Acupuncture for chemotherapy-induced neuropathy
Numb, tingling or painful hands and feet after taxanes, platinum or bortezomib have no proven preventive treatment. Small trials suggest acupuncture may ease the symptoms, but they are too small and inconsistent to be sure, so it is an option to try inside a trial or with careful tracking rather than an established treatment.
Overview
Chemotherapy-induced peripheral neuropathy affects a large share of patients treated with taxanes, oxaliplatin, cisplatin, vincristine and bortezomib and can be permanent. Duloxetine is the only drug with randomised evidence for painful neuropathy, and no agent reliably prevents it. Acupuncture has been tested in pilot randomised trials of a few dozen patients each, several reporting improved neuropathy symptom scores against usual care or sham, but heterogeneous point protocols, short follow-up and small sizes mean systematic reviews call the evidence insufficient. Larger sham-controlled trials are recruiting. Meanwhile exercise, balance training and foot care have practical value, and dose modification remains the only certain way to limit progression.
How it works
Proposed mechanisms include improved peripheral microcirculation, modulation of dorsal horn signalling and release of endogenous opioids; none is established for chemotherapy neuropathy specifically.
- Low risk
- Consistent direction of small-trial results
- Larger trials under way
- No adequately powered sham-controlled trial
- Protocols vary widely
- No effect on the nerve damage itself has been shown
The first chemotherapy to extend life in prostate cancer (2004), now part of triplet therapy at first metastatic diagnosis.
A microtubule poison discovered in the Pacific yew tree, among the most used chemotherapies in breast, lung, and ovarian cancer.
Latest papers
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