Hopkins Hollis, A.S. (2010). Acupuncture as a treatment modality for the management of cancer pain: The state of the science. Oncology Nursing Forum, 37, E344–E348.

To explore the current state of the science regarding acupuncture as a treatment modality for cancer pain

TYPE OF STUDY: Systematic review

Databases searched were PUBMED and CINAHL, in addition to websites from the National Cancer Institute, the National Institute of Health's Complementary and Alternative Medicine Program, and the American Cancer Society.

Keywords were acupuncture for cancer pain and cancer pain management acupuncture.

Studies that focused on cancer pain and acupuncture using human participants, were English language, and described attitudes associated with acupuncture or complementary and alternative medicine were included in the search.

Studies that focused on postoperative pain and studies that combined acupuncture with other modalities, such as massage, were excluded from the search.

A total of 130 studies from  2000 to 2009 were retrieved.

• A final number of 11 studies were included in the review.
• The 11 studies included 3 randomized controlled trials, 1 pilot study, 1 meta-analysis, 1 case-control study, 1 prospective cohort study, and 4 expert reviews.

• Level I evidence: The administration of true acupuncture resulted in decreased pain when compared to the sham acupuncture and the control group (p < 0.05). No long-term difference in pain improvement was noted among groups.
• Level III evidence: The low statistical power of this study and the lack of attempts to control for confounding variables affected the external validity.
• Level V evidence: A decrease in pain was reported at one month for 16 of the 34 patients treated with acupuncture (p < 0.05) and at the six-month follow-up for 14 of the 34 patients treated with acupuncture (p < 0.05).

The use of acupuncture as a complementary treatment for the management of cancer pain may have the potential to improve the quality of life of patients with cancer. Benefits of the addition of acupuncture for cancer pain management must be supported by evidence of safety and effectiveness. A synthesis of the current evidence reveals a lack of level I and level II studies pertaining to acupuncture as an intervention for the management of cancer pain. The nonexperimental studies cannot adequately infer causality.