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Acupuncture for Chemotherapy Induced Peripheral Neuropathy (CIPN)

Anticancer treatments are neurotoxic and can damage peripheral nerves which leads to patients experiencing allodynia, loss of sensation and loss of motor function.  Statistics show that 68% of the time, patient will experience chemotherapy-induced peripheral neuropathy (CIPN) months to years after the start of their treatment.  At this time, conventional medicine does not have effective CIPN prevention strategy and the treatment of established chronic CIPN is limited.  Patients are usually given Gabapentin, duloxetine, exercise therapies, supplements or even decreasing chemotherapy doses.  The effectiveness with these approaches are modest at best or leads to decrease effectiveness of treatment.  Patients have reported decrease in quality of life due to CIPN.        

Common chemotherapeutics and incidence or prevalence of reported neuropathy.

Chemotherapy

Approximate incidence/ prevalence of CIPN (%)

Oxaliplatin

Acute: 85-96; Chronic wide range: 40-93

Cisplatin

12-85

Paclitaxel

61-92

Bortezomib

47

Vincristine

20

Combined cisplatin and paclitaxel

69-76

According to Traditional Chinese Medicine (TCM) theory, CIPN is similar to Xue Bi which means pain and numbness in the extremities.  Herbal medicine and acupuncture are common therapies for Xue Bi.  Patients are assessed during their initial visit in order to determine where needles are placed. The placement of acupuncture needles in the hands, feet, ears and other areas on the body helps to promote circulation to the areas and facilitates nerve regeneration.  Needles can be attached to a stimulator to increase the effectiveness of the treatment.  The number of treatments to completely resolve CIPN will depend on the severity of the neuropathy, length of time from onset and other underlying health concerns.  Often, the acupuncturist will give dietary and exercise recommendations based on the patient’s health needs to compliment the acupuncture treatments. 

Multiple studies show that acupuncture is a safe therapy with no known adverse effects in treating CIPN.  Course of treatment in the studies average twice a week for eight weeks with significantly higher pain reduction in the acupuncture groups compared to sham or only drug therapies.  Patients continue to report decrease in CIPN 4-8 months after the initial course of treatment; improving the patient’s overall quality of life.

1.Curr Oncol. 2019

A systematic review of acupuncture for chemotherapy-induced peripheral neuropathy

K. Li, BSc,corresponding author* D. Giustini, MLS MEd, and D. Seely, ND MSc

2. Acupuncture for Chemotherapy-Induced Peripheral Neuropathy in Breast Cancer Survivors: A Randomized Controlled Pilot Trial

Weidong Lu1Anita Giobbie-Hurder2Rachel A Freedman1Im Hee Shin3Nancy U Lin1Ann H Partridge1David S Rosenthal1Jennifer A Ligibel1.

3. March 11, 2020

Effect of Acupuncture vs Sham Procedure on Chemotherapy-Induced Peripheral Neuropathy SymptomsA Randomized Clinical Trial

Ting Bao, MD, DABMA, MS1,3Sujata Patil, PhD2Connie Chen, MD1; et al

4. Effectiveness of Acupuncture Treatment on Chemotherapy-Induced Peripheral Neuropathy: A Pilot, Randomized, Assessor-Blinded, Controlled Trial

Somayeh Iravani,1 Amir Hooman Kazemi Motlagh,2 Seyede Zahra Emami Razavi,3 Farhad Shahi,4 Jing Wang,5 Li Hou,5 Wenjun Sun,6 Mohammad Reza Afshari Fard,1 Mahdi Aghili,7 Mehrdad Karimi,2 Hossein Rezaeizadeh,2 and Baixiao Zhao8

5. 29 Jun 2020  The Efficacy of Acupuncture in Chemotherapy-Induced Peripheral Neuropathy: Systematic Review and Meta-Analysis

Tsai-Ju Chien12Chia-Yu Liu2345Ching-Ju Fang67Chun-Yu Kuo2

6. 2012 Mar. acupmed; Acupuncture for chemotherapy-induced peripheral neuropathy (CIPN): a pilot study using neurography

Sven Schroeder1Gesa Meyer-HammeSusanne Epplée

7. Incidence, prevalence, and predictors of chemotherapy-induced peripheral neuropathy: a systematic review and meta-analysis; Review published: 2014.

Seretny M, Currie GL, Sena ES, Ramnarine S, Grant R, MacLeod MR, Colvin L, Fallon M.  Incidence, prevalence, and predictors of chemotherapy-induced peripheral neuropathy: a systematic review and meta-analysis. Pain 2014; 155(12): 2461-2470.

8. NIH.gov Pain. Author manuscript; available in PMC 2020 May 1.Lesley A Colvin

Chemotherapy-induced peripheral neuropathy (CIPN): where are we now?

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