One session a week to sleep better. To overcome the difficulty of falling asleep, to forget the short sleep or continuous awakenings throughout the night, to live the day without the weight of tiredness. To improve mood, and ultimately also the quality of life, especially if this is already compromised by the therapies that must keep breast cancer under control. It can be done with acupuncture. This is demonstrated by a study just published on Advances in Social Sciences Research Journal by the research group of Paolo Marchetti, oncologist and scientific director of the IDI-IRCCS in Rome. “Many cancer patients – explain the researchers who conducted the study – often report sleep disturbances, as a result of the disease or treatments. The objective of this analysis was to measure the efficacy and safety of acupuncture in women with breast cancer receiving hormone replacement therapy.
The 58 participants were divided into two groups: the patients of the first underwent acupuncture sessions once a week for 8 weeks, while those of the second continued the standard treatments in the same way. After 8 weeks, changes in sleep quality and quantity were significantly different in the two groups. In the acupuncture group, the researchers report, 43.33% declared a complete remission, therefore having solved the problem of insomnia, while this did not happen in any of the patients in the control group. Also in the first group, the severity of sleep disturbances had decreased by several points on the ISI rating scale (from 15.87 to 9.80), while in the control group the reduction was significantly lower (from 17.46 to 15 ,39). None of the patients reported problems or discomfort associated with acupuncture. Conclusion: Acupuncture can be considered as an alternative intervention to improve sleep and quality of life for cancer patients.
Integrated oncology, increasingly based on scientific evidence
by Tiziana Moriconi
Insomnia affects 40% of sufferers
Marchetti reiterates that insomnia is an important issue in general, and even more so in cancer patients. “At a time when there is a lot of talk about precision oncology, i.e. the possibility of identifying potentially active drugs against the underlying disease in an ever more precise manner, we sometimes tend to overshadow some side effects which, from a point of from a clinical point of view they appear to be of modest importance, but which, evaluated over the long term of the therapies, can become highly disabling”. Insomnia is one of them. Certainly less visible than the side effects caused by the “old” chemotherapy, it nevertheless afflicts more than 40% of the women undergoing treatment. Its causes are many, explains Marchetti again. But it is evident that in patients who have breast cancer and are being treated with aromatase inhibitors, the reason must also be sought in the further reduction of estrogen levels, a factor which produces important metabolic consequences. And if we think that sleep disturbances are one of the most frequent symptoms in menopausal women, the picture immediately appears clearer. Also because, continues the oncologist, estrogen deprivation in physiological conditions occurs very gradually, while drugs produce a very abrupt reduction in estrogen. So this symptomatology tends to be more frequent.
Acupuncture is safe
To date, although there is various evidence in the literature that acupuncture can play an important role, sleep disturbances in this category of patients have been tackled almost exclusively from a pharmacological point of view. And yet, adding medicines to a person who is already following more or less impactful therapies is never a good idea, because – explains Marchetti – the probability is increased that the side effects due to the drugs that treat the disease are added to those of the drugs that we use to reduce side effects, in an endless vicious circle. For this reason, today the path is that of “therapeutic reconciliation”, which consists in trying to understand which drugs are truly indispensable and which ones we could avoid or replace with alternative treatment methods. Acupuncture, acting through the remodulation of the production of endorphins, in this trial was practically devoid of side effects, given that it did not cause any discomfort in the patients of the first group. Safe, as well as effective, it is in fact used in many structures, in Italy and abroad, also for pain relief therapy.
Treating pain with integrative medicine, the new guidelines from the USA
by Tina Simoniello
Insomnia ruins the quality of life
However, the implications of this study on treatment centers still need to be evaluated. “Of course, the ideal would be to have acupuncture clinics in hospitals”, continues Marchetti. However, this requires, in addition to adequate spaces, also a specific preparation of the doctors. But it would be worth it. Because insomnia is one of the symptoms that have the greatest interference in the quality of life of patients and their families, generating emotional instability and irritability from which everyone suffers. In Italian hospitals where acupuncture centers are already available, it will therefore be easy to offer this type of support to patients. In various situations, however, this is not possible in a structural way: “when there is a lack of doctors and nurses – adds the oncologist – this path may not be at the top of the priorities. And instead in protracted treatments, this type of symptomatology assumes a value of extraordinary importance. For this reason, Marchetti concludes, I believe that these aspects deserve the attention of the medical profession and of those who organize and define the care pathways”.