Acupuncture for Post-Thoracotomy pain

ABSTRACT: BACKGROUND: Thoracotomy is associated with severe pain that may persist for years. Acupuncture is a complementary therapy with a proven role in pain control. A randomized trial showed that acupuncture was effective in controlling pain after abdominal surgery (see analysis of this study), but the efficacy of this technique for the treatment of thoracotomy pain has not been established. We developed a novel technique for convenient application of acupuncture to patients undergoing thoracotomy, and in a pilot evaluated the safety of this intervention and the feasibility of doing a randomized trial. METHOD: Adult patients scheduled for unilateral thoracotomy with preoperative epidural catheter placement received acupuncture immediately prior to surgery. Eighteen semi-permanent intradermal needles were inserted on either side of the spine, and four were inserted in the legs and auricles. Needles were removed after four weeks. Using a numerical rating scale, pain was measured on the first five postoperative days. After discharge, pain was assessed using the Brief Pain Inventory at 7, 30, 60 and 90 days. RESULTS: Thirty-six patients were treated with acupuncture. Of these, 25, 23, and 22 patients provided data at 30, 60, and 90 days, respectively. The intervention was well tolerated by patients with only one minor and transient adverse event of skin ulceration. CONCLUSIONS: The rate of data completion met our predefined criterion for determining a randomized trial to be feasible (at least 75% of patients tolerated the intervention and provided evaluable data). This novel intervention is acceptable to patients undergoing thoracotomy and does not interfere with standard preoperative care. There was no evidence of important adverse events. We are now testing the hypothesis that acupuncture significantly adds to standard perioperative pain management in a randomized trial. Read the Full study here

Alex's comment: Even though this study is about a particularly dramatic surgery, I can tell you from my experience press tacs are very good for many types of pain. The use of intradermal needles - very small 1 1mm needles on a sticky backing - is a great way to use acupuncture to extend a regular acupuncture treatment or to use in place of a regular treatment. The advantage of is that they can be safely kept in place for days, thus extending the treatment over a longer period.

My patients report this is effective and pain free. I will often use intradermal needles or ear press tacs. Ear press tacs are the same concept as an intradermal needle but instead of a needle they have a small metal ball on a sticky backing that are pressed on the microsystem points of the outer ear. This too is effective.

Melatonin Use in Cancer Treatment

Melatonin Reduces Pain
Some doctors are noting that melatonin supplementation reduces pain in cancer patients in a metastatic stage of the disease. This seems to be due to the connection between the pineal gland and the opioid system. These metastatic patients were found to have a lower beta-endorphin/melatonin ratio. Italian researchers say “The low beta-endorphin/melatonin ratio observed in metastatic patients suggests the presence of an unbalanced relation between the pineal and the opioid system in those subjects. Therefore, an anomalous relationship between pineal function and opioid activity might play a role in the clinical course of neoplastic disease.. See abstract

Melatonin Reduces Side-Effects of Platin Drugs
Melatonin can also be quite useful for mitigating the side-effects of platnum drugs along with Vitamin E.

In addition to its potential direct antitumor activity, melatonin has proved to modulate the effects of cancer chemotherapy, by enhancing its therapeutic efficacy and reducing its toxicity. The increase in chemotherapeutic efficacy by melatonin may depend on two main mechanisms, namely prevention of chemotherapy-induced lymphocyte damage and its antioxidant effect, which has been proved to amplify cytotoxic actions of the chemotherapeutic agents against cancer cells

See the abstract Five years survival in metastatic non-small cell lung cancer patients treated with chemotherapy alone or chemotherapy and melatonin: a randomized trial.

Additional Melatonin Information
For More information about melatonin on wikipedia Click here.
Literature Review of Melatonin from Memorial Sloane Kettering's website. Click here
Melatonin levels can be tested. See here.

Acupuncture Theory Applied To Cancer Treatment

The following article comes from Are Thoreson and his wife Annica Nygrena Thoreson. They are practicing Vetenarians in Sweden.

From a holistic viewpoint we may evaluate the Processes that control a cancerous tumour to be totally normal, even healthy. The normal thing for a cell is to grow and multiply. It is when this growth gets out of control that cancer may arise. This uncontrolled growth may be forced under control again with the help of acupuncture.

In holistic medicine it is most important to stimulate the body's controlling Processes. The idea is to "bring control" to the growth processes; otherwise they become uncontrolled, which is the basic problem with cancerous cells. If we stimulate the wrong Processes, we may aggravate the disorder by stimulating tumour growth. In my opinion, working via the Ko Cycle (Controlling) Cycle is the best way to stimulate the controlling Processes of the body.

Cancer treatment in practice.

First, we must make a Channel Diagnosis, either via Pulse Diagnosis, or by a pure observation of where the tumour has arisen. This is one case where the location of the lesion is very important to indicate the Channel that has lost its control. Let us take mammary cancer as an example. It manifests on ST Channel. We must particularly avoid stimulating ST Channel, but we should stimulate LV, the Ko Controlling Channel of ST. For this, we could use the Ting (Wood) Point (LV01), or Shu-Earth Point (LV03). We should stimulate only the Ko (Controlling) Father Channel, not the Ko (Controlling) Point of ST itself. During the period of treatment, we should stimulate no other Channel or Process. However, we may combine other therapies that stimulate LV.

I have tried this method throughout several years and several colleagues both in the USA and Australia have also, following my instructions, tried it. The results have been very encouraging. Between 80-90% of confirmed cancer cases have improved noticeably. The improvements included increased joy in living, better sleep, increased appetite and a glossier coat. 40-50% have been totally cured of the illness. Tumour(s) have, in such cases, vanished within a few weeks. Two examples:

Read on

I concur . I have used the method outlined in this article with good success for cancer pain and effecting the tumor also.

Auricular Acupuncture To Reduce Cancer Related Pain

A quick story about ear acupuncture: Just yesterday, I was treating an 84 year old woman one year post-stroke. She was depressed over her circumstance and in acute back pain from a fall. She also had a a left-side tremor. She could not get up on the table so I did auricular acupuncture on her in a chair. During the treatment the tremor had stopped, her back pain was improved and her gait was more spry and so was her mood. Not bad. It is no surprise that auricular acupuncture should be good for cancer related neuropathic pain and this study demonstrates it.

Analgesic Effect of Auricular Acupuncture for Cancer Pain: A Randomized, Blinded, Controlled Trial

"Our study shows that auricular acupuncture at points where an electrodermal signal is detected is associated with a significant reduction in pain intensity in patients with neuropathic pain. It also shows that the reduction in pain is associated with a decline in the average electrical signal detected at ear points. The observed reduction of 20 mm on the VAS is of clear benefit for these cancer patients who, despite stable analgesics, continue to be in pain, especially considering the low cost, low inconvenience, and low risk of auricular acupuncture."

Read the Full Text article.

To someone who has never had ear acupuncture it is usually met with fascination, skepticism and a little (unfounded) fear of needles. "What is the connection", they want to know, "between the ear and the rest of the body?"

Ear acupuncture is not part of the ancient tradition of Traditional Oriental Medicine (TCM). Actually it was developed in France in the 1950's. For an interesting history and mechanism of action click here.

Lectures On line from Memorial Sloane Kettering

Web Casts

Smart Talk About Cancer From
Memorial Sloan-Kettering

The CancerSmart Community Lectures listed below were recorded and are now being presented on our Web site. To watch, you'll need either Windows Media Player, which can be downloaded for free from Windows Media, or RealMedia Player, which can be downloaded for free from RealMedia.

Recorded CancerSmart Lectures

The Effect of Acupuncture on Tumors

Infrared imaging before and after acupuncture demonstrates acupuncture reduces tumor activity Read on. This is according to Yin Lo, Ph.d. author of the book Biophysics of Acupuncture

Studies have confirmed that acupuncture is effective in treating certain aspects of cancer. The results of these studies are summarized as follows:

• Experiments with implanted mammary cancer on rats found that there were differences in pathological section, adenoid structure, lymphocytic infiltration and tumor volume between treatment groups and control groups. Acupuncture probably inhibits growth of mammary cancer and reduces malignancy.

• Acupuncture had a dramatic effect on xerostomia, dysphagia and articulation on cancer patients suffering from xerostomia. Release of neuropeptides that stimulate the salivary glands and increased blood flow are possible explanations.
• Acupuncture enhanced the cellular immunity of patients with malignant tumors: percentages of CD3+, CD4+, ratios of CD4+/CD8+, and the levels of beta-EP increased, while the levels of SI-2R decreased.
• Acupuncture was performed on breast and uterine cancer patients who had suffered skin injuries from radiation therapy. Radionuclide and rheographic studies as well as evaluation of hemostatic function showed acupuncture to be effective for edema and pain. It also improved lymph flow and rheovasographic indexes, and normalized stasis.