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Acupuncture (PDQ®)     
Last Modified: 09/26/2008
Health Professional Version
Overall Level of Evidence for Acupuncture Treatment of Cancer-Related Symptoms

It is noteworthy that almost all reported clinical studies on the effects of acupuncture on cancer or cancer therapy –related symptoms focus on symptom management rather than the disease itself. Investigations into the effects of acupuncture on chemotherapy -induced nausea and vomiting, many of which were randomized and well-controlled, produced the most convincing findings. Although a considerable number of favorable clinical acupuncture studies have been reported, most were case studies, clinical observations, or nonrandomized and poorly controlled clinical trials. In many studies, methodologic flaws in clinical study design hampered rigorous scientific efforts to evaluate the effects of acupuncture. Although pain relief is the most clinically common use of acupuncture, only a few studies on cancer pain are well-controlled or have sample sizes large enough to support their findings.

Separate levels of evidence scores are assigned to qualifying human studies on the basis of statistical strength of the study design and scientific strength of the treatment outcomes (i.e., endpoints) measured. The resulting two scores are then combined to produce an overall score. For additional information about levels of evidence analysis, refer to Levels of Evidence for Human Studies of Cancer Complementary and Alternative Medicine 1.



Glossary Terms

acupuncture (AK-yoo-PUNK-cher)
The technique of inserting thin needles through the skin at specific points on the body to control pain and other symptoms. It is a type of complementary and alternative medicine.
cancer (KAN-ser)
A term for diseases in which abnormal cells divide without control. Cancer cells can invade nearby tissues and can spread to other parts of the body through the blood and lymph systems. There are several main types of cancer. Carcinoma is cancer that begins in the skin or in tissues that line or cover internal organs. Sarcoma is cancer that begins in bone, cartilage, fat, muscle, blood vessels, or other connective or supportive tissue. Leukemia is cancer that starts in blood-forming tissue such as the bone marrow, and causes large numbers of abnormal blood cells to be produced and enter the blood. Lymphoma and multiple myeloma are cancers that begin in the cells of the immune system. Central nervous system cancers are cancers that begin in the tissues of the brain and spinal cord.
chemotherapy (KEE-moh-THAYR-uh-pee)
Treatment with drugs that kill cancer cells.
clinical
Having to do with the examination and treatment of patients.
clinical study
A type of research study that tests how well new medical approaches work in people. These studies test new methods of screening, prevention, diagnosis, or treatment of a disease. Also called a clinical trial.
controlled clinical trial
A clinical study that includes a comparison (control) group. The comparison group receives a placebo, another treatment, or no treatment at all.
endpoint
In clinical trials, an event or outcome that can be measured objectively to determine whether the intervention being studied is beneficial. The endpoints of a clinical trial are usually included in the study objectives. Some examples of endpoints are survival, improvements in quality of life, relief of symptoms, and disappearance of the tumor.
levels of evidence (LEH-vulz uv EH-vih-dents)
A ranking system used to describe the strength of the results measured in a clinical trial or research study. The design of the study (such as a case report for an individual patient or a randomized double-blinded controlled clinical trial) and the endpoints measured (such as survival or quality of life) affect the strength of the evidence.
methodology (MEH-thuh-DAH-loh-jee)
In medicine, the rules and procedures for doing research and evaluating results.
nausea
A feeling of sickness or discomfort in the stomach that may come with an urge to vomit. Nausea is a side effect of some types of cancer therapy.
nonrandomized clinical trial
A clinical trial in which the participants are not assigned by chance to different treatment groups. Participants may choose which group they want to be in, or they may be assigned to the groups by the researchers.
randomized clinical trial
A study in which the participants are assigned by chance to separate groups that compare different treatments; neither the researchers nor the participants can choose which group. Using chance to assign people to groups means that the groups will be similar and that the treatments they receive can be compared objectively. At the time of the trial, it is not known which treatment is best. It is the patient's choice to be in a randomized trial.
scientist
A person who has studied science, especially one who is active in a particular field of investigation.
symptom
An indication that a person has a condition or disease. Some examples of symptoms are headache, fever, fatigue, nausea, vomiting, and pain.
symptom management
Care given to improve the quality of life of patients who have a serious or life-threatening disease. The goal of symptom management is to prevent or treat as early as possible the symptoms of a disease, side effects caused by treatment of a disease, and psychological, social, and spiritual problems related to a disease or its treatment. Also called palliative care, supportive care, and comfort care.
therapy (THAYR-uh-pee)
Treatment.
vomit
To eject some or all of the contents of the stomach through the mouth.


Table of Links

1http://cancer.gov/cancertopics/pdq/levels-evidence-cam/HealthProfessional