Jury still out on acupuncture for hot flashes

NEW YORK (Reuters Health) - While some studies have found that acupuncture may cool women's hot flashes, new findings suggest that for women with breast cancer, it works no better than a "sham" version of the procedure.

Hot flashes are a common symptom of menopause, and they also frequently arise as a side effect of breast cancer treatment. Hormone replacement therapy effectively eases hot flashes, but it carries increased risks of heart disease and breast cancer. Acupuncture has emerged as a potential alternative, but study results have been mixed as to whether it works.

In the new study, researchers at Memorial Sloan-Kettering Cancer Center in New York found that acupuncture did seem to ease breast cancer patients' hot flashes. However, patients who received a sham version of acupuncture -- where the needles did not penetrate the skin -- were as likely to report improvements.

The reasons for the findings are not completely clear, according to the researchers, led by Dr. Gary Deng.

But one possibility, they explain, is that women who received sham acupuncture benefited from the "placebo effect" -- that is, the psychological effects of receiving treatment changed patients' perceptions of their symptoms.

Deng and his colleagues report the findings in the Journal of Clinical Oncology.

The study included 72 women with breast cancer who were having at least three hot-flashes per day. They were randomly assigned to undergo real acupuncture or the sham procedure twice a week for four weeks.

Acupuncture involves the insertion of fine needles into specific points on the skin. According to traditional Chinese medicine, these points are connected to internal pathways that conduct energy, and stimulating them helps balance the flow of energy throughout the body.

During the sham procedure used in this study, needles were inserted away from traditional acupuncture points, and the needles retracted into the handle after they were placed on the skin. All of this was out the patients' view.

When the women were interviewed six weeks into the study, both groups reported similar improvements. On average, hot-flash episodes declined from nearly nine per day to about six per day among women who received real acupuncture; women in the sham group went from 10 per day to fewer than eight per day.

The researchers also found that the improvements persisted in both groups for six months.

The findings do not, however, mean that acupuncture has no true effects on hot flashes, according to Deng and his colleagues. One possibility, they note, is that the sham version was not "entirely inactive."

It's also possible that the women simply did not receive enough acupuncture sessions.

"We cannot exclude the possibility that a longer and more intense acupuncture intervention could produce a larger reduction in hot flashes," the researchers write.

SOURCE: Journal of Clinical Oncology, December 10, 2007.