Acupuncture and acupressure for chemotherapy nausea
Stimulating the P6 point on the inner wrist, with needles, electrical stimulation or a pressure band, adds a small further reduction in chemotherapy vomiting on top of modern anti-sickness drugs. It is safe and cheap, and guidelines say it can be offered.
Overview
A Cochrane review of 11 randomised trials found that acupuncture-point stimulation reduced the proportion of patients with acute chemotherapy-induced vomiting; electroacupuncture reduced acute vomiting while manual acupuncture did not, and acupressure reduced acute nausea severity but not vomiting. Most of these trials predate NK1 antagonists and olanzapine, so the size of any added benefit on top of current antiemetic regimens is uncertain, and later sham-controlled wristband trials were largely negative. The 2017 SIO breast cancer guideline, endorsed by ASCO in 2018, grades acupressure and electroacupuncture as reasonable additions to standard antiemetics. It is an adjunct, never a substitute for the guideline antiemetic regimen matched to the emetic risk of the chemotherapy.
How it works
Needling or pressure at PC6 (Neiguan) is thought to modulate vagal tone and brainstem emetic circuits and to raise endogenous opioid and serotonin activity; sham-controlled trials suggest part of the effect is expectation.
- Very low risk when performed by a trained practitioner with sterile needles
- Wristbands are cheap and self-administered
- Endorsed as an add-on in SIO and ASCO guidance
- Trials are old and predate current antiemetics
- Sham-controlled wristband trials mostly negative
- Not a replacement for 5-HT3, NK1 and olanzapine regimens
Latest papers
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