The effectiveness of acupuncture and self-acupuncture in managing cancer-related fatigue in breast cancer patients: a pragmatic randomised trial

atigue is a common problem experienced by breast cancer patients, it is distressing and affects their quality of life. We have limited treatment options to manage fatigue, and a small trial that our team recently completed testing the effect of acupuncture found an improvement rate of 36% after 6 sessions of acupuncture. The proposed study is based on our earlier trial and will use a large sample of patients to see if acupuncture is effective in managing fatigue and if improvements can be sustained for longer when patients are taught self-acupuncture and continue their treatment in that way for another 4 weeks. The biological reasons for experiencing fatigue will also be explored. Data will be collected using validated scales of fatigue, psychological status and quality of life. A blood sample will assist in finding any links between fatigue and immune parameters. Findings could help identify another treatment option for patients, especially for a symptom where treatment options are limited.

Background to the proposal

As many as 90% of breast cancer patients receiving chemotherapy and 40% of long term survivors may experience fatigue, a distressing symptom affecting their quality of life. Recently we have completed a feasibility trial of acupuncture in the management of fatigue and improvements were as high as 36%.

Specific aims of the research

To assess the efficacy of acupuncture in the management of fatigue in breast cancer patients; to assess if improvements with acupuncture can be sustained for longer if patients continue with self acupuncture; and to explore biological mechanisms responsible for the effects of acupuncture on fatigue.

Outline plan of research

The study will be a three-group single-blinded randomised controlled trial. 201 patients will be randomised to receive either weekly sessions of acupuncture for 6 weeks, the same course followed by self acupuncture weekly for 4 weeks or sham acupuncture weekly for 6 weeks. Validated scales of fatigue, anxiety/depression and quality of life will be collected at baseline, end of 6-weeks treatment, 10th week and 18th week of the patients’ participation. A blood sample from a subgroup of patients using a case control method will be used for identifying any biological links with fatigue.

Long term goal and ultimate purpose

This intervention could assist breast cancer survivors to live more fully after cancer treatments, improve their cancer experience and add to the limited treatment choices for managing this complex symptom.