7/25/2019 acupuncture for cancer baraye 1.pptx
1/134
Acupunctu
e in canceDr Mehran Rezvani pain fellowship anesthesiologist
& acupuncturist
7/25/2019 acupuncture for cancer baraye 1.pptx
2/134
Acupuncture is dened as the application of stsuch as needling, moxibustion, cupping, and aon specic sites of the body nown as acupunc
Dr Mehran Rezvani pain fellowship anesthesiologist& acupuncturist
7/25/2019 acupuncture for cancer baraye 1.pptx
3/134
!n "hina, acupunctureis part of a#"M system traditionalmedical nowledge and is practiced along withtreatment modalities such as $
%erbal medicine
#ui na massage and acupressure'
Mind(body exercise e)g),*igong and tai chi'
Dietary therapy
Dr Mehran Rezvani pain fellowship anesthesiologist& acupuncturist
7/25/2019 acupuncture for cancer baraye 1.pptx
4/134
Acupuncture has been practiced in"hina and other Asian countries fomore than +, years
Dr Mehran Rezvani pain fellowship anesthesiologist& acupuncturist
7/25/2019 acupuncture for cancer baraye 1.pptx
5/134
#he relatively brief history of acupuncture in th.tatescan be traced bac about / years, when Dr) 1achepublished a report in the 2orth American Medi
.urgical3ournal on his use of acupuncture to treat lowe
Dr Mehran Rezvani pain fellowship anesthesiologist& acupuncturist
7/25/2019 acupuncture for cancer baraye 1.pptx
6/134
#he -).) 0ood and Drug Administration approthe acupuncture needle as a medical device i
Dr Mehran Rezvani pain fellowship anesthesiologist& acupuncturist
7/25/2019 acupuncture for cancer baraye 1.pptx
7/134
#he human body must be perceived and treatewhole andas part of nature7health is the result of harmobodily functions and between the body and nadisease occurs
when this harmony is disrupted
Dr Mehran Rezvani pain fellowship anesthesiologist& acupuncturist
7/25/2019 acupuncture for cancer baraye 1.pptx
8/134
Acupuncture is closely associated with "hinetheory
According to this theory, there are 4/ primarorchannels, and 8 additional meridians, each foparticular directional course along the body
Dr Mehran Rezvani pain fellowship anesthesiologist& acupuncturist
7/25/2019 acupuncture for cancer baraye 1.pptx
9/134
Dr Mehran Rezvani pain fellowship anesthesiologist& acupuncturist
7/25/2019 acupuncture for cancer baraye 1.pptx
10/134
A vital energy nown as *i 9ows through these and participates in the homeostatic regulation bodilyfunctions)
Along the meridians are approximately :6 poi
serveas both pathognomonic signs of disorder and aacupuncture treatments
Dr Mehran Rezvani pain fellowship anesthesiologist& acupuncturist
7/25/2019 acupuncture for cancer baraye 1.pptx
11/134
Dr Mehran Rezvani pain fellowship anesthesiologist& acupuncturist
7/25/2019 acupuncture for cancer baraye 1.pptx
12/134
;hen the normal 9ow of energy over a meridiaobstructede)g), as a result of tissue in
7/25/2019 acupuncture for cancer baraye 1.pptx
13/134
Dr Mehran Rezvani pain fellowship anesthesiologist& acupuncturist
7/25/2019 acupuncture for cancer baraye 1.pptx
14/134
AcupunctureMechanisms
Dr Mehran Rezvani pain fellowship anesthesiologist& acupuncturist
7/25/2019 acupuncture for cancer baraye 1.pptx
15/134
Acupuncture Mechanisms
Activate the hypothalamusand the pituitary gla
1alance the sympathetic and parasympathetic s
Anti=in9ammatorye>ects
?ndogenous opioidsystem
1oost animal immune function by enhancing 2@and lymphocyte activity
Dr Mehran Rezvani pain fellowship anesthesiologist& acupuncturist
