Pain after Cancer Surgery

Acupuncture is effective in decreasing pain and depression following surgery in cancer patients.
The findings of the randomized controlled clinical trial are reported in the March 2007 issue of the “Journal of Pain and Symptom Management.”

From UCSF News Office:

“This pilot study confirmed that pain after surgery decreased when patients underwent a combination of massage and acupuncture. This is a significant finding because there are implications for further study to see if these therapies should be offered to hospitalized patients for symptom management,” said Wolf Mehling, MD, lead author and UCSF assistant professor of family and community medicine.

The study compared the post-operative symptoms of pain, nausea and mood and the cost of symptom-related medications in two groups of hospitalized patients during the first three days after cancer-related surgery. One group underwent a combination of massage and acupuncture in addition to usual care, and one group had usual care alone. Usual care is defined as traditional treatment through medication.

Study results showed a greater decrease in both pain and depressive mood in the group that underwent massage/acupuncture therapy along with usual care. The study was conducted at the UCSF Osher Center for Integrative Medicine.

According to Mehling, 40 percent of people with cancer are treated with complementary and alternative medicine therapies. Although the measurable benefits of these therapies have been promising, there have been no conclusive results, he said.

“The combination of massage and acupuncture for symptom management in perioperative cancer patients has never been studied,” said Mehling. “We know that integration of these therapies has shown short-term benefit on psychological well-being, but there has not been strong evidence to support it until now.”

In the study, cancer surgery was characterized as any surgery related to a diagnosis of malignancy: mastectomy or reconstructive surgery for breast cancer; abdominal surgery for intestinal or hepatic malignancies; pelvic surgery for ovarian, uterine or cervical malignancies; urological surgery for testicular, prostate, bladder or renal malignancies; and head and neck cancer surgery.

During the three-day post-operative period, patients used an 11-point (0-10) numeric rating scale to rank severity of current pain and of pain during the previous 24 hours.

“There was quite a variance when it came to level of pain for each patient. Patients who were very well medicated for pain and nausea still experienced dramatic ups and downs during their post-operative days,” Mehling said. “Getting up from bed for the first time after abdominal surgery or having a catheter removed probably contributed to the patient’s pain rating. For patients who received acupuncture and massage, it is possible that this personal attention contributed to a marked decrease in anxiety.”

Patients received Swedish massage, which involves kneading and applying long strokes to soft tissue and muscles, and an acupressure-type (shiatsu) foot massage for 10-30 minutes depending on their clinical needs and condition. Acupuncture treatment was based on the traditional Chinese medicine standardized core set of acupuncture points and was used to treat pain, nausea and anxiety.

“Pain decreased for those in the intervention group more than for those in the control group,” said Mehling. “Looking at an average pain baseline score, we found 1.1 point improvement in pain level on the first post-operative day for the group given massage and acupuncture, and only 0.1 point improvement in the control group that did not have intervention. Over the three days of the study, the average scores among patients reporting significant pain improved by 1.8 for the massage and acupuncture group compared to 0.3 in the control group.”

The important point here is that relieving pain will relieve stress, which will help overall healing and well-being. Talk to your doctor about using alternatives in the hospital, immediately following operations. You don't have to wait until you are sent home to take control of your own healing process. If your doctor is not open to the idea, please refer him/her to the article about acupuncture and massage in the March 2007 issue of the “Journal of Pain and Symptom Management.”

Hypertension

Hypertension, commonly referred to as "high blood pressure", is a medical condition where the blood pressure is chronically elevated. Persistent hypertension is one of the risk factors for strokes, heart attacks, heart failure, and arterial aneurysm, and is a leading cause of chronic renal failure. Hypertension is often without symptoms. The simplest and easiest way to see if you are at risk or have high blood pressure is to have your blood pressure checked regularly.

Acupuncture is becoming more widely known as an alternative therapy for curbing high blood pressure. It provides an excellent complement to other medical treatments for high blood pressure and other heart-related conditons. During acupuncture, needles are inserted into specific body points to help relieve pain and disease. Studies have shown that acupuncture excites brain cells, causing them to release neurotransmitters that can inhibit or heighten the heart's activity.

When a needle is inserted at specific points, opioid chemicals in the brain that reduce excitatory responses in the cardiovascular system are released. This results in a decrease in heart activity and need for oxygen, which can lower blood pressure and promote the healing of heart-related conditions like myocardial ischemia (insufficient blood flow to the heart) and hypertension.

In the Journal of Applied Physiology from March 2005, researchers from the University of California applied electroacupuncture to sites on the forelimbs of rats. Low frequencies lowered elevated blood pressure rates by 40 percent to 50 percent. A 30-minute treatment was able to reduce blood pressure by 25 mmHg, and the reduction lasted for nearly two hours.

Researcher Professor John Longhurst, a specialist in heart medicine at the University’s Irvine campus, said: "This type of electroacupuncture is only effective on elevated blood pressure levels, such as those present in hypertension, and the treatment has no impact on standing blood pressure rates.

"Our goal is to help establish a standard of acupuncture treatment that can benefit everyone who has hypertension and other cardiac ailments."

He added: "This study suggests that acupuncture can be an excellent complement to other medical treatments, especially for those treating the cardiac system. "

Not all research studies on acupuncture and hypertension agree. In my experience, acupuncture depends on proper diagnosis, proper choice of acupuncture points, and proper needle technique. These are difficult factors to control in research studies, and may be why results often differ.

A trained Acupuncturist can recognize the origins of high blood pressure by observing certain symptoms. Headache, dizziness, eye disorders, and numbness suggest a Liver imbalance. Palpitations, poor memory, and insomnia represent Heart distress. And ringing in the ears and accumulation are resultant of Kidney disorder. Control studies prefer to use the same acupuncture points on all test subjects, which is not a proper test for acupuncture.

Conflicting studies are why it is important to investigate the effectiveness of acupuncture for yourself. In addition, if one acupuncturist is unable to help, consider trying another who may be better able to help you. In any case, don't give up on your health, or accept the results of a single strategy. There are many health options and you need to find the one that is right for you.