Alberta Cancer Foundation

Is Group Acupuncture More Effective Than Individual Acupuncture?

Dr. Jessa Landmann (left) and Dr. Linda Carlson (right) are investigating the benefits of group acupuncture in cancer patients. Photograph by Bryce Meyer.

 

The benefits of acupuncture for people suffering from chronic pain have been well-documented. Now, a research study co-funded by the Alberta Cancer Foundation wants to know if acupuncture performed in a group setting works as well as individual treatments for targeting cancer-related pain.

Acupuncture is an ancient form of traditional Chinese medicine that utilizes stimulation of acupuncture points to affect the physiology of the body, explains Dr. Jessa Landmann, a Calgary-based naturopathic doctor and co-investigator who is administering acupuncture treatments for the project.

According to Landmann, previous studies that analyzed patients’ blood before and after acupuncture treatments have demonstrated some of the benefits of acupuncture therapy.

“We know that acupuncture treatment can affect levels of certain neurotransmitters in the body, like serotonin and endorphin levels — things that are basically our own, innate pain-release mechanisms,” Landmann says.

What does that mean when it comes to cancer care?

“I think acupuncture is another one of those complementary therapies that has a growing evidence-base showing that it might help treat symptoms that patients have a real hard time with, and often there is no good treatment for,” says Dr. Linda Carlson, who is leading the group acupuncture study.

A professor in the Department of Oncology at the University of Calgary, and also the program director of the Integrative Oncology Program at the Tom Baker Cancer Centre, Carlson says that the strongest evidence for the use of acupuncture during cancer care is for treating pain, nausea, vomiting, fatigue and hot flashes.

For this study, which began in October 2017 at the Tom Baker Cancer Centre, participants undergo an initial assessment in which they are asked about their diagnosis, their pain and any contraindications (for example, low platelets). They are then put randomly into one of two treatment groups — individual or group acupuncture — and receive two treatments a week over six weeks, for a total of 12 treatments. All participants are asked about their pain both before and after each treatment (and at the beginning and end of the study), and patients must have a minimum level of pain (a 3/10 on a typical pain scale) to participate in the study.

While pain reduction is the primary focus, the study, which involves about 50 patients in total, will also assess stress level, fatigue, sleep and anxiety.

In the group setting, Landmann uses a larger room to offer treatments to two to six people at the same time. She inserts ultra-thin needles — 0.2 millimetres in diameter — into the first patient’s identified acupuncture points, then moves on to the next patient until everyone in the room is being treated. Landmann says side effects are minimal; patients might feel a tiny poke as each needle is inserted, and some patients may experience some bruising at the site. Needles are typically left in place for 20 to 25 minutes.

Karen Iversen is one of the study participants who was selected for group acupuncture. She says prior to enrolling in the study, she was suffering from neuropathy in her feet, as well as itching in her arms and across her back and neck, a result of the chemotherapy treatment she was receiving for stage 4 breast cancer. In addition to a lack of feeling in her feet, Iversen — an avid walker — was falling down often.

Today, she is back to walking five miles a day and credits acupuncture for helping with some of her symptoms.

“The study has been hugely beneficial to me,” Iversen says, pointing both to the pain relief the acupuncture has given her, and to the social side of the group experience. “The ladies in my group were a lot of fun, and we could joke. I feel it’s beneficial for the social aspect.”

Landmann believes the group acupuncture setting will reveal a variety of emotional and psychological benefits (beyond pain relief), due to common experiences of the patients involved.

“I have observed that patients are really able to share their stories in an environment where people truly understand and can empathize,” Landmann says. “The ability to speak freely among a group of non-judgmental and empathetic people can help with overall well-being. There is a lot of advice-giving, as well.”

Another benefit of group acupuncture is its price tag. As both Landmann and Carlson point out, acupuncture delivered in a group setting can be much more cost-effective for the patient. Individual acupuncture sessions at a private clinic can cost between $90 to $110 per session, while some group acupuncture sessions can cost a patient in the neighbourhood of $40 per session.

The study is projected to wrap up in May 2018, and results will be shared in conference presentations, peer-reviewed publications and via social media. Landmann is hopeful results will show that group acupuncture can help reduce pain in cancer patients, and that a permanent group acupuncture program will be established at the Tom Baker Cancer Centre in the future.

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