“The placebo effects for both acupuncture and drugs are quite intriguing, as they both seem to persist over time,” Mao said. “The magnitude of the placebo effect for acupuncture is bigger than for the drug.”
The results with the sham acupuncture, which bested gabapentin, suggest that “there is more than a placebo effect with the sham acupuncture,” said Dr. Gary Deng, interim chief of the integrative medicine service at Memorial Sloan Kettering Cancer Center in New York City. “There is a component of behavior of doing a sham procedure, so it psychologically may trigger a different kind of reaction from patients versus taking the placebo pill.”
Deng pointed out that clinicians have come to realize that the placebo effect is very important in treatment. “In fact, in clinical practice, every doctor uses it all of the time,” he said. “The so-called bedside manner or communication with patients — all of these enhance the effect of the patients feeling they’re getting something.”
No one is quite sure why placebos work for some people and not for others, said Deng. “It’s like psychotherapy,” he added. “Why does it work for some people and not others?” He suggested that differences in anatomy and genetics might be possible explanations, but said “there is a fertile field for further research.”
Some patients might wonder if acupuncture that’s helpful for hot flashes among breast cancer patients might be helpful for the hot flashes associated with natural menopause. But Mao pointed out that hot flashes in breast cancer patients are more common, more severe and longer lasting than menopausal hot flashes.
However, Deng said that both might have similar causes related to lower estrogen levels. “Breast cancer survivors have hot flashes because of hormonal repression,” he said. Menopause also is linked to declining estrogen levels.
One big distinction between the two populations, though, is that breast cancer survivors do not have the option of hormone replacement therapy open to them because those hormones are linked to breast cancer. Some women undergoing natural menopause still might have that option available. For this reason, most studies of acupuncture for hot flashes have focused on breast cancer survivors, Deng explained.
But should a woman undergoing natural menopause try acupuncture for hot flashes?
“For patients suffering symptoms, they can look for all kinds of possible solutions and are better off talking to their doctor to find out what’s most appropriate for them,” Deng said.
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Surviving Hot Flashes…After Surviving Breast Cancer was originally published on blackdoctor.org
