Do you have any information on self-needling for chronic cancer pain?

Q: I am an oncology pain specialist nurse and I am currently doing a Masters in nursing. My question relates to 'self Acupuncture for chronic Cancer pain'. I appear to be struggling for published data on this topic so wanted to ask if there are any trials in this area or who I could ask?

A:To be honest there isn't a great deal of information about self-needling, although there have been some interesting articles over the years. A relatively recent one discusses the use of self needling in research trials for breast cancer treatment. You will need to find someone in your section with access to research databases to download this, but it looks like interesting reading.

We came across a hospital In Truro many years ago where patients were being trained in the use of a specific point (Nei Guan) to reduce post-chemotherapy nausea, for which there is considerable positive research evidence, and they did have some very well laid out and clear instructions.

However, it would be fair to say that we are still very much on the side of the view expressed by Val Hopwood in the article on self-needling to be found in this journal where she says that the risks outweigh the benefits.

We have not tended to encourage people to needle themselves. There are two main reasons. First, acupuncture involves piercing the skin and safely disposing of needles, and a professional practitioner spends a considerable time learning the skills and knowledge necessary to remove any risk of infection or cross-infection from the process. Our main complaint about very short training courses is that while they may train people in useful adjunctive skills they cannot hope to ensure that the person taking them is sufficiently well trained in safe needle practice and all the cautions that go with being a professional acupuncturist.

Second, although the treatment of symptoms has its place in Chinese medicine, symptoms are regarded as only a part of the picture, and are usually indicators of imbalances within the system which need attention. The risk is that using acupuncture in a first aid way, the underlying pattern is deteriorating, but the alarm bell which the symptom represents keeps getting turned off. This is less likely in a controlled setting like continuing treatment under supervision. However, we have to be realistic; for most patients in continuing care this can mean quarterly or half yearly check-ups, and a great deal could happen in between without necessarily being picked up or seen as being masked by a treatment intended for another purpose.

That said, you can find some data by chasing the references in these two papers. There are also a number of recent studies which are well worth looking at. Jacqueline Filshie is one of the UK's experts in acupuncture and cancer treatment, and her paper is as always enlightening and solidly grounded in experience. There is also a useful paper here for a study in which Jacqueline also took part.

We hope that these give you enough to start with and wish you well with your studies.

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