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A Retrospective Review Investigating the Feasibility of Acupuncture as a Supportive Care Agent in Children with Cancer
Kathy Taromina, MS, LAc, Diane Rooney, MS, LMT, LAc, Elena J. Ladas, MS, RD, Deborah Hughes,
Kara Kelly, MD
Integrative Therapies Program for Children with Cancer, Columbia University, Division of Pediatric Oncology,
New York, NY, United States, 10032
Background Acupuncture is an ancient Chinese method of
healing and is a component of Chinese medical treatment.
Published reports have cautioned against the use of acupuncture in the pediatric population
Clinical trials have suggested that acupuncture may have a role as a supportive care agent in adults undergoing treatment for cancer
No clinical trials have been published for children undergoing treatment for cancer.
Acupuncture and Pediatrics Pediatrics has historically been part of
Chinese medicine and is widely used in China.
Recommended for children of all ages and conditions
Adjustments need to be made to treatment and delivery
Acupuncture and Children with Cancer
More consideration needed when giving acupuncture to children already having frequent needle exposure.
Developmental Stage Difficult to avoid toddlers from moving around or
grabbing at needles Body image concerns with adolescents
Strategies Fewer needles, thinner
gauge and shorter duration of treatment
Needles do not have to be retained to have a therapeutic effect
Gently inserting needles and coordinating breathing exercises with insertion can minimize the sensation of the needle being placed.
Private room option
Acupuncture and Thrombocytopenia Many cancer patients encounter
thrombocytopenia at some point in their therapy
Recommendations from the acupuncture community are practitioner-dependent
Theoretical concern in patients with < 50 µMol/mL
Program Description Acupuncture services were initiated in March 2005
The primary oncologist of each patient is approached by the director of the program prior to acupuncture treatment
Upon physician approval, patient/guardian consent is obtained per NY State Guidelines
Acupuncture Treatment Description
Treatment is integrated with outpatient and inpatient treatments
Appointments not necessary
Acupuncturist makes daily rounds in outpatient center and inpatient unit
Primary Objectives
To describe the first year of the introduction of an acupuncture program to children with cancer.
To describe the feasibility, patient acceptance, symptoms addressed, and overall experience of an acupuncture program provided to children undergoing treatment for cancer.
Methods 25 patient records of subjects between the age of 1
and 22 who were undergoing treatment for cancer
Patient diagnosis, gender, age, chief complaint, number of treatments, acceptance, outcome, and adverse events were recorded over a 6-month period.
Patient treated with acupuncture at the same time as receiving conventional therapies
Monitoring of Side-Effects
Acute A thorough exam of the acusites was conducted
after each treatment session. Delayed
Acusites were examined during the patient’s routine visit to monitor for any delayed side-effects.
Results
Over a 6-month period, we provided 172 sessions of acupuncture to children ages 1– 22 undergoing treatment for cancer
The provision of services was feasible to a wide range of diagnoses and ages and in both the inpatient and outpatient settings
Demographic Data
Caucasian (15)
Hispanic (7)Black, not Hispanic (1)
Other (2)Female (14)
Male (11)
N=25
Age Range: 1 to 22 years
Race Gender
Patient Diagnoses
0 1 2 3 4 5 6
Sickle Cell Anemia
AML
Rhabdomyosarcoma
Nasopharyngeal
Hodgkins Disease
Osteosarcoma
ALL
Ewings
Brain Tumor
# of Patients
Signs & Symptoms Treated
Pain Headache
Dry Mouth
High Blood Pressure
Fatigue / Weakness
Cachexia
Nausea / Vomit
Anxiety
Well-Being
Thrombocytopenia
Side-Effects Associated with Treatment with Acupuncture Out of 172 sessions of acupuncture, only two side
effects reported
Two patients reported a small hematoma at the acupoint site 16-year old male with relapsed Ewings Sarcoma. Patient
was receiving high-dose dexamethasone and developed a hematoma at one acusite after one treatment.
11-year old female with relapsed Ewings Sarcoma. Patient suffered chronic thrombocytopenia and developed a hematoma at one acusite after one treatment.
0
2
4
6
8
10
12
14
Patient Platelet Counts
< 50 µMol/mL > 50 µMol/mL< 20 µMol/mL
Treatments Per Patient
0
5
10
15
20
25
30
35
# of
Tre
atm
ents
Conclusions Provision of acupuncture is feasible and well-accepted
among children with diverse malignancies and undergoing stem cell transplantation
Provision of acupuncture is feasible in both the in/out-patient settings
Acupuncture is well-accepted by a wide age range of patients
Acupuncture may be a supportive care agent for a variety of therapy-related side-effects; however, this needs to be confirmed in future clinical trials
Next Steps
The descriptive nature of this study helped identify potential areas where acupuncture may have a role as a supportive care agent.
Future randomized, controlled trials in a homogenous patient population will aid investigators in identifying the role of acupuncture in pediatric oncology
Acknowledgements Staff of The Integrative Therapies Program for
Children with Cancer
Kara Kelly, MD Elena J Ladas, MS, RD Deborah Hughes, BA Diane Rooney, L.Ac Christine Grimaldi, PhD
The patients treated at the Division of Pediatric Oncology,
Columbia University Medical Center