Changing perceptions: using acupuncture in the management of lymphoedema

Acupuncture in the management of lymphoedema is controversial because needling the affected area is assumed, and this procedure is perceived to carry the risk of exacerbating the condition or introducing infection. This innovative three-step, patient-centred, mixed-methods study explored the use of traditional acupuncture as an adjunct to usual care for lymphoedema by testing its acceptability, and measuring its impact on the well-being and quality of life of cancer survivors with breast cancer, and head and neck cancer (BC and HNC, respectively). In step 1, it was established that focus groups involving patients and clinicians found traditional acupuncture to be an acceptable intervention, providing that the affected area was not needled. Step 2 was a single-arm observational study that tested recruitment, acceptability and effects. Participants received seven traditional acupuncture treatments (S1) with six additional optional treatments (S2). The Measure Yourself Medical Outcome Profile (MYMOP) and the 36-Item Short Form Health Survey (SF-36) were administered at baseline, and at the end of S1 and/or S2, with SF-36 follow-up at 4 and 12 weeks post-treatment. The primary outcome was a change in MYMOP scores at the end of each series. In step 3, six focus groups explored the participants’ experiences. Thirty-five participants were recruited for step 2 (BC=27; HNC=8): 30 completed S1 and S2; three completed only S1; and two were lost to the study. The mean changes in MYMOP scores were clinically and statistically significant at the end of each series; the SF-36 scores for Vitality and Bodily Pain were significant at 4 weeks post-treatment. No serious adverse affects were reported, and there were no changes in volume for subjects with BC outside of the normal range. Traditional acupuncture can be a safe and acceptable adjunct to usual care, and it has the potential to reduce the symptom burden in cancer survivors with upper-body lymphoedema. Improvements in well-being may lead to improved concordance with long-term management.