SUNDAY, June 1 (HealthDay News) -- Two of the more common and
unpleasant side effects of treatment for head and neck cancer
patients may be relieved by the ancient Chinese practice of
acupuncture.
A new study found significant reductions in both dry mouth and
pain and shoulder dysfunction after neck dissection in patients
receiving acupuncture.
"Although further studies are needed, this does support the
potential role of acupuncture," said study author Dr. David
Pfister, chief of the head and neck medical oncology service at the
Memorial Sloan-Kettering Cancer Center in New York City. He
presented the findings Saturday at the American Society of Clinical
Oncology annual meeting, in Chicago.
Neck dissection, or removal of the lymph nodes and surrounding
tissue, is common in treating head and neck cancers. The dissection
can be severe, involving removing of all the lymph nodes, the
muscle involved in turning the head, a vein and a nerve which
allows patients to lift their arms above their head.
"Side effects vary with the extent of the procedure," Pfister
said. "Pain and shoulder dysfunction are common following a
comprehensive neck resection. Although exercise and
anti-inflammatory drugs are widely prescribed to address pain and
dysfunction, efficacy is often disappointing or incomplete.
Postoperative radiation is also frequently administered, leading to
dry mouth, which further adds to the burden of symptoms."
In the study, 70 patients were randomized to receive weekly
acupuncture sessions for four weeks or "usual care" (suggestions
for physical therapy exercises and anti-inflammatory pain
relievers).
Almost 40 percent of participants receiving acupuncture
experienced improvements in both pain and mobility, compared with
just 7 percent in the standard-care group.
There was also a notable decrease in dry mouth. "Five people in
the acupuncture group had improvements as opposed to none in the
usual-care arm," Pfister said.
A second study presented Saturday at the meeting found the
narcolepsy drug Provigil (modafinil) provided significant relief
for patients suffering from chemotherapy-related fatigue.
The drug is usually prescribed to sleep-related disorders.
"These are basically non-amphetamine-based stimulants. They don't
have the same type of typical problems that amphetamines do,"
explained study author Dr. Gary Morrow, associate director for
community research at the University of Rochester Cancer
Center.
Fatigue is a leading complaint of cancer patients undergoing
chemotherapy. Some nine out of 10 patients polled said they
expected to experience this side effect, close to the percentage
that actually do.
"The majority of patients expected fatigue and, unfortunately,
they're right," Morrow said.
In this group of 631 patients, Provigil had a significant effect
on excessive tiredness, and the effect was greater among patients
who started out with more fatigue.
"The payoff was among patients who had severe fatigue," Morrow
said. "It was numerically different but not statistically different
for people who had mild or moderate fatigue. Modafinil appears
useful to treat severe fatigue. If found again through pivotal
studies submitted through proper regulatory authorities, it might
take place in the armamentarium."
More information
Visit the
National
Certification Commission for Acupuncture and Oriental
Medicine for more on this therapy.