Ting Bao

Symptom burden continues to be a significant challenge throughout the cancer care continuum, frequently persisting even when guideline-directed pharmacologic treatments are used. Acupuncture has emerged as a nonpharmacologic supportive care option with growing evidence of benefit in selected cancer-related symptoms and has been incorporated into multiple professional oncology guidelines. However, uncertainty about proper indications, safety issues, referral processes, and reimbursement structures has hindered its adoption into standard oncology practice. This review provides practical guidance for oncology clinicians about the roles of acupuncture in cancer care. We summarize clinical indications supported by guidelines, outline oncology-specific safety and risk stratification principles, and discuss implementation strategies within cancer centers, which include referral workflows, use of patient-reported outcomes, staffing and training considerations, and financial sustainability. When administered by oncology-trained practitioners and coordinated within multidisciplinary care teams, acupuncture is typically safe, provided that clinicians consider the patient's treatment phase, relevant laboratory and imaging results, presence of implanted devices, surgical scheduling, and extent of metastatic disease. Although insurance coverages for acupuncture in cancer care remains heterogenous in the United States, experience from mixed-payer environments demonstrates that services can be implemented using flexible delivery and staffing models, although financial sustainability remains influenced by payer mix and institutional support. For oncology professionals, familiarity with acupuncture referral criteria and available evidence can help broaden care options and support patient-centered symptom management.

Background: Cancer-related pain is a common and distressing symptom among patients with cancer. Although acupuncture is widely used and supported by growing evidence, its real-world use and related patient attitudes remain underexplored in South Korea. This study aimed to investigate patterns of acupuncture use and identify factors influencing its use among Korean cancer patients experiencing pain. Methods: A cross-sectional survey was conducted from October 2023 to May 2024 at six Korean medicine hospitals. A total of 201 cancer patients with pain completed a questionnaire assessing acupuncture use, pain severity and interference, and beliefs using a modified version of the ABCAM (Attitudes and Beliefs about Complementary and Alternative Medicine) instrument. Treatment concerns, logistical barriers, and social norms were analyzed. Results: Of the 201 participants, 80.6% reported using acupuncture for cancer-related pain. Pain severity was the only significant predictor of acupuncture use (OR = 1.53, 95% CI: 1.10–2.12, p = 0.01). Acupuncture users reported fewer concerns about safety and side effects, fewer logistical barriers, and stronger encouragement from family, healthcare providers, and peers. Conclusions: This is the first study to explore real-world use of acupuncture for cancer pain in South Korea. Greater pain severity, perceived safety, ease of access, and social support were associated with higher acupuncture use. These findings suggest that improved patient education and integration of acupuncture into cancer care may enhance pain management for Korean patients.

Alice Feng, Mingxiao Yang, Weidong Lu, Wanqing Iris Zhi, Ting Bao. Journal of Acupuncture Research 2025;42:286-94. https://doi.org/10.13045/jar.25.0002

Integrative medicine use is prevalent among breast cancer survivors to improve lifestyle and manage symptoms associated with cancer or its treatment. This review provides an overview of integrative therapies used for lifestyle improvement and symptom management in breast cancer patients, including diet and exercise recommendations, mind-body approaches including mindfulness-based intervention, acupuncture, yoga, massage, and dietary supplements. A balanced diet with an emphasis on plant-based foods and limited consumption of red meat, processed meats, alcohol, and refined sugar is recommended for cancer patients and survivors. Physical activity is also important, with recommendations of 30 minutes of moderate exercise daily, aiming for 150 minutes per week. Mind-body approaches such as meditation, yoga have been shown to improve emotional self-regulation, anxiety, depression, and other symptoms. Acupuncture has demonstrated potential benefits for aromatase inhibitor-induced musculoskeletal symptoms, hot flashes, peripheral neuropathy, and fatigue. Massage may help address pain, anxiety, stress, and improve quality of life (QoL). Supplement use should be approached with caution, especially during active treatment, due to potential interactions with cancer therapies. The review highlights the role of specialized integrative medicine practitioners, such as naturopathic doctors and acupuncturists, in safely incorporating these therapies into standard cancer care. This collaborative approach supports survivors’ diverse needs and empowers them to actively participate in their recovery, ultimately improving health outcomes and QoL. Integrative therapy programs within cancer care institutions can provide structure, guidance, and support for patients to safely incorporate these modalities into their treatment and recovery plans.

