Acupressure May Ease Breast Cancer-Related Pain, FatigueOct 14, 2015
Early-stage research suggests that pressing on tiny seeds taped to the ear just three times a day appears to greatly relieve pain and fatigue in women with breast cancer. This is according to a study published by an American Cancer Society grantee in the September 18, 2015 online edition of the journal Cancer Nursing.
Pain is one of the most challenging symptoms that patients with cancer experience. "More than 40% of women with breast cancer still report persistent pain 2 to 3 years after breast surgery," says Chao Hsing Yeh, PhD, RN, an associate professor in the department of health promotion and development at the University of Pittsburgh. "Over half of these patients have moderate to severe pain, which ultimately impacts their quality of life."
Pain may be the result of nerve damage from breast cancer surgery or chemotherapy. It may also be triggered by anti-hormone medications called aromatase inhibitors (AIs), which may be needed for up to 5 years. About half of all breast cancer survivors develop a musculoskeletal disorder called AI-induced arthralgia. "It causes joint pain and stiffness, and is one of the most frequent, distressing, and debilitating symptoms," adds Yeh. "Sometimes they drop out of treatment because of this pain."
How can pressing on your ears help? The concept is called auricular point acupressure (APA). It's like acupuncture, but without the needles. Yeh, with the help of an American Cancer Society grant, has been testing the method on women with breast cancer, and she's found it's an easy and inexpensive way to help them relieve their pain at home.
The Ear's Connected to the Brain
APA therapy is a form of traditional Chinese medicine (TCM) based on a concept called the meridian theory. It proposes that how you feel is governed by the flow of energy, or qi, through a network of invisible pathways that connect different organs in the body. Specific points on the ear correspond to specific areas of the brain, and these areas have a reflex connection with specific parts of the body. Stimulating the ear points can signal the brain to prompt reactions in the body to relieve symptoms, such as breast cancer-related pain.
"We have all the points on the ear that correspond to our body parts," says Yeh. "That means I can always find a point on the ear to deliver treatment."
The World Health Organization has recognized the therapeutic effects of APA, but the technique has not been widely adopted in the United States due to a limited understanding of how it works and a lack of high-quality randomized controlled trials, Yeh explains. However, studies using functional magnetic resonance imaging (fMRI) have demonstrated the correlation of ear points and brain activity. Yeh plans on demonstrating any changes in patterns and levels of blood biomarkers linked to inflammation (and subsequent pain) in women who are undergoing APA treatment.
APA can be performed at home. However, it first requires a visit with a licensed provider who will tape small botanical plant seeds, called vacarria, to specific ear acupoints and teach you how to apply pressure to them with your thumb and index finger. The waterproof tape with the seeds remains on the ear for up to 4 weeks in most patients. You apply pressure to your ears three times a day for 3 minutes each time. The ears’ small size makes them very sensitive to stimulation. That means you don't have to press very hard, or for very long.
Yeh’s small study included 31 middle-aged women with persistent-post mastectomy pain. The participants received either active APA or a dummy APA procedure once a week for 4 weeks.
Yeh says her research has shown that women who performed APA at home for 7 days had a 51% reduction in breast cancer-related pain. After 4 weeks of treatment, they had an even greater decrease in pain intensity (71%). The women also said they felt less fatigued, slept better, and had less difficulty performing daily activities.
"APA is a non-invasive, non-pharmacological method that is not only simple to learn and administer, but also has few side effects," says Yeh, who adds that pain medicines can cause troubling side effects like constipation and the possibility of addiction or tolerance. "Better non-pharmacological pain management is needed."
The valuable pilot data that she has gathered with funding from the American Cancer Society has helped build the foundation for further study of the subject in a larger group of women. She plans to submit a proposal to the National Institutes of Health in October 2015 to further evaluate APA as an effective pain management strategy in women with breast cancer, particularly those with AI-related arthralgia.