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Topic: Acupressure for cancer symptom relief

Summary

Acupressure is a safe treatment that can be used to relieve some symptoms of cancer and side effects of treatment. Light pressure applied to key points on the body may help with fatigue, sleep, nausea and possibly other symptoms as well. (Posted 8/1/24)

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Acupressure for cancer symptom relief
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RELEVANCE

Most relevant for: People diagnosed with cancer.

Relevance: High

Research Timeline: Post Approval


What is this topic about?

This XRAY review covers a Chinese medical technique called acupressure to relieve common cancer symptoms. It describes acupressure, discusses how it might be used by people with cancer, and provides information on where you can learn more.

Why is this topic important?

Cancer treatment can cause side effects such as fatigue and nausea. These symptoms can affect how you feel mentally and physically and your ability to work or enjoy life. People with cancer often look for ways to manage these side effects without taking additional medication. Acupressure is low- or no-cost and does not involve medicine or shots. With training, a person can do acupressure on their own.

What is acupressure?

Acupressure is an ancient Chinese approach to treating pain and other illnesses. It involves applying pressure to specific points on the body, usually for three minutes. Acupressure can be done by someone else or by yourself (self-acupressure).

The points on your body where pressure is applied are called acupoints. Acupuncture stimulates the same points with needles. Acupoints have Chinese names or are identified by numbers, words and letters. The body has over 350 acupoints, and choosing the right point for the symptom is important. Multiple points around the ears are used for acupressure. Examples of other common acupoints include:

  • Yin Tang: On the forehead between the eyebrows
  • Heart 7: On the inside wrist, right under the pinky finger
  • GV20: In the middle of the top of the head, halfway between the ears
  • Large intestine 4: Between the thumb and index finger on the hand

What does the research say?

Research on acupressure is mixed, in part because it is hard to study. People may not use acupressure in the same way for the same length of time. Some studies have been small or have not used the best research methods. Other studies combine acupressure with acupuncture. Despite this, the evidence suggests that acupressure can work for some people to help relieve nausea and fatigue. It is also being studied for pain and depression related to cancer.

Examples of recent findings include:

  • A control trial of self-administered acupressure for breast cancer looked at relaxing acupressure and stimulating acupressure to help with fatigue and sleep and improve quality of life. The two kinds of acupressure use different points on the body. Both approaches helped to reduce fatigue. Relaxing acupressure also improved sleep-related quality of life.
  • A small control trial of people with breast cancer found that acupressure on points around the ears helped nausea better than standard care. The study compared real acupressure, sham acupressure (using fake acupoints) and standard treatment. People who received sham acupressure also did better than people in the standard treatment group, suggesting a effect.
  • A small study in Turkey found that acupressure relieved cancer-related fatigue among older adults with cancer.
  • A review of 11 mostly smaller studies of self-acupressure found that self-acupressure helped with nausea and vomiting. The authors were unable to draw conclusions about other symptoms due to the size or quality of the studies involved.
  • A 2018 review of 11 studies of acupressure for fatigue found that acupressure improved fatigue in people with cancer.
  • A recent small study found that an app called EnergyPoints may help people with cancer use acupressure for sleep issues. People who participated in the study found it user-friendly. The next step is a larger study of people from a wider geographic area.
  • A small study looking at training nurses to provide acupressure to their patients showed beneficial results. Participants saw improved pain, fatigue, sleep and a reduced need for medication. A larger study is planned.

What does this mean for me?

If you have nausea or fatigue related to cancer, you may want to try acupressure. It may be helpful for pain and depression as well.

Even if you plan to do acupressure on your own, seek help to get started. Acupressure is considered very safe, but it is important to find the correct pressure point for the symptom. Many major cancer centers have information on their websites about acupressure. Some even have videos and step-by-step instructions online to help you find pressure points and try it out. Apps like EnergyPoints might be useful too.

You may also consider acupuncture. If you are interested, ask your healthcare team to refer you to a licensed acupuncturist who can help you get started. A nurse or doctor who specializes in or symptom management might be another good resource.

Reference

Beck SL, Smith R, Mindes J, et al. Feasibility and usability of EnergyPoints: A mobile health app to guide acupressure use for cancer symptom management. Integrative Cancer Therapies; 2024, 23:15347354231223965. Published online January 29, 2024.

Cheng H-L, Yeung W-F, Wong H-F, et al. Self-acupressure for symptom management in cancer patients: A systemic review. Journal of Pain and Symptom Management; 2023: 66. Published online March 8, 2023.