7/25/2019 acupuncture for cancer baraye 1.pptx
16/134
aboratory and animal studies to explore themechanisms of acupuncture for cancer treatmfocused mainly on therole of acupuncture in the activation of immunfunctions, such
as increasing blood cell count and enhancingandnatural iller cell activity
Dr Mehran Rezvani pain fellowship anesthesiologist& acupuncturist
7/25/2019 acupuncture for cancer baraye 1.pptx
17/134
Acupuncture indications in ca
Manage cancer=related symptoms
#reat side e>ects induced by chemotherapy therapy
1oost blood cell count
?nhance lymphocyte and natural iller 2@'
Dr Mehran Rezvani pain fellowship anesthesiologist& acupuncturist
7/25/2019 acupuncture for cancer baraye 1.pptx
18/134
Brimary use is symptommanagement
"ancer pain
"hemotherapy=induced nausea and vomiting
Dr Mehran Rezvani pain fellowship anesthesiologist& acupuncturist
7/25/2019 acupuncture for cancer baraye 1.pptx
19/134
#he positive results of the studies on chemotheinduced 2(C, which benet from scientically soresearch designs, are the most convincing
Dr Mehran Rezvani pain fellowship anesthesiologist& acupuncturist
7/25/2019 acupuncture for cancer baraye 1.pptx
20/134
ther indications
;eight lossAnxiety
Depression
!nsomnia
Boor appetite
Eerostomia
%ot 9ashes
Beripheral neuropathy
Fastrointestinal symptoms constipation and diarr
Dr Mehran Rezvani pain fellowship anesthesiologist& acupuncturist
7/25/2019 acupuncture for cancer baraye 1.pptx
21/134
Dr Mehran Rezvani pain fellowship anesthesiologist& acupuncturist
7/25/2019 acupuncture for cancer baraye 1.pptx
22/134
Laboratory &Animal
Preclinical Studie
Dr Mehran Rezvani pain fellowship anesthesiologist& acupuncturist
7/25/2019 acupuncture for cancer baraye 1.pptx
23/134
At least seven animal studiesinvestigating the e>ects of acupunin cancer or cancer=related condithave been reported in the scient
literature
Dr Mehran Rezvani pain fellowship anesthesiologist& acupuncturist
7/25/2019 acupuncture for cancer baraye 1.pptx
24/134
0our ex vivo studies suggested thacupuncture is useful in anticancer th
either by actively stimulating immuactivity or by preventing chemother
suppression of immune activity
Dr Mehran Rezvani pain fellowship anesthesiologist& acupuncturist
7/25/2019 acupuncture for cancer baraye 1.pptx
25/134
!n a study involving normalrats,electroacupu
applied at the point#su=.anli .t:6' for / hours dconsecutive days enhanced the cytotoxicity of natural iller 2@' cells compared with a stimula
non acupuncture control point in the
abdominal muscle
Sato T, Yu Y, Guo SY, et al.: Acupuncture stimulation enhances splenic natural killer cein rats. Jpn J Physiol 46 !": #$#%6, #&&6'
Dr Mehran Rezvani pain fellowship anesthesiologist& acupuncturist
7/25/2019 acupuncture for cancer baraye 1.pptx
26/134
Another study found that 2@ cell activity and #=lymphocyte transformation rate were increased inmouse model of transplanted mammary cancercompared with a control after eight sessions ofacupuncture and moxibustion
(iu (J, Guo )J, Jiao *+: -ect o/ acupuncture on immunolo0ic /unction an1 histopathtransplante1 mammary cancer in mice2 3hon00uo 3hon0 *i Yi Jie e 3a 3hi #5 #": 6
Dr Mehran Rezvani pain fellowship anesthesiologist& acupuncturist
7/25/2019 acupuncture for cancer baraye 1.pptx
27/134
A study using moxibustionto warm the acupunctpoint Fuanyuan "C+'once a day for 4 days fousignicantly increased production of erythrocytescompared with a nontreatment control
