On Pins and Needles


When it comes to acupuncture, most people fall into two groups — the avid fans and the absolutely-nots. But as Dr. Neri Cohen of Greater Baltimore Medical Center (GBMC) and Sarah O’Leary of Mend Acupuncture see it, the practice is more than just a nightmare for the needle-shy: It’s a potential replacement for some conventional medicines, particularly among cancer patients.

“I’ve been interested in complementary medicine for a while now,” Cohen says. “I’ve had acupuncture myself and I’ve referred patients to acupuncturists post-op. Ultimately, my goal is to demonstrate that it’s valuable for all patients as a form of symptom management.”

With this aim in mind, Cohen recently partnered with acupuncturist O’Leary and her company, Mend, to launch a clinical trial at GBMC that examines the role of acupuncture in symptom relief for those with head and neck cancer.

In the study, which is sponsored by The Center for Healthcare Innovation, Cohen and O’Leary plan to gather a group of 60 volunteers and cancer patients receiving active treatment at GBMC. Thirty will receive standard treatment for 12 weeks, while 30 will receive the same treatment over the same period with the addition of twice-weekly acupuncture treatments.

“Almost every cancer patient will undergo surgery, radiation, chemotherapy or all of the above in the course of their treatments,” O’Leary says. “Acupuncture is a tool to manage the symptoms of the treatments: Nausea, pain, dry mouth, anxiety, depression, fatigue — these are things we know acupuncture can help alleviate.”

The study focuses specifically on the effects of the treatment on pain, dry mouth, loss of taste and nausea, which are particularly common among patients with head and neck cancer. To measure how patients feel while undergoing treatment (with or without acupuncture), each participant will answer periodic quality- of-life surveys. Though this approach is subjective by nature, Cohen acknowledges, the comprehensive body-mind surveys were designed to account for individual variations and are not the sole source of data. (Participants’ medication consumption, overall health and other factors will be considered.)

Their anticipated results are unsurprising: Both Cohen and O’Leary expect that those who receive acupuncture along with standard care will experience more relief from symptoms. After all, this has been suggested in a number of independent studies. What sets this study apart is twofold: The trial examines acupuncture as a form of primary care, and it considers the cost benefits of integrating the practice into traditional courses of treatment.

“[Assuming the results pan out as expected], we’re asking how we can start to integrate it, if it’s possible that acupuncture actually belongs in mainstream hospital systems,” O’Leary says.

“We’re expecting to see that patients undergoing acupuncture will use less narcotics and have a better sense of self,” Cohen adds, referring to the increased well-being patients of the practice often experience. “Once we’ve finished data collection, we can go into each patient record and measure the cost of care, and how much acupuncture could help relieve those costs.”

If you’re thinking this all sounds too good to be true, though, you’re not alone; Cohen and O’Leary cite skepticism as one of the primary obstacles to the widespread integration of acupuncture.

“One of the things that can be most frustrating is that there’s no full understanding of the mechanisms behind how [acupuncture] works,” O’Leary says. “We know some things, like how it can lower blood pressure and even cortisol levels out, but our main understanding is just that it has a positive effect on the peripheral nervous system, which connects everything in our body.”

“I can’t explain how exactly it works,” Cohen agrees, “but just because we don’t understand why something does what it does doesn’t mean it doesn’t do it.”

In other words, he laughs, “a billion Chinese people can’t have been wrong for 8,000 years.”

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