Ozdemir U and Tasci S. Acupressure for cancer-related fatigue in elderly cancer patients: A control study. Alternative Therapies in Health and Medicine; 2023, May;29(4):57-65.

Tan JY, Molassiotis A, Suen LKP, et al. Effects of auricular acupressure on chemotherapy-induced nausea and vomiting in breast cancer patients: a preliminary . BMC Complementary Medicine and Therapies; 2022; 87. Published online March 24, 2022.

Van de Castle B, Lukkahatai N, Billing BL, et al. Nurse-administered auricular point acupressure for cancer-related pain. Integrative Cancer Therapies; 2023;22. Published online September 14, 2023.

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. Journal of the American Medical Association Oncology; 2016:2(11):1470-1476. Published online July 7, 2016.

Zick SM and Harris RE. Acupressure for cancer-related fatigue. The ASCO Post; Published online July 25, 2018.

Self-Acupressure for cancer-related fatigue. Dana-Farber Cancer Institute Zakim Center for Integrative Therapies Remote Programming.

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.

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posted 8/1/24

Questions To Ask Your Doctor
Questions To Ask Your Doctor

Relevance: High

  • Studies suggest that acupressure may help relieve nausea and fatigue for some people. It is also being studied for pain and depression related to cancer.
  • Acupressure is hard to study. People in studies may not use acupressure in the same way for the same length of time. For example, studies differ on acupressure training, acupoint selection, and how long and how often acupressure is used. 
     

Guidelines
Guidelines

The American Society of Clinical Oncology (ASCO) endorses the Society for Integrative Oncology (SIO) guidelines that recommend the following evidence-based integrative therapies for reducing fatigue, pain, anxiety and depression.

Fatigue

To reduce fatigue during cancer treatment, the SIO recommends:

  • Exercise
  • behavioral therapy (CBT) uses exercises and skills to reduce symptoms
  • Mindfulness-based programs
  • Tai chi, a Chinese martial art, is composed of gentle, low-impact exercise while focusing on deep, slow breathing
  • Qigong is a Chinese practice using movement, body posture, breathing and meditation to optimize energy within the body, mind, and spirit.
  • American ginseng, an herb 
  • Psychoeducation is an intervention for patients and their loved ones that provides information and support to better understand and cope with illness

 

To reduce fatigue after cancer treatment the SIO recommends:

  • Exercise
  • CBT
  • Mindfulness-based programs
  • Yoga
  • Acupressure
  • Moxibustion (a type of therapy that involves burning the leaves of mugwort—a small spongy herb—close to the skin)

    CBT and mindfulness-based programs are particularly effective for managing moderate to severe fatigue after treatment.

 

Pain

To reduce pain, the SIO recommends:

  • Acupuncture for aromatase inhibitor-related joint pain
  • Acupuncture, reflexology or acupressure for general cancer pain or musculoskeletal pain
  • Hypnosis for patients who experience pain after a procedure
  • Massage for patients experiencing pain during

 

ASCO provides guidelines on use of opioids to reduce pain in cancer patients:

  • should be offered to patients experiencing moderate-to-severe pain from cancer or cancer treatment
  • dose should start at lowest possible
  • for patients with a substance use issues, clinicians should collaborate with a , pain, and/or substance use disorder specialist(s)
  • patients should be monitored for adverse effects

 

Anxiety

To reduce anxiety during cancer treatment, the SIO recommends:

  • Mindfulness-based programs, yoga, relaxation, music therapy, reflexology and aromatherapy (using inhalation).

To reduce anxiety after cancer treatment, the SIO recommends:

  • Mindfulness-based programs, yoga, acupuncture, tai chi or qigong and reflexology.

 

Depression

To reduce depression during treatment, the SIO recommends:

  • Mindfulness-based programs, yoga, music therapy, relaxation and reflexology.


To reduce depression after treatment, the SIO recommends:

  • Mindfulness-based programs, yoga, tai chi or qigong.

Updated: 07/02/2024

Open clinical trials
Open clinical trials

The following studies look at integrative medical care for people diagnosed with cancer.

Multiple cancer types

Breast cancer

Gynecologic cancer

cancer

 

Updated: 06/06/2024

  • Do you think acupressure might help with my symptoms?
  • Where can I learn more about acupressure?
  • What should I know before trying acupressure?
  • How much will it cost for me to try acupressure? Will my insurance pay for acupressure treatments?

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