Acupuncture for Hot Flashes in Cancer Patients: Clinical Characteristics and Traditional Chinese Medicine Diagnosis as Predictors of Treatment Response

Abstract

Background: Acupuncture is a recognized integrative modality for managing hot flashes. However, data regarding predictors for response to acupuncture in cancer patients experiencing hot flashes are limited. We explored associations between patient characteristics, including traditional Chinese medicine (TCM) diagnosis, and treatment response among cancer patients who received acupuncture for management of hot flashes. Methods: We reviewed acupuncture records of cancer outpatients with the primary reason for referral listed as hot flashes who were treated from March 2016 to April 2018. Treatment response was assessed using the hot flashes score within a modified Edmonton Symptom Assessment Scale (0-10 scale) administered immediately before and after each acupuncture treatment. Correlations between TCM diagnosis, individual patient characteristics, and treatment response were analyzed. Results: The final analysis included 558 acupuncture records (151 patients). The majority of patients were female (90%), and 66% had breast cancer. The median treatment response was a 25% reduction in the hot flashes score. The most frequent TCM diagnosis was qi stagnation (80%) followed by blood stagnation (57%). Older age (P = .018), patient self-reported anxiety level (P = .056), and presence of damp accumulation in TCM diagnosis (P = .047) were correlated with greater hot flashes score reduction. Conclusions: TCM diagnosis and other patient characteristics were predictors of treatment response to acupuncture for hot flashes in cancer patients. Future research is needed to further explore predictors that could help tailor acupuncture treatments for these patients.

Association Between Acupoint Selection, Target Symptoms, and Traditional Chinese Medicine Diagnosis in Real-Time Clinical Practice in a Comprehensive Cancer Center

“…16 TCM diagnosis may be also important in predicting symptom response to acupuncture treatment. 17,18 Our previous review of acupuncture treatment for hot flashes among cancer patients observed that presence of damp accumulation in TCM diagnosis was correlated with greater hot flashes score reduction. 17 Future TCM acupuncture research should consider using TCM diagnosis to select a specific subgroup of a disease/syndrome or keep subgroups separate when deciding treatment efficacy.…”

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“…For instance, particular features of TCM diagnoses were predictors of treatment response to acupuncture used for hot flashes in patients suffering from cancer. 43 Therefore, it may be logical to select patients for acupuncture based on an individualized process, in order to optimize the response obtained from treatment.…”

Overcoming Barriers for Clinical Research of Acupuncture

“…11 Research findings have mirrored this highly individualized acupuncture approach and indicate that TCM diagnosis may be predictive of acupuncture treatment response. 12,13 Few studies have actually compared using the fixed-point approach versus a more individualized approach that is used in clinical care. The appeal of using fixed points based on specific symptoms is that it is easy to replicate in the clinical research setting.…”