8u P, )ao Y, 8u J: -ects o/ moxa%cone moxi9ustion at Guanyuan on erythrocytic imre0ulatie /unction in tumor%9earin0 mice. J Tra1it )hin +e1 !# #": 6;%7#, !#'
Dr Mehran Rezvani pain fellowship anesthesiologist& acupuncturist
7/25/2019 acupuncture for cancer baraye 1.pptx
28/134
Repeated ?A treatments 4/ treatments administover : days' in
B" ratssignicantly lowered the concentrationsin the ovaries, compared with untreated B" rats
G.tener=Cictorin ?, undeberg #, ;aldenstrHm -, et al)$ ?>ects of electro=acupuncture on nerve gr
factor and ovarian morphology in rats with experimentally induced polycystic ovaries) 1iol ReprodI:, /K
Dr Mehran Rezvani pain fellowship anesthesiologist& acupuncturist
7/25/2019 acupuncture for cancer baraye 1.pptx
29/134
A study of cyclophosphamide =induced emesis in behavioral model used acupuncture as an adects ofchemotherapy signicantly reducedthe total numemetic episodes by L :6=J:
Gao , hang F, ;ong R%, et al)$ #he e>ect of electroacupuncture as an ad
7/25/2019 acupuncture for cancer baraye 1.pptx
30/134
#he ndings of these studies suggest tacupuncture may be e>ective in treaticancer=related symptoms and cancertreatmentNrelated disorders and that
acupuncture may be able to activateimmune functions and regulate theautonomic nervous system
Dr Mehran Rezvani pain fellowship anesthesiologist& acupuncturist
7/25/2019 acupuncture for cancer baraye 1.pptx
31/134
nly one studyreported a decrease in tumor voluanimals treated with acupuncture compared with animals imited scientic value'
Giu 3, Fuo "3, 3iao EM$ O?>ect of acupuncture on immunologic function andhistopathology of transplanted mammary cancer in miceP hongguo hong Ehi 4I 4'$ 64I=J, 455IK
Dr Mehran Rezvani pain fellowship anesthesiologist
& acupuncturist
7/25/2019 acupuncture for cancer baraye 1.pptx
32/134
Dr Mehran Rezvani pain fellowship anesthesiologist
& acupuncturist
7/25/2019 acupuncture for cancer baraye 1.pptx
33/134
%uman("linical.tudies
Dr Mehran Rezvani pain fellowship anesthesiologist
& acupuncturist
7/25/2019 acupuncture for cancer baraye 1.pptx
34/134
?>ect of Acupuncture !mmune 0unction
Dr Mehran Rezvani pain fellowship anesthesiologist
& acupuncturist
7/25/2019 acupuncture for cancer baraye 1.pptx
35/134
At least seven human studies have evaluated theof acupuncture on immune system function in patall in china'
0our randomized controlled trials
ne nonrandomized clinical study
#wo case series
Acupunctureenhanced orregulatedimmunefunction
Dr Mehran Rezvani pain fellowship anesthesiologist
& acupuncturist
7/25/2019 acupuncture for cancer baraye 1.pptx
36/134
#he rst randomized controlled immune
Acupuncture treatment enhanced platecount and prevented leuocyte decreaafter radiation therapy or chemotherap
Eia Q, hang D, Qang "E, et al)$ An approach to the e>ectumors of acupuncture in combination with radiotherapy ochemotherapy) 3 #radit "hin Med 6 4'$ /:=6, 4586
Dr Mehran Rezvani pain fellowship anesthesiologist
& acupuncturist
7/25/2019 acupuncture for cancer baraye 1.pptx
37/134
.econd studyimmune
euocyte phagocytosis was enhancedin the
treated group, compared with the baseline measuB S )4'
hou RE, %uang 0, 3iang .R, et al)$ #he e>ect of acupuncture on the
activity of human leuocytes) 3 #radit "hin Med 8 /'$ 8:=+, 4588)
Dr Mehran Rezvani pain fellowship anesthesiologist
& acupuncturist
