Acupuncture in cancer care: recommendations for safe practice (peer-reviewed expert opinion)
Beverley de Valois1, Teresa Young1, Catherine Zollman2, Ian Appleyard3, Eran Ben‑Arye4, Mike Cummings5, Ruth Green6, Caroline Hoffman7, Judith Lacey8, Felicity Moir9, Rachel Peckham3, Jacqui Stringer10, Susan Veleber11, Matthew Weitzman12, Kathrin Wode13
Affiliations:
1 Supportive Oncology Research Team (SORT), East and North Hertfordshire NHS Trust Incorporating Mount Vernon Cancer Centre, Northwood, Middlesex, UK
2 Penny Brohn UK, Pill, Bristol, UK
3 British Acupuncture Council, London, UK
4 Clalit Health Services, Haifa, Israel
5 British Medical Acupuncture Society, London Office, London, UK
6 Imaging, Royal National Orthopaedic NHS Trust, Stanmore, Middlesex, UK
7 British Society for Integrative Oncology, London, UK
8 Supportive Care and Integrative Oncology, Chris O'Brien Lifehouse Comprehensive Cancer Hospital, Sydney, NSW, Australia
9 University of Westminster (Retired), London, UK
10 The Christie NHS Trust GB, Manchester, UK
11 Integrative Medicine, Fred Hutchinson Cancer Center, Seattle, WA, USA
12 Integrative Medicine Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA
13 Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
Abstract
Purpose: Up-to-date recommendations for the safe practice of acupuncture in integrative oncology are overdue with new cancer treatments and an increase in survivors with late effects of disease; 17 years have elapsed since Filshie and Hester's 2006 guidelines. During 2022/2023 an expert panel assembled to produce updated recommendations aiming to facilitate safe and appropriate care by acupuncturists working with people with cancer.
Methods: A core development team comprising three integrative oncology professionals comprehensively updated pre-existing unpublished recommendations 12 invited international experts (senior acupuncturists with and without experience of working in oncology settings, oncologists, physicians and nurses trained in integrative oncology, researchers, academics, and professional body representatives) reviewed the recommendations. In multiple iterations, the core team harmonized comments for final ratification period to aid dissemination and uptake the panel represents national and international Integrative Oncology Associations and major cancer treatment centres in Europe, USA, Australia, and the Middle East.
Results: Od these recommendations facilitate safe care by articulating contraindications, cautions, and risks for patients both on and off treatment (surgery, SACT, radiotherapy). situations where acupuncture may be contraindicated or practices need adapting or identified. "Red and Amber Flags" Highlight Where urgent referral is essential.
Conclusion: These are the first international, multidisciplinary peer-reviewed recommendations for safe acupuncture practice and integrative oncology. Concerns about safety remain a significant barrier to appropriate referral from oncology teams, to use by acupuncturists and to uptake by patients. Disseminating trustworthy, widely accessible guidance should facilitate informed, confident practice of acupuncture in and outside of oncology healthcare settings.
https://doi.org/10.1007/s00520-024-08386-6