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A new study found significant reductions in both dry mouth and pain and shoulder dysfunction after neck dissection in patients receiving acupuncture.
"Although further studies are needed, this does support the potential role of acupuncture," said study author Dr. David Pfister, chief of the head and neck medical oncology service at the Memorial Sloan-Kettering Cancer Center in New York City. He presented the findings Saturday at the American Society of Clinical Oncology annual meeting, in Chicago.
Neck dissection, or removal of the lymph nodes and surrounding tissue, is common in treating head and neck cancers. The dissection can be severe, involving removing of all the lymph nodes, the muscle involved in turning the head, a vein and a nerve which allows patients to lift their arms above their head.
"Side effects vary with the extent of the procedure," Pfister said. "Pain and shoulder dysfunction are common following a comprehensive neck resection. Although exercise and anti-inflammatory drugs are widely prescribed to address pain and dysfunction, efficacy is often disappointing or incomplete. Postoperative radiation is also frequently administered, leading to dry mouth, which further adds to the burden of symptoms."
In the study, 70 patients were randomized to receive weekly acupuncture sessions for four weeks or "usual care" (suggestions for physical therapy exercises and anti-inflammatory pain relievers).
Almost 40 percent of participants receiving acupuncture experienced improvements in both pain and mobility, compared with just 7 percent in the standard-care group.
There was also a notable decrease in dry mouth. "Five people in the acupuncture group had improvements as opposed to none in the usual-care arm," Pfister said.
The drug is usually prescribed to sleep-related disorders. "These are basically non-amphetamine-based stimulants. They don't have the same type of typical problems that amphetamines do," explained study author Dr. Gary Morrow, associate director for community research at the University of Rochester Cancer Center.
Fatigue is a leading complaint of cancer patients undergoing chemotherapy. Some nine out of 10 patients polled said they expected to experience this side effect, close to the percentage that actually do.
"The majority of patients expected fatigue and, unfortunately, they're right," Morrow said.
In this group of 631 patients, Provigil had a significant effect on excessive tiredness, and the effect was greater among patients who started out with more fatigue.
"The payoff was among patients who had severe fatigue," Morrow said. "It was numerically different but not statistically different for people who had mild or moderate fatigue. Modafinil appears useful to treat severe fatigue. If found again through pivotal studies submitted through proper regulatory authorities, it might take place in the armamentarium."
SOURCES: May 31, 2008, news conference with David Pfister, M.D., chief, head and neck medical oncology service, Memorial Sloan-Kettering Cancer Center, New York City, and Gary Morrow, Ph.D., associate director, community research, University of Rochester Cancer Center, New York; May 31, 2008, presentations, American Society of Clinical Oncology annual meeting, Chicago
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