7/25/2019 acupuncture for cancer baraye 1.pptx
38/134
#hird studyimmune
#he data showed that !=/ level and2@ cell activisignicantly increasedin the acupuncture group,compared with the control group B S )4'
G;u 1, hou RE, hou M.$ O?>ect of acupuncture on interleuin=/ level and 2@ cell immof peripheral blood of malignant tumor patientsP hongguo hong Ei Qi 3ie %e a hi 4+455+K
Dr Mehran Rezvani pain fellowship anesthesiologist
& acupuncturist
7/25/2019 acupuncture for cancer baraye 1.pptx
39/134
0ourth studyimmune
#he data showed that acupuncture treatment increaproportion of the "D:T and "D+T #=lymphocyte subthe "D+T("D8T ratio B S )4', and the level of bet
#he investigators suggested that the anticancer e>eacupuncture may be mediated via the mechanism oimmunomodulation
G;u 1, hou RE, hou M.$ O?>ect of acupuncture on immunomodulation in patients withmalignant tumorsP hongguo hong Ei Qi 3ie %e a hi 46 :'$ 4:5=+4, 4556K
Dr Mehran Rezvani pain fellowship anesthesiologist
& acupuncturist
7/25/2019 acupuncture for cancer baraye 1.pptx
40/134
0ifth studyimmune
?lectroacupuncturein patients undergoing chemoexperienced no declines in # cells "D:T, "D+T, or in 2@ cell activity, both of which are usuallysuppressed by chemotherapy
GQe 0, "hen ., iu ;$ ?>ects of electro=acupuncture on immune function after chemothcases)3 #radit "hin Med // 4'$ /4=:, //K
Dr Mehran Rezvani pain fellowship anesthesiologist
& acupuncturist
7/25/2019 acupuncture for cancer baraye 1.pptx
41/134
.ixth studyimmune
+8 patients with leuopeniaUincluding two cancepatientsUwho were treated with manual acupuncexperienced improvements in leuocyte count, animmunoglobulin!gF, !gA, and !gM' levels after 4+acupuncture treatments, compared with theirpretreatment levels
G;ei $ "linical observation on therapeutic e>ect of acupuncture at zusanli foleuopenia)
3 #radit "hin Med 48 /'$ 5+=I, 4558KDr Mehran Rezvani pain fellowship anesthesiologist& acupuncturist
7/25/2019 acupuncture for cancer baraye 1.pptx
42/134
Dr Mehran Rezvani pain fellowship anesthesiologist
& acupuncturist
7/25/2019 acupuncture for cancer baraye 1.pptx
43/134
?>ect of Acupunctuon "ancer Bain
Dr Mehran Rezvani pain fellowship anesthesiologist
& acupuncturist
0i t t d
7/25/2019 acupuncture for cancer baraye 1.pptx
44/134
0irst studypain
Randomized trial compared two type acupuncturea
conventional analgesic treatment in patients with gacancer pain
#here was e*uivalent analgesic e>ect among the thgroups observed after / months of treatment7 howeconventionally treated group experienced signicansuperior analgesia in rst 4 days of treatment
GDang ;, Qang 3$ "linical study on acupuncture treatment of stomach carcinoma pain) 3 #ra
Med 48 4'$ :4=8, 4558K
Dr Mehran Rezvani pain fellowship anesthesiologist
& acupuncturist
. d t d
7/25/2019 acupuncture for cancer baraye 1.pptx
45/134
.econd studypain
!n study evaluated the e>ect of auricular acupunctu
cancer patients who were still experiencing pain aftetreatment with analgesics ;hile patients continued tanalgesic medication, auricular acupuncture needlesembedded in ear acupuncture points)
pain intensity decreased or remained stable after au
acupuncture in all patients, with a signicant averagintensity decrease of :: mm B S )4'
GAlimi D, Rubino ", eandri ?B, et al)$ Analgesic e>ects of auricular acupuncture for cancer pain) 3 Bain .45 /'$ 84=/, /K Dr Mehran Rezvani pain fellowship anesthesiologist
& acupuncturist
