Acupuncture Relieves 'Dry Mouth' Discomfort in Cancer Patients -- Even though it didn't significantly increase saliva flow, acupuncture improved symptoms of "dry mouth" in head-and-neck cancer patients.
In a pilot study, 19 patients with xerostomia resulting from radiation therapy had significantly improved measurements of physical well being and quality of life when treated twice a week for eight weeks with acupuncture, M. Kay Garcia, Ph.D., of the University of Texas M.D. Anderson Cancer Center, and colleagues reported online in Head & Neck.
However, there was no significant improvement in stimulated saliva flow rates, which rose to only 1.94 g from 1.92 at baseline with a peak at 2.59 g in the first week of treatment.
Radiation therapy for head-and-neck cancer patients often renders salivary glands incapable of producing adequate saliva. Previous research has found that acupuncture is effective in improving symptoms of xerostomia, and much literature has shown that the therapy improves salivary flow, the researchers said.
The current study found comparable results in symptom improvement. Measures of disease intensity on the Xerostomia Inventory were significantly better after eight weeks of acupuncture (P=0.0001), as were Patient Benefit Questionnaire scores (P=0.0011).
Quality of life scores on questions relating to head and neck cancer increased significantly as well (P=0.006).
And measures of physical well being improved significantly (P=0.04), although measures of social, emotional, and functional well being did not.
The researchers found no statistically significant improvements in stimulated and unstimulated saliva flow rates.
"If you look at the [quality of life] scores, they keep getting better, but if you look at saliva flow, it fluctuates over this period of time," said Gary Deng, M.D., Ph.D., of Memorial Sloan Kettering Cancer Center in New York, who was not involved in the study.
"So you have to wonder if increased salivary flow is induced by acupuncture or not," he said. "[Based on the quality of life scores], you would expect it to get better and better. So there is the possibility of natural fluctuation."
Dr. Deng and colleagues have previously reported favorable findings for improvement in xerostomia in head-and-neck cancer patients.
He said that since the present study had only a single arm, the researchers should conduct a follow-up study "with a good control group."
But Dr. Garcia said even small changes in salivary flow can result in increased oral comfort, as symptoms of xerostomia tend to appear when salivary flow rate is decreased to about half of an individual's baseline rate.
The researchers also noted that patients who have had major salivary glands irradiated do not spontaneously improve after four months, so the improvements in their study "were most likely attributable to the acupuncture treatment rather than spontaneous recovery."
The major limitation of the study was that there was only a treatment arm, raising the possibility of placebo effect.
The researchers said they plan to perform "well-designed placebo-controlled trials to ensure the findings hold in a more methodologically rigorous study." ( medpagetoday.com )
In a pilot study, 19 patients with xerostomia resulting from radiation therapy had significantly improved measurements of physical well being and quality of life when treated twice a week for eight weeks with acupuncture, M. Kay Garcia, Ph.D., of the University of Texas M.D. Anderson Cancer Center, and colleagues reported online in Head & Neck.
However, there was no significant improvement in stimulated saliva flow rates, which rose to only 1.94 g from 1.92 at baseline with a peak at 2.59 g in the first week of treatment.
Radiation therapy for head-and-neck cancer patients often renders salivary glands incapable of producing adequate saliva. Previous research has found that acupuncture is effective in improving symptoms of xerostomia, and much literature has shown that the therapy improves salivary flow, the researchers said.
The current study found comparable results in symptom improvement. Measures of disease intensity on the Xerostomia Inventory were significantly better after eight weeks of acupuncture (P=0.0001), as were Patient Benefit Questionnaire scores (P=0.0011).
Quality of life scores on questions relating to head and neck cancer increased significantly as well (P=0.006).
And measures of physical well being improved significantly (P=0.04), although measures of social, emotional, and functional well being did not.
The researchers found no statistically significant improvements in stimulated and unstimulated saliva flow rates.
"If you look at the [quality of life] scores, they keep getting better, but if you look at saliva flow, it fluctuates over this period of time," said Gary Deng, M.D., Ph.D., of Memorial Sloan Kettering Cancer Center in New York, who was not involved in the study.
"So you have to wonder if increased salivary flow is induced by acupuncture or not," he said. "[Based on the quality of life scores], you would expect it to get better and better. So there is the possibility of natural fluctuation."
Dr. Deng and colleagues have previously reported favorable findings for improvement in xerostomia in head-and-neck cancer patients.
He said that since the present study had only a single arm, the researchers should conduct a follow-up study "with a good control group."
But Dr. Garcia said even small changes in salivary flow can result in increased oral comfort, as symptoms of xerostomia tend to appear when salivary flow rate is decreased to about half of an individual's baseline rate.
The researchers also noted that patients who have had major salivary glands irradiated do not spontaneously improve after four months, so the improvements in their study "were most likely attributable to the acupuncture treatment rather than spontaneous recovery."
The major limitation of the study was that there was only a treatment arm, raising the possibility of placebo effect.
The researchers said they plan to perform "well-designed placebo-controlled trials to ensure the findings hold in a more methodologically rigorous study." ( medpagetoday.com )
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