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Acupuncture could be a viable option for reducing pain and dysfunction after neck dissection in head and neck cancer patients, new data suggest. The results of a randomized trial, presented here at the American Society of Clinical Oncology 44th Annual Meeting, that compared acupuncture to usual care after surgery, found that acupuncture was more effective in reducing chronic musculoskeletal pain, xerostomia, and dysfunction.

"Neck dissection is a common procedure for head and neck cancer, and the side effects vary with the specific procedure being performed," said senior author David Pfister, MD, chief of the Head and Neck Medical Oncology Service at Memorial Sloan-Kettering Cancer Center, in New York, New York. "Pain and shoulder dysfunction are common following comprehensive neck dissection, particularly when the procedure is unmodified."

This can significantly affect quality of life and, in certain occupations, employability. Some patients are eligible for nerve-sparing and other modified radical techniques that can preserve certain structures without compromising disease control. However, although postsurgical symptoms are decreased in such patients, they are not entirely eliminated.

"Although physical therapy, exercise, and anti-inflammatory drugs are widely prescribed following neck dissection, their benefit is often limited," he said. "There is room for improvement."

In addition, radiation is often administered as an adjuvant to surgery and can lead to xerostomia, which adds to the discomfort of the patient. Uncontrolled trials have suggested that acupuncture is beneficial in treating xerostomia and, in randomized studies, acupuncture has demonstrated benefits in the treatment of chronic musculoskeletal pain, including that of the neck and shoulder.

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"Significant reductions in pain, dysfunction, and xerostomia were observed in patients receiving acupuncture, [compared with] usual care, and acupuncture was well tolerated," said Dr. Pfister.

Dr. Pfister added that although further study is needed, this trial does support the potential benefit of acupuncture in this population.

"Like any other treatment, acupuncture does not work for everyone, but it can be extraordinarily helpful for many," coauthor Barrie Cassileth, PhD, chief of the Integrative Medicine Service at Memorial Sloan-Kettering Cancer Center, said in a statement. "It does not treat illness, but acupuncture can control a number of distressing symptoms, such as shortness of breath, anxiety, depression, chronic fatigue, pain, neuropathy, and osteoarthritis."

She added that cancer patients who are interested in this therapy should use acupuncturists who are certified by the National Certification Commission for Acupuncture and Oriental Medicine, and who are trained, or at least experienced, in working with the special symptoms and problems caused by cancer and cancer treatment."
The study was supported by the National Cancer Institute.