Molly Siegel, Sylvia Baedorf Kassis, Weidong Lu, Im Hee Shin, Ting Bao, Barbara E. Bierer. Journal of Acupuncture Research 2025;42:41-5. https://doi.org/10.13045/jar.24.0053

Purpose: Chemotherapy-induced peripheral neuropathy (CIPN) worsens the quality of life for people with cancer. Massage therapy involves neuromuscular modulations and can potentially reduce CIPN symptoms. We examined the immediate improvements in CIPN-related pain and neuropathy following massage therapy among patients with CIPN. Methods: In a retrospective cohort, we assessed patients who received 1 massage therapy session for CIPN symptom relief during or after chemotherapy at a National Cancer Institute-Designated Comprehensive Cancer Center from October 2017 to September 2022. We measured the severity of pain and neuropathy before and after massage therapy with a 4-item verbal rating scale (VRS) or a 0 to 10 numerical rating scale (NRS). We converted NRS to VRS scores and examined the pre-post differences in symptom severity using the Wilcoxon rank test. Results: Among 23 patients (median [range] age 64 [4-85] years, female 74%, White 70%), one session of massage therapy decreased the percentage of patients reporting moderate-to-severe pain from 81% at baseline to 0% (none) post-massage; percentage of patients reporting neuropathy also reduced from 77% at baseline to 12% following treatment. The pre-post differences were statistically significant for both pain (mean: −1.6, 95% confidence interval [CI] −1.9 to −1.2; P = .001) and neuropathy scores (mean: −1.2, 95%CI −1.4 to −0.9; P < .0001). Conclusion: Among cancer patients with CIPN, one session of massage therapy was associated with immediate neuropathy and CIPN pain relief reported by patients following treatment. However, this preliminary finding requires further rigorous verifications in future randomized controlled clinical trials.

Purpose Chemotherapy-induced peripheral neuropathy (CIPN) is a debilitating side effect of neurotoxic chemotherapy. Exercise activates neuromuscular function and may improve CIPN. We examined the association between exercise and CIPN symptoms in breast cancer survivors. Methods In a retrospective cross-sectional study, we included patients completing a survey assessing exercise exposure and neuropathy symptoms in a tertiary cancer center survivorship clinic. We evaluated exercise duration and intensity using a standardized questionnaire quantified in metabolic equivalent tasks (MET-h/wk). We defined exercisers as patients meeting the National Physical Activity Guidelines’ criteria. We used multivariable logistic regressions to examine the relationship between exercise and CIPN and if this differed as a function of chemotherapy regimen adjusting for age, gender, and race. Results We identified 5444 breast cancer survivors post-chemotherapy (median age 62 years (interquartile range [IQR]: 55, 71); median 4.7 years post-chemotherapy (IQR: 3.3, 7.6)) from 2017 to 2022. CIPN overall prevalence was 34% (95% confidence interval [CI]: 33%, 36%), 33% for non-taxane, and 37% for taxane-based chemotherapy. CIPN prevalence was 28% (95% CI: 26%, 30%) among exercisers and 38% (95% CI: 37%, 40%) among non-exercisers (difference 11%; 95% CI: 8%, 13%; p < 0.001). Compared to patients with low (20.25 MET-h/wk) levels of exercise reported CIPN. Exercise was associated with reduced prevalence of all CIPN symptoms regardless of chemotherapy type. Conclusion CIPN may persist several years following chemotherapy among patients with breast cancer but is significantly reduced by exercise in a dose-dependent manner.