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Acupuncture eases radiotherapy side effects
Some cancer patients who have a dry mouth after radiotherapy may benefit from acupuncture
24th October 2012 - Acupuncture can relieve the symptoms of a dry mouth in patients with head and neck cancer who have received radiotherapy, say researchers.
A dry mouth is a distressing side-effect which is caused by damage to the salivary glands from radiation. Known as xerostomia, it can affect patients’ quality of life, interfering with taste, chewing, speaking and sleeping.
There are short-term solutions such as mouthwashes, gels and toothpastes, while treatment with a medication called pilocarpine has side-effects of its own.
Acupuncture vs. oral care
In order to research more effective solutions, UK doctors recruited 145 cancer patients with radiation-induced xerostomia and compared those who received acupuncture with others who received advice about oral care. Half the patients received 20 minute acupuncture sessions each week for eight weeks, while the remainder were instructed in oral care during two hour-long lessons. This continued for nine weeks, and then after a four week interval, the groups swapped over to the other treatment for a similar period.
The dryness of the mouth was assessed using paper strips, called Schirmer strips, which measure the amount of saliva in the mouth. They were also questioned about individual symptoms such as sticky saliva, dry lips, needing to sip water to relieve a dry mouth, needing to sip water to help swallow food and waking at night to sip water.
The researchers found that there was no significant change in saliva production between those in the two treatment regimes. However, those who had received nine weeks of acupuncture were twice as likely to experience relief of their symptoms from a dry mouth than those who had only received advice about oral care.
Dr Richard Simcock, consultant clinical oncologist at the Sussex Cancer Centre and one of the authors of the study, says in a statement: "Time had an important effect on key symptoms, with patients receiving acupuncture showing a quick response from acupuncture, which was sustained over several weeks."
The researchers say that the subjective reporting of improvements in xerostomia was of more significance than the lack of changes in the objective test with the Schirmer strips. "There was no clear relationship between a patient indicating they had a very dry mouth and the measurement of saliva on the Schirmer strips,” explains Dr Simcock. "By definition these patients with chronic xerostomia produced little or no saliva, making objective measurements really difficult.
"Many studies have focused on the objective measurement of how much saliva is produced, but the amount of saliva produced does not necessarily influence the experience of a dry mouth. Xerostomia is therefore an entirely subjective symptom - it is what the patient says it is, regardless of salivary measurement."
'No placebo effect'
The researchers say they do not believe that the improvement in symptoms is down to any placebo effect. Dr Valerie Jenkins, deputy director of Sussex Health Outcomes Research & Education in Cancer at Brighton & Sussex Medical School, University of Sussex, who supervised the research, says in a statement: "The profound impact that xerostomia exerts on functions such as eating, talking and sleeping, which were relieved by the acupuncture means that if it is entirely a placebo effect than this is a pretty powerful placebo. In addition, the results showed that patients were less likely to wake at night to sip water after treatment - this effect seems difficult to ascribe solely to placebo."