#hi d t d
7/25/2019 acupuncture for cancer baraye 1.pptx
46/134
#hird studyPain
!n a case series involving 48: cancer patients whotreated with acupuncturefor cancer=related pain, were signicantly helped B value not stated
G0ilshie 3, Redman D$ Acupuncture and malignant pain problems) ?ur 3 .urg ncol 44 +458IK
Dr Mehran Rezvani pain fellowship anesthesiologist
& acupuncturist
0orth stud
7/25/2019 acupuncture for cancer baraye 1.pptx
47/134
0orth studypain
case series, /5 patients with malignant tumors wdeveloped pain received ?A treatment ) All experivarious degrees of pain relief, and /I out of /5 weto either reduce or eliminate their
analgesic re*uirements following multiple ?A trea
G;en %$ "ancer pain treated with acupuncture and electrical stimulation) Mod Med As6, 45JJK
Dr Mehran Rezvani pain fellowship anesthesiologist
& acupuncturist
Most of these studies were positive but the ndin
7/25/2019 acupuncture for cancer baraye 1.pptx
48/134
Most of these studies were positive but the ndinlimited signicance because of methodologic weasuch as $
.mall sample sizes
An absence of patient blinding to treatment in mcases
Carying acupuncture treatment regimens
A lac of standard outcome measurements
Absence of ade*uate randomization
Dr Mehran Rezvani pain fellowship anesthesiologist
& acupuncturist
7/25/2019 acupuncture for cancer baraye 1.pptx
49/134
Dr Mehran Rezvani pain fellowship anesthesiologist
& acupuncturist
7/25/2019 acupuncture for cancer baraye 1.pptx
50/134
?>ect of Acupuncture on"ancer#reatmentNrelated.ide ?>ects
Dr Mehran Rezvani pain fellowship anesthesiologist
& acupuncturist
B i d 4
7/25/2019 acupuncture for cancer baraye 1.pptx
51/134
Bain due to cancer treatment =4
A R"# evaluated the e>ect of various combinations of
acupuncture, "hinese herbs, and epidural morphine to
postoperative pain in 46 patients with liver cancer
All of the combination treatment groups experienced banalgesia than did the placebo=treated control group
Gi ., "ao .%, Eie FM, et al)$ "ombined traditional "hinese medicine and ;estern medicine) Relieving e>eherbs, ear=acupuncture and epidural morphine on postoperative pain in liver cancer "hin Med 3 ?ngl' 4J
Dr Mehran Rezvani pain fellowship anesthesiologist
& acupuncturist
B i d t t t t /
7/25/2019 acupuncture for cancer baraye 1.pptx
52/134
Bain due to cancer treatment =/#he e>ect of acupuncture in postoperative painmanagement and arm movement in breast cancer pafter surgical excision of the cancer and axillary lym
#he acupuncture group had signicant pain relief dumovementon the fth and seventh days following sand at the time of discharge) #he range of arm motiincreased signicantly in the treatment group, B S
G%e 3B, 0riedrich M, ?rtan A@, et al)$ Bain=relief and movement improvement by acupuncture after ablatlymphadenectomy in patients with mammary cancer) "lin ?xp bstet Fynecol /6 /'$ 84=+, 4555K
Dr Mehran Rezvani pain fellowship anesthesiologist
& acupuncturist
B i d t t t t :
7/25/2019 acupuncture for cancer baraye 1.pptx
53/134
Bain due to cancer treatment =:
A small retrospective case review of acupuncture
chemotherapy=induced peripheral neuropathy in patients showed benetwith reduced symptoms
GDonald F@, #obin !, .tringer 3$ ?valuation of acupuncture in the management of chemotherapyindneuropathy) Acupunct Med /5 :'$ /:=:, /44K
Dr Mehran Rezvani pain fellowship anesthesiologist
& acupuncturist
Arthralgias and myalgias from
