Connecting (T)issues: How Research in Fascia Biology Can Impact Integrative Oncology.

Complementary and integrative treatments, such as massage, acupuncture, and yoga, are used by increasing numbers of cancer patients to manage symptoms and improve their quality of life. In addition, such treatments may have other important and currently overlooked benefits by reducing tissue stiffness and improving mobility. Recent advances in cancer biology are underscoring the importance of connective tissue in the local tumor environment. Inflammation and fibrosis are well-recognized contributors to cancer, and connective tissue stiffness is emerging as a driving factor in tumor growth. Physical-based therapies have been shown to reduce connective tissue inflammation and fibrosis and thus may have direct beneficial effects on cancer spreading and metastasis. Meanwhile, there is currently little knowledge on potential risks of applying mechanical forces in the vicinity of tumors. Thus, both basic and clinical research are needed to understand the full impact of integrative oncology on cancer biology as well as whole person health. Cancer Res; 76(21); 6159-62. ©2016 AACR.

Assessing the feasibility of using acupuncture and moxibustion to improve quality of life for cancer survivors with upper body lymphoedema.

PURPOSE: Within a three-step mixed-methods study to investigate using acupuncture and moxibustion (acu/moxa) in the management of cancer treatment-related upper body lymphoedema, Step 2 obtained preliminary data about: 1) whether acu/moxa can improve quality of life, 2) the most troublesome symptoms, and 3) adverse effects. METHODS AND SAMPLE: An exploratory single-arm observational clinical study included breast (BC) and head and neck cancer (HNC) survivors with mild-to-moderate uncomplicated lymphoedema for ≥3 months, ≥3 months post active-cancer treatment, no active cancer disease, undergoing routine lymphoedema maintenance. Participants received seven individualised treatments (S1), and six optional additional treatments (S2). MYMOP, SF-36 and PANAS were administered at baseline, during each series, and at follow-up 4 and 12 weeks after end-of-treatment. The primary outcome was change in MYMOP scores at the end of each series. KEY RESULTS: Of 35 participants recruited, 30 completed S1 and S2, 3 completed S1, 2 were lost to the study. Mean MYMOP profile change scores for BC participants were 1.28 points improvement on a 7-point scale (sd = 0.93, p < 0.0001, n = 25) for S1; and 1.41 for S2 (sd = 0.94, p < 0.0001, n = 24). S1 HNC change scores were 2.29 points improvement (sd = 0.62, p < 0.0001, n = 7); and 0.94 for S2 (sd = 0.95, p = 0.06, n = 6). Changes in some SF-36 scores for BC participants were significant to 4 weeks after treatment. No serious adverse effects were reported. CONCLUSION: This small study suggests acu/moxa is an acceptable adjunct to usual care for cancer survivors with lymphoedema. Further rigorous research is warranted to explore the effectiveness of acu/moxa in reducing the symptom burden.

Using traditional acupuncture for breast cancer-related hot flashes and night sweats.

OBJECTIVES: Women taking tamoxifen experience hot flashes and night sweats (HF&NS); acupuncture may offer a nonpharmaceutical method of management. This study explored whether traditional acupuncture (TA) could reduce HF&NS frequency, improve physical and emotional well-being, and improve perceptions of HF&NS. DESIGN/SETTINGS/LOCATION: This was a single-arm observational study using before and after measurements, located in a National Health Service cancer treatment center in southern England. SUBJECTS: Fifty (50) participants with early breast cancer completed eight TA treatments. Eligible women were ≥ 35 years old, ≥ 6 months post active cancer treatment, taking tamoxifen ≥ 6 months, and self-reporting ≥ 4 HF&NS incidents/24 hours for ≥ 3 months. INTERVENTIONS: Participants received weekly individualized TA treatment using a core standardized protocol for treating HF&NS in natural menopause. OUTCOME MEASURES: Hot Flash Diaries recorded HF&NS frequency over 14-day periods; the Women's Health Questionnaire (WHQ) assessed physical and emotional well-being; the Hot Flashes and Night Sweats Questionnaire (HFNSQ) assessed HF&NS as a problem. Measurements taken at five points over 30 weeks included baseline, midtreatment, end of treatment (EOT), and 4 and 18 weeks after EOT. Results for the primary outcome: Mean frequency reduced by 49.8% (95% confidence interval 40.5-56.5, p < 0.0001, n = 48) at EOT over baseline. Trends indicated longer-term effects at 4 and 18 weeks after EOT. At EOT, seven WHQ domains showed significant statistical and clinical improvements, including Anxiety/Fears, Memory/Concentration, Menstrual Problems, Sexual Behavior, Sleep Problems, Somatic Symptoms, and Vasomotor Symptoms. Perceptions of HF&NS as a problem reduced by 2.2 points (standard deviation = 2.15, n = 48, t = 7.16, p < 0.0001). CONCLUSIONS: These results compare favorably with other studies using acupuncture to manage HF&NS, as well as research on nonhormonal pharmaceutical treatments. In addition to reduced HF&NS frequency, women enjoyed improved physical and emotional well-being, and few side-effects were reported. Further research is warranted into this approach, which offers breast cancer survivors choice in managing a chronic condition.