivors or people with breast cancer respond to acupressure, these findings may not be applicable to all breast cancer survivors. Additionally, this study looked only at doing acupressure for 6 weeks and only measured its effects after 10 weeks; researchers do not know how well the effects might hold up beyond 10 weeks. Six women could not complete the study because of bruising or difficulty doing the acupressure. And while the women were assessed to see how well they performed the acupressure, the therapy was self-administered, which means that the women’s techniques may have varied, and that they may have not adhered perfectly to the recommended daily schedule.
Finally, as pointed out in a PLOS blog post by James Coyne, a professor of health psychology, this was a single blind trial, which means that the patients’ health care providers knew which treatment they were getting, which could potentially bias how they were treated by their health care provider. And while the patients technically did not know which treatment they were getting, it would be obvious to the patients if they were getting the control treatment (no acupressure). More work should be done to see which breast cancer survivors are more likely to benefit from acupressure.
Conclusions:
The results of this study suggest that acupressure may be a therapeutic option for breast cancer survivors experiencing persistent cancer-related fatigue. According to the study authors, “Self-administered relaxing acupressure could offer an inexpensive, easy-to-learn intervention for improving fatigue, sleep, and quality of life in fatigued breast cancer survivors.” However, more work needs to be done to explore these findings further. These findings have not changed clinical guidelines—acupressure is not guaranteed to improve fatigue for breast cancer survivors. Patients should discuss with their health care providers to see if acupressure would be a good option for them.
Posted 8/9/16
Share your thoughts on this XRAYS article by taking our brief survey.
The National Comprehensive Cancer Network (NCCN) in their Survivorship Guidelines has specific recommendations related to fatigue in people diagnosed with cancer.
- Patients should be told that fatigue management is an important part of their care and that fatigue can persist even after treatment ends.
- Patients should be screened for fatigue at their first visit and at regular intervals during and after treatment as indicated.
- Treating fatigue is best managed by a team of experts with specialties in different areas of supportive care, including:
- survivorship
- nutrition
- integrative medicine
- mental health
- physical therapy
- occupational therapy
- sleep therapy
- Patients should be screened and treated for symptoms that may be seen along with fatigue, including pain, emotional distress and sleep disruption.
- Interventions may include:
- physical activity
- rehabilitation, physical therapy
- yoga
- acupunture
- massage therapy
- behavioral therapy
- nutrition consultation
- consider stimulant drugs
- treatment for sleep dysfunction
Updated: 08/06/2022
- Should I try acupressure for my cancer-related fatigue?
- What are the side effects of acupressure?
- What other methods can I use to reduce my cancer-related fatigue?
- Who should I call if I experience a side effect from treatment?
- Do all women experience side effects after breast cancer treatment?
- What are potential side effects I may have after breast cancer treatment?
- What are ways to alleviate the side effects that I may experience after breast cancer treatment?
The following studies are looking at management of side effects:
Multiple cancers
- NCT02296450: Quality of Life (QoL) Assessment in Cancer Patients and Survivors With Dermatologic Conditions Using Dermatologic QoL Instruments. This large study is designed to see how skin conditions that are related to different kinds of cancer or cancer treatments affect a patient's overall well-being.
- NCT05056077: Tools to be Fit. This is a quality of life study for people with bladder, breast, colon, endometrial, kidney (renal cell carcinoma), ovarian, , or rectal cancer to figure out what tools work best for helping cancer survivors improve their diet and exercise.
- NCT03996265: Bupropion in Reducing Cancer Related Fatigue in Cancer Survivors. This will study how well the drug bupropion (welbutrin) reduces cancer-related fatigue in cancer survivors.
Breast cancer
- NCT04621721: Physical Activity at Home for Relief from Neuropathy Caused by Taxanes in People with Breast Cancer. This study will look at the effects of gain and balance training and resistance exercise (using bands) on gait, balance, and lower extremity muscle strength after a 16-week home-based exercise program compared to educational materials without an exercise program.
- NCT04586530: Telehealth and Memory Study (TAMS). The overall purpose of this trial is to confirm the effectiveness of Memory and Attention Adaptation Training (a cognitive-behavioral therapy) as a treatment for chemotherapy-related dysfunction among breast cancer survivors.
- NCT02290834: Chemotherapy-induced and brain changes in older adults with breast cancer. The study will investigate abilities and brain images before and after chemotherapy to identify people at risk for side effects and to better understand the effects of treatment on brain structure and function.
- NCT04906200: Web-Based Symptom Monitoring and Self-Management Portal for Adolescent and Young Adult Breast Cancer Survivors. This compares a web-based patient-reported symptom-monitoring and self-management portal to standard therapy in young breast cancer survivors.
- NCT04837820: The Effect of Acupuncture on Cancer-Related Difficulties. This study will test whether acupuncture can improve thinking and insomnia in breast cancer survivors. This study will also look at insomnia's link to difficulties.
- NCT03879629: TrAstuzumab Cardiomyopathy Therapeutic Intervention With Carvedilol (TACTIC). Breast cancer patients receiving Herceptin or other HER2-directed therapy are at risk of heart damage. This study is looking at whether beta-blocker drugs could help prevent this from happening.
Colorectal cancer
- NCT05239338: Preserving Fertility After Colorectal Cancer Study (PREFACE). The PREFACE Study is a study of reproductive health and clinical outcomes among individuals diagnosed with colorectal cancer between age 18 to 49 years.
- NCT06420726: Resistance Exercise and Creatine in Colorectal Cancer. This study aims to assess the feasibilty of combining creatine supplementation with resistance training versus resistance training alone in colorectal cancer survivors.
Ovarian cancer
- NCT04533763: Living WELL: A Web-Based Program for Ovarian Cancer Survivors. This studies a group-based and web-delivered tool for ovarian cancer survivors in increasing quality of life and decreasing stress, depressive mood, anxiety, and fatigue across a 12-month period.
- NCT05047926: Prehabilitation for Advanced Ovarian Cancer Patients. Prehabilitation may improve peri-operative outcomes in patients undergoing cancer surgery. This study will look at structured activity for women undergoing chemotherapy to improve their physical state prior to surgical intervention and thus improve outcomes.
cancer
- NCT03971591: Men Moving Forward: A Lifestyle Program for African-American Cancer Survivors (MMF). This study will look at Men Moving Forward (MMF), a community-based lifestyle intervention that supports adherence to nutrition and physical activity guidelines to promote improved body composition and lessen the side effects of treatment.
- NCT05155501: Pelvic Fascia spARing Radical Prostatectomy TrIAL (PARTIAL). This clinical trial is studying whether pelvic fascia-sparing radical prostatectomy has similar cancer control and sexual function outcomes; and significantly better urinary function, less penile deformity and inguinal hernia risks as compared to radical prostatectomy.
Updated: 08/28/2024
Who covered this study?
Reuters
Also published in:
The same article was also covered by Fox News
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