The Effect of Acupuncture on Post-Cancer Fatigue and Well-Being for Women Recovering from Breast Cancer: A Pilot Randomised Controlled Trial

Abstract

Objective To determine the feasibility and acceptability of acupuncture in managing fatigue and well-being in breast cancer survivors. Methods A randomised controlled trial compared acupuncture was with sham acupuncture and wait list controls was performed in Sydney, Australia. A total of 30 women with fatigue following breast cancer treatment participated in the trial. Women received six sessions of acupuncture over 8 weeks. Outcomes related to an assessment of interest to participate in the trial and identification of appropriate recruitment strategies, appropriateness of eligibility criteria and compliance with treatment attendance. Clinical outcomes assessed fatigue and well-being. In-depth interviews were undertaken with seven women, who described their experience of acupuncture. Results Our study demonstrated feasibility with appropriate trial entry criteria, good acceptability and treatment compliance with the study interventions, and with the completion of outcome forms. There was a significant reduction in fatigue for women receiving acupuncture compared with control after 2 weeks mean difference (MD) 5.3, 95% CI 4.5 to 6.2, p=0.05, and a significant improvement in well-being at 6 weeks for acupuncture compared with the sham and wait list control, MD 2.7, 95% CI 2.1 to 3.2, p=0.006. Women described their experience of acupuncture positively, and interview data may also offer explanations for the improved outcomes of well-being, with women reporting an improvement in sleep, mood and relaxation.

Defining the Quality of Acupuncture

“…Five trials had 2 study groups, [22][23][24][25][26] and 2 trials had 3 study groups. 27,28 Risk of bias assessment has been completed elsewhere for these trials. [15][16][17] Population, Intervention, Comparator, Outcome (Domain 1)…”

“…Three studies used the Brief Fatigue Inventory (BFI), 22,24,28 including only patients with a BFI ≤4. One study used the Functional Assessment of Cancer Therapy Treatment instrument (FACIT-F) including patients scoring below <44.…”

“…To recruit patients with persistent CRF, studies sought patients who had chemotherapy at least 1 month [24][25][26][27][28] or at least 60 days prior to the trial commencement date. 22 One study did not include length of time since chemotherapy or radiotherapy.…”

“…23 Molassiotis and colleagues included patients who reported high fatigue levels >5 on a visual analogue scale (VAS) of 0 to 10. [25][26][27] The primary outcome measures used were FACIT-F, 23 BFI, 22,24,28 and the Multidimensional Fatigue Inventory (MFI). [25][26][27] Interventions were acupuncture alone, or acupuncture combined with education.…”

“…23 The type of chemotherapy was documented in all 3 Molassiotis studies and length of chemotherapy regime or radiotherapy in one study. 28 Five studies were conducted in breast cancer patients [23][24][25]27,28 the 2 other studies included a variety of tumor types.…”