Acupuncture in Cancer Care: What Guidelines Say

Cancer treatment comes first

Acupuncture is used to manage symptoms of cancer and its treatment. The National Cancer Institute (NCI) says its primary use in cancer is symptom management. [1] It is not a treatment for the cancer itself, and nothing here suggests delaying or replacing surgery, chemotherapy, radiation or any medicine. Tell your oncology team before you start. In the United States, call 911 for an emergency; fever or sudden illness during treatment should be reported to your cancer team right away.

The short answer

Guidelines support acupuncture for a few specific problems, mainly joint pain from aromatase inhibitors and chemotherapy-related nausea. For other symptoms the research is mixed, partly because many trials lacked sham controls. Evidence labels are in the table.

What the guidelines say

The 2022 Society for Integrative Oncology and ASCO guideline for adults searched trials published to 2021 and found 227 relevant studies. [2] It recommends acupuncture for aromatase inhibitor-related joint pain, and says acupuncture or reflexology or acupressure may be recommended for general cancer pain or musculoskeletal pain, based on an intermediate level of evidence. [2] For children, evidence was insufficient or inconclusive. [2] NCCIH notes that a 2018 trial of 226 women taking aromatase inhibitors found less joint pain after 6 weeks of twice-weekly acupuncture than with sham or no acupuncture. [3] NCCIH says experts generally agree that acupuncture helps treatment-related nausea, but the research mostly predates current anti-nausea treatments, so benefit alongside them is uncertain. [3] See chemotherapy nausea and cancer pain and joint pain.

Other symptoms

NCI patient information says trials on hot flashes showed acupuncture was safe and decreased hot flashes, but it was not clear that real acupuncture beat sham. [5] For fatigue, acupuncture improved fatigue compared with standard care, with the same uncertainty about sham. [5] Nerve pain from chemotherapy has shown promise in some trials, but more evidence is needed. [5] See hot flashes and menopause and neuropathy.

Low blood counts and infection

NCI says a strict clean needle method must be used with people who have cancer, because chemotherapy and radiation weaken the immune system. [5] One study in children found no higher rate of adverse events with low platelets or neutrophils. [5] Proper evidence not found in the sources we read for specific blood-count cutoffs in adults, so your oncology team should decide whether and when acupuncture is suitable. Bleeding with blood thinners is covered in bleeding and bruising. NHS guidance also lists blood-thinning medicine and skin infection as reasons acupuncture may not be safe. [7]

Practical points

• Ask whether the practitioner has experience with people in cancer treatment; see coordinating acupuncture with medical care.
• For acupuncture offered inside hospitals and cancer centers, see acupuncture in modern health care.
• Check credentials using how to choose an acupuncturist.