7/25/2019 acupuncture for cancer baraye 1.pptx
54/134
Arthralgiasand myalgiasfromaromatase inhibitors#rue acupuncture was signicantly more e>ective than
acupuncture, as measured by 1rief Bain !nventory=.hoscores in relieving
7/25/2019 acupuncture for cancer baraye 1.pptx
55/134
"hemotherapy induced nausea andvomiting
#he positive e>ect of acupuncture on chemothera
induced nausea and vomiting 2(C' is the mostconvincing, as demonstrated by the consistency oresults of a variety of clinical study types
Dr Mehran Rezvani pain fellowship anesthesiologist
& acupuncturist
"hemotherapy=induced nausea
7/25/2019 acupuncture for cancer baraye 1.pptx
56/134
"hemotherapy induced nausea vomitingA systematic review of the e>ect of acupuncture o
describes ve clinical trials of chemotherapy=indu2(C, conducted by di>erent investigators on di>ergroups of patients and using di>erent forms ofacupuncture point stimulation
All ve trials yielded positive results
GCicers A3$ "an acupuncture have specic e>ects on healthV A systematic review of ac
antiemesis trials) 3 R .oc Med 85 6'$ ::=44, 4556)K
Dr Mehran Rezvani pain fellowship anesthesiologist
& acupuncturist
Radiation=induced nausea and
7/25/2019 acupuncture for cancer baraye 1.pptx
57/134
ad a o duced ausea a dvomiting!n one randomized study, patients who were rand
assigned to acupuncture experienced fewer episonausea and vomiting than did those who receivedstandard care
G?nblom A, eander M, %ammar M, et al)$ Fetting the grip on nonspecic treatment ein patients randomized to acupuncture or sham compared to patients receiving standane 6 :'$ e4+J66, /44)K
Dr Mehran Rezvani pain fellowship anesthesiologist
& acupuncturist
Casomotor symptoms
7/25/2019 acupuncture for cancer baraye 1.pptx
58/134
Casomotor symptoms
.ome studies have reported that acupuncture ma
e>ectivein reducing vasomotor symptoms amongpostmenopausal women with breast cancer andpcancer patients on androgen=deprivation therapy
Dr Mehran Rezvani pain fellowship anesthesiologist& acupuncturist
Casomotor symptoms 4
7/25/2019 acupuncture for cancer baraye 1.pptx
59/134
Casomotor symptoms =4
!n women with hormone receptorNpositive breast
Acupuncture wasective as venlafaxinecaused fewer adverse e>ects
G;aler ?M, Rodriguez A!, @ohn 1, et al)$ Acupuncture versus venlafaxine for the manavasomotor symptoms in patients with hormone receptor=positive breast cancer$ a randcontrolled trial) 3 "lin ncol /8 +'$ 6:+=+, /4)K
Dr Mehran Rezvani pain fellowship anesthesiologist& acupuncturist
Casomotor symptoms /
7/25/2019 acupuncture for cancer baraye 1.pptx
60/134
Casomotor symptoms =/
An uncontrolled prospective case series of I wom
tamoxifen for early breast cancer evaluated womeacupuncturevasomotor symptoms dropped by +5S )4'
Gde Calois 1A, Qoung #?, Robinson 2, et al)$ -sing traditional acupuncture for breast cahot 9ashes and night sweats) 3 Altern "omplement Med 46 4'$ 4+J=IJ, /4)K
Dr Mehran Rezvani pain fellowship anesthesiologist& acupuncturist
Casomotor symptoms :
7/25/2019 acupuncture for cancer baraye 1.pptx
61/134
Casomotor symptoms =:
!n retrospective evaluation of 45+ patients with
predominantly breast or prostate cancer found longrelief of vasomotor symptoms associated with acup
G0ilshie 3, 1olton #, 1rowne D, et al)$ Acupuncture and self acupuncture for long=term treatmvasomotor symptoms
in cancer patients==audit and treatment algorithm) Acupunct Med /: +'$ 4J4=8, /I)K
Dr Mehran Rezvani pain fellowship anesthesiologist& acupuncturist
0atigue
7/25/2019 acupuncture for cancer baraye 1.pptx
62/134
0atigue
!n a R"#, +J cancer patients with moderate to sev
fatigue were randomly assigned to one of three g
#he study concluded that acupuncture was a more>ective method than acupressure or sham acup
GMolassiotis A, .ylt B, Diggins %$ #he management of cancer=related fatigue after chemacupuncture and acupressure$ a randomised controlled trial) "omplement #her Med 4I:J,/J)K
Dr Mehran Rezvani pain fellowship anesthesiologist& acupuncturist
7/25/2019 acupuncture for cancer baraye 1.pptx
63/134
!n next study, :/ breast cancer patients were ra
assigned to a 6=wee course of either daily Acupusignicantly reduced fatigue and improved *ualityover that of the Wenhanced usual careW group
GMolassiotis A, 1ardy 3, 0innegan=3ohn 3, et al)$ Acupuncture for cancer=related fatigue inbreast cancer$ a pragmatic randomized controlled trial) 3 "lin ncol : :6'$ ++J=6, /
Dr Mehran Rezvani pain fellowship anesthesiologist& acupuncturist
Eerostomia
7/25/2019 acupuncture for cancer baraye 1.pptx
64/134
Eerostomia
Acupuncture was associated with a decrease in th
of symptoms and an increased saliva 9ow in tworandomized studies that compared acupuncture wstandard care for preventing xerostomia in patien
undergoing radiation therapy
1raga 0B, emos 3unior "A, Alves 0A, et al)$ Acupuncture for the prevention of radiationxerostomia in patients with head and nec cancer) 1raz ral Res /I /'$ 48=I, /44 Ma
Meng , Farcia M@, %u ", et al)$ Randomized controlled trial of acupuncture for prevenradiation=induced xerostomia among patients with nasopharyngeal carcinoma) "ancer :::J=++, /4/)
Dr Mehran Rezvani pain fellowship anesthesiologist& acupuncturist
Eerostomia
7/25/2019 acupuncture for cancer baraye 1.pptx
65/134
Eerostomia
"ompared with standard care, acupuncture signican
improved xerostomia symptomsin patients who expethe condition following radiation therapy
.imcoc R, 0alloweld , Monson @, et al)$ AR!E$ a randomised trial of acupuncture v oral care
patients with chronic xerostomia following treatment of head and nec cancer) Ann ncol /+
/4:)
Bster DF, "assileth 1R, Deng F?, et al)$ Acupuncture for pain and dysfunction after nec dissof a
randomized controlled trial) 3 "lin ncol /8 4I'$ /I6I=J, /4)
Dr Mehran Rezvani pain fellowship anesthesiologist& acupuncturist
7/25/2019 acupuncture for cancer baraye 1.pptx
66/134
Dr Mehran Rezvani pain fellowship anesthesiologist& acupuncturist
7/25/2019 acupuncture for cancer baraye 1.pptx
67/134
ther #reatment=rela.ide ?>ects
Dr Mehran Rezvani pain fellowship anesthesiologist& acupuncturist
!n a R"# J6 patients with various types of cancer, iesophageal cancer,gastric cancer, lung cancer
7/25/2019 acupuncture for cancer baraye 1.pptx
68/134
esophageal cancer,gastric cancer, lung cancer
#he acupuncture group in combination with radiattherapy or chemotherapy, had the below benets $
signicantly more body weight B S )4'
Freater improvements in the symptoms of cough,thoracodynia, hemoptysis, and fever for patients wcancer and the symptoms of chest pain, mucus vomand diXculty in swallowingfor patients with esoph
su>ered
Eia Q, hang D, Qang "E, et al)$ An approach to the e>ect on tumors of acupuncture in cwith radiotherapy or chemotherapy) 3 #radit "hin Med 6 4'$ /:=6, 4586)
Dr Mehran Rezvani pain fellowship anesