Acupuncture for Treatment of Uncontrolled Pain in Cancer Patients: A Pragmatic Pilot Study

Purpose. Pain control is an ongoing challenge in the oncology setting. Prior to implementing a large randomized trial at our institution, we investigated the feasibility, safety, and initial efficacy of acupuncture for uncontrolled pain among cancer patients. Hypotheses. Our hypotheses were that the acupuncture treatments provided would be (a) feasible, (b) safe, and (c) a beneficial adjunct to pain management. Study Design. This was a single arm, nonrandomized pragmatic pilot study. Methods. Participants experiencing pain 4 on a 0 to 10 numeric rating scale received a maximum of 10 treatments on an individualized basis. Recruitment, attrition, compliance, and adverse events (AEs) were assessed. Pain (Brief Pain Inventory-Short Form), quality of life (MD Anderson Symptom Inventory [MDASI]), and patient satisfaction were assessed at baseline and at the end of treatment. Results. Of 115 patients screened, 52 (45%) were eligible and agreed to participate. Eleven (21%) were lost to follow-up, leaving 41 who completed all study procedures. No AEs were reported. Mean pain severity was 6.0 +/- 1.3 at baseline and 3.8 +/- 2.0 at follow-up (P < .0001). Pain interference was 6.2 +/- 2.3 at baseline and 4.3 +/- 2.8 at follow-up (P < .0011). On the MDASI, the mean symptom severity was 4.6 +/- 1.8 at baseline and 3.2 +/- 1.9 at follow-up (P < .0001), and mean symptom interference was 5.8 +/- 2.4 at baseline and 4.1 +/- 2.9 at follow-up (P < .002). Prescribed pain medications decreased across the course of the study. Patient satisfaction was high: 87% reported that their expectations were met very well or extremely well; 90% said they were likely to participate again; 95% said they were likely to recommend acupuncture to others; and 90% reported they found the service to be useful or very useful. Conclusions. Acupuncture was feasible, safe, and a helpful treatment adjunct for cancer patients experiencing uncontrolled pain in this study. Randomized placebo-controlled trials are needed to confirm these results.