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Group acupuncture in a hospital oncology setting

Group acupuncture in a hospital oncology setting

The Fountain Centre (FC) is a local cancer charity based in the Royal Surrey hospital in Guildford which offers complementary therapies and emotional support to patients (and their loved ones) living with and beyond cancer. In this blog, research and development coordinator, Natalie Silverdale, talks about the benefits of group acupuncture in a hospital oncology setting.

All our patients are having, or have had, their cancer treatment at St Luke’s Cancer Centre. Our service is provided by volunteers and we have around 35 complementary therapists who give three hours of their time each week. Safe to say, our service would not run without the amazing service they provide!

Acupuncture is our most popular complementary therapy. However because it is in such high demand, there can be a two or even three week waiting time. And even though we know consecutive weekly treatments produce the best results, this is often not possible in practice.

We have therefore looked at other ways we can provide a more reliable, beneficial and most importantly, free, acupuncture service to our patients.  In this regard, both NADA (National Acupuncture Detoxification Association Protocol) and balance acupuncture can be given when the person is fully clothed and as such, can be delivered in groups.  This is not only beneficial to patients but cost-effective for us - as up to four people can be treated in any one-hour session!

NADA

NADA was originally developed for addiction, but published research has shown the benefits of this technique for cancer treatment-related hot flushes[i].  We successfully piloted and evaluated three eight-week NADA clinics in the Fountain Centre.  For most male (prostate cancer) and female (breast cancer) attendees, hot flushes significantly reduced.  The encouraging findings led us to train up all our acupuncturists in NADA and we have integrated these clinics into our service provision. We now regularly run free eight-week hot flush clinics to groups of breast and prostate cancer patients, and are planning on introducing regular top up clinics in 2019.

Balance Acupuncture

Despite the benefits we have seen, particularly for pain relief, much less has been written about the balance method. This type of acupuncture has its roots in the I Ching, and has been adapted and made popular by Dr Richard Teh-Fu[ii].  In balance acupuncture, the needled points are distal to the area being treated, and are applied to the lower arms, legs, hands, feet and head. This means the patient can remain clothed and a multi-bed setting can be used.

We originally piloted and evaluated a balance acupuncture service for generic cancer related pain[iii]. Patients attended the clinic twice a week for six weeks and our findings showed significant reductions in pain scores. One of the attendees was a post-operative oesophageal cancer patient. He had been suffering from unrelieved shoulder/neck issues since his operation, which had left him both in pain and unable to lift his arm above his shoulder.  After a couple of sessions of balance acupuncture he could freely move his arms and neck and his pain had greatly reduced. 

If oesophageal cancer has not spread, patients are able to undergo an oesophagectomy. However the operation itself, as well as the recovery period, is long and complex. Common post-operative side effects include shoulder/neck pain and stiffness. This is debilitating, not only because it is largely unrelieved by medication, but also due to associated arm/neck mobility issues

As a result of his own positive experience, the gentleman who attended our original pain clinic persuaded his medical team to fund a pilot balance acupuncture service to explore whether it could help these issues in other post-operative oesophageal cancer patients. 

The first clinic was a resounding success and the medical team agreed to continue to fund more.  In total, three clinics ran during 2016 and 2017, and 19 patients were treated. Two did not complete the acupuncture because of a cancer recurrence and one moved abroad.  Out of the remaining 16 patients, 13 were male and the average age was 63 (46-82). Using a validated pain visual analogue scale[iv], average pain scores reduced by almost 60%, from 6.1 before the clinic to 2.6 after. Most patients had never had acupuncture before, and the majority hadn’t previously believed in its potential.  In post clinic interviews, they commented how their initial scepticism had been replaced with amazement that acupuncture really works.  It was not uncommon for attendees to change their arrangements to make sure they could attend all sessions.  They also got invaluable social support from being part of a group with others in a similar position to themselves. Unfortunately issues outside our control - most notably staff illness - resulted in a lack of longer-term follow up, and no clinics ran in 2018.  However new staff are being recruited, and we hope to restart these clinics in 2019. 

 

[i] De Valois, B, Young, TE, Robinson N, McCourt, C., & Maher, J.  (2012). NADA Ear Acupuncture for Breast Cancer Treatment–Related Hot Flashes and Night Sweats: An Observational Study. Medical Acupuncture. 24(4): 256-268. De Valois B, Young TE, Thorpe, P, Preston J., & Tarsem D. (2015). Improving Well-Being of Prostate Cancer Survivors Using the NADA Acupuncture Protocol: A Clinical Outcome Study. 27(3): 194-205.

[ii] Teh-Fu Tan, R. ( 2007).  Acupuncture 1,2,3. ISBN-10 0-9759412-3-2

[iii] Hudson B, Burby R, Silverdale N. & Storey L. (2016). Balance Acupuncture for Pain Relief in Cancer Patients in a Multi-bed setting – An Internal Feasibility Audit. European Journal of Oriental Medicine 8(4):44-50.

[iv] Choiniere, M. & Amsel,  R. (1996). A visual analogue thermometer for measuring pain intensity. Journal of Pain and Symptom Management. 11(5): 299- 311

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