Relieving nausea in chemotherapy patients

Townsend Letter for Doctors and Patients,  July, 2005  by Honora Lee Wolfe

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Over 175,000 women in the United States are diagnosed with breast cancer each year. While many women combine it with various complementary and alternative therapies, the most prevalent treatment for breast cancer is still chemotherapy. Unfortunately, chemotherapy is often accompanied by a number of unwanted side effects, the most common of which is nausea.

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There are some drugs available to reduce the symptoms of nausea, but many people receiving chemotherapy do not wish to add drugs on top of the chemotherapy. As many as 60% of chemotherapy patients report being nauseous after undergoing treatment, and many cancer patients identify nausea as a main reason for being reluctant to begin chemotherapy or for discontinuing treatment.

Numerous studies have shown the effectiveness of both acupressure and acupuncture in relieving nausea associated with pregnancy, surgery, and chemotherapy. Based on the evidence from these studies, Western science has acknowledged the value of acupuncture and acupressure for breast cancer chemotherapy patients (if not chemotherapy patients in general).

A treatment protocol for chemotherapy-induced nausea

Since chemotherapy patients frequently experience great fatigue and hair loss as well as nausea, we can posit that, in such cases, they have the Chinese medical patterns of spleen qi vacuity as well as liver assailing earth causing counterflow of the stomach and possible depressive liver heat. The best acupuncture treatment that I know for this combination of patterns is the "Old Replete Needle" protocol from Golden Needle Wang Le-ting. Dr. Wang was one of the most famous acupuncturists in Beijing between 1950 and 1980 and he treated thousands of patients with all types of serious diseases. He created many treatment protocols that are still used all over the world today.

This treatment protocol consists of: Zhong Wan (CV 12), Nei Guan (Per 6), Qi Hai (CV 6), Zu San Li (St 36), Zhang Men (Liv 13). In China, the treatment would likely be given once per day for several days before and after each chemotherapy treatment.

This protocol accomplishes all the treatment principles required to effectively stop vomiting, reverse counterflow, rectify the qi of the liver, and supplement the qi. There will, of course, also be other patterns depending upon each patient. If more spleen qi supplementation is required, you might add San Yin Jiao (Sp 6) or Tai Bai (Sp 2), depending on your style of practice. If more qi rectification is required, you could include Tai Chong (Liv 3). However, it is important to keep in mind that people who are receiving chemotherapy are often weakened both by their disease as well as the harsh therapy they are receiving. That being the case, it is my experience that the fewer number of points you use, the better. It is also prudent to monitor carefully how long you leave the needles in place. Sometimes a very few minutes is preferable to a standard 20-30 minute treatment in these cases. You can also give patients with severe nausea problems an ear seed on the Stomach and Shen Men ear points as well as teaching them how to press Nei Guan (Per 6) on their own whenever needed. This treatment can be a helpful addition for cancer patients receiving chemotherapy who wish to maintain as much as possible, a normal life during the course of their therapy.

Bibliography

Yu Hui-chan and Han Fu-ru, Golden Needle Wang Le-ting: A 20th Century Master's Approach to Acupuncture, Blue Poppy Press, Boulder, CO 1997, p. 38

King CR., Nonpharmacologic management of chemotherapy-induced nausea and vomiting. Oncology Nursing Forum 1997;24 (suppl. 7):41-48

Rhodes VA, McDaniel RW., Measuring nausea, vomiting and retching. In: Frank-Stromberg M, Olsen SJ (eds.) Instruments for Clinical Health Care Research, 2nd ed. Boston, Jones and Bartlett, 1997, pp. 509-518.

de Aloysio D, Penacchioni P., Morning sickness control in early pregnancy by Neiguan point acupressure. Obstetrics and Gynecology 1992;80:852-854.

Belluomini J, et al. Acupressure for nausea and vomiting of pregnancy: a randomized, blinded study. Obstetrics and Gynecology 1994;84:245-248.

Dibble SL, Chapman J, Mack KA, Shih A., Acupressure for nausea: results of a pilot study. Oncology Nursing Forum Feb 2000;27(1):41-7.

abstracted & translated by Honora Lee Wolfe, Dipl. Ac., Lic. Ac., FNAAOM

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