Debunked: Acupuncture for Relief of Cancer Medication Side Effects

Mick West

Administrator
Staff member
Acupuncture is a popular alternative medicine treatment, often used for very subjective symptoms - pain and general malaise. The only way of measuring if a treatment works is "patient reported outcomes" - i.e. what the patient feels about changes in their symptoms, so it's very susceptible to the placebo effect - where the patient thinks they feel better just because they have received a treatment that they think works.


With drugs it's fairly easy easy to test for the placebo effect by giving one group of patients in a study a harmless pill. If there's no way the patient can tell if they got the drug or the placebo, then any difference between the placebo group and the drug group will be due to the effects of the drug.

With acupuncture though, this is more difficult. It's quite hard to devise a fake needle. It's difficult to convince a patient that they have had a needle stuck in them when they actually did not. So most acupuncture studies compare the effects of "real" acupuncture against the effects of no treatment at all, or against some treatment that the patient can tell is not the real thing. So the placebo effect could be all that's happening. People could simply be feeling better because they think they got "real" acupuncture.

So a new study published in the journal Cancer is particularly interesting, as the researchers devised a way around this. They created a fake non-penetrating needle, which they applied to random points on the body, whereas the "real" group received traditional acupuncture with penetrating needles.


The result: both groups reported improvement! There was no statistical difference between the sham and the real treatments.



So clearly the inserting of needles, and the the placement of needles is unimportant to the eventual result. So what's actual going on? It seems to be one of:
  • Simply thinking you are being treated is sufficient to improve your symptoms, or
  • The physical process of laying down, being touched, and relaxing for a while helps your symptoms.
Basically though, it seems like acupuncture is only operating via some kind of placebo effect.

It's interesting how this has been reported though. Most reports are along the lines of "acupuncture is a pseudoscience", yet on a nursing forum the results of the study were reported with the bold headline: "How acupuncture helps breast cancer patients".

http://blog.staffnurse.com/2013/12/24/how-acupuncture-helps-breast-cancer-patients/
The takeaway here is that acupuncture "works", even if it's only the placebo effect, and hence it's still a useful treatment.

It's difficult to argue with that, after all if something makes someone feel better, then why not do it? That fact that the needles are not actually doing anything does not ultimately detract from the fact that people feel better after having the needles stuck in them. It might rankle the skeptic, but even the author of the study says that there's no real downside in trying it, as it might work for you - even if it's just placebo.

But the really interesting thing for science here is to try to understand why the placebo effect works. Hopefully when we can understand that we can treat the symptoms more directly and efficiently, without resorting to meaningless rituals of stabbing people with needles, just to make them think they have been treated.
 
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Soulfly

Banned
Banned
There is a commercial that plays here for a rehab treatment center called Passages at Malibu. I can't quote it directly but they talk about taking a scientific approach to treatment, then they show someone getting acupuncture.
 

Mick West

Administrator
Staff member
There is a commercial that plays here for a rehab treatment center called Passages at Malibu. I can't quote it directly but they talk about taking a scientific approach to treatment, then they show someone getting acupuncture.

Fairly standard pseudoscience claims:
http://www.passagesmalibu.com/addiction-treatment/addiction-treatment-methods/acupuncture/
The acupuncture and yoga sessions probably make them feel more relaxed. But the detoxification comes simply from not taking drugs and alcohol.

The placebo effect is likely the primary active ingredient with most "Alternative" medicines. They get away with it because placebo works, so long as you don't realize it's placebo.

It's a pity the study did not have a couple of additional control groups. One where nothing at all was done besides a doctor telling them they should start to feel better soon, and maybe one where they are given some placebo pills, and told they will help.
 

Mick West

Administrator
Staff member
This new study is quite similar to a larger 2009 study that used toothpicks for the acupuncture placebo in treatment of back pain, and had similar results, and a similar reception:

http://www.sciencebasedmedicine.org/acupuncture-does-not-work-for-back-pain/
 

Soulfly

Banned
Banned
I might actually be confusing two commercials for two different treatment centers as far as one saying it takes a scientific approach and then the commercial showing acupuncture.

Can't think of the name of the other center though.
 

Dan Wilson

Senior Member.
It's a pity the study did not have a couple of additional control groups. One where nothing at all was done besides a doctor telling them they should start to feel better soon, and maybe one where they are given some placebo pills, and told they will help.

I think that would be the next logical step for those studying this. Sometimes all a placebo effect is showing us is the patient's improvement over time. In order to demonstrate that the dummy treatment is activating a mechanism that makes the patient feel better (which it does to some extent in some cases), then we should expect to see significantly less improvement in a group receiving nothing.

Aside from reporting bias, the only mechanism that we know of that is probably responsible for most patients feeling better after placebos is the countering of stress. Reducing stress can alleviate a number of temporary symptoms. Too much cortisol (stress hormone) in you blood, for example, can increase blood pressure and interfere with immune function. If you feel relaxed and as though you are being treated by a professional, it's reasonable to expect to feel better about relatively superficial symptoms.
 

Mick West

Administrator
Staff member
Pain is a tricky thing, due to the general absence of any way of measuring it short of patient reports. Fatigue and itching are other symptoms with similar problems. So there's big issues with the reports being subjective (one person might be experiencing physically identical problems, but report it in very different ways), and the issue of somatization.

These types of issues came up a lot with Morgellons.
 

Cairenn

Senior Member.
And in discussing pain, not everyone will have the same reaction to the same level of pain. Most vets can tell you stories about Dobermans and Shepherds with a torn toe nail that can't walk without screaming, and terriers with wounds that leave exposed bone, and bird dogs with ripped pads, that walk in with their tails wagging.
 

Mick West

Administrator
Staff member
In a way, since the patient is the one taking observations of the pain, they become scientists with a very limited data set, and a possibly strong case of the biases that afflict scientists - particularly the observer expectancy effect. They might feel better after acupuncture because they were told they would, but conversely they might feel more ill after medication because they were told the list of side-effects.

What would happen to people if they were given acupuncture, but were told that they were using special super-detox needles that would make them nauseous while they were cured?

What might happen if people getting the cancer medication were not told of the long list of nasty side effects, and instead told it would make them feel better, full of energy, pain free?

If you don't know you are supposed to suffer, then will you still suffer as much as if you were expecting it?
 

AluminumTheory

Senior Member.
I think that some illusions do have purpose, and if you can make someone feel better by making them think that they received treatment for their condition; then who am I to judge?
Unfortunately, the problem arises when people reject scientifically proven, life saving treatments in favor of psuedoscience. And in that sense, you could argue that they commitrmuch more harm than good.
 

cosmic

Senior Member.
The takeaway here is that acupuncture "works", even if it's only the placebo effect, and hence it's still a useful treatment.

It's difficult to argue with that, after all if something makes someone feel better, then why not do it? That fact that the needles are not actually doing anything does not ultimately detract from the fact that people feel better after having the needles stuck in them. It might rankle the skeptic, but even the author of the study says that there's no real downside in trying it, as it might work for you - even if it's just placebo.

Even if there's a potential benefit via placebo, I don't think these sorts of archaic procedures should receive any endorsement, and especially not in lieu of science-based, conventional treatment. The foundation and ideas behind acupuncture are flatly wrong, and its continued practice is part of larger CAM and TCM ideologies which are wrought with specious claims and flawed methods. These don't just include examples of pseudoscience but also pre-scientific thinking and folklore. Personally, I'm not willing to give all that a pass. Alt-med nonsense has too large a foot in the door already, and in my opinion, any short-term benefit is greatly outweighed by a growing list of negative consequences in the long term.
 

Gavriel

Member
Do you mind if I translate your articles to portuguese and publish them on other websites (giving the proper credits, of course)?
 

Mick West

Administrator
Staff member
Do you mind if I translate your articles to portuguese and publish them on other websites (giving the proper credits, of course)?

Go ahead. Just the posts written by me (ask other posters for their permission individually), and for portuguese language non-commercial internet use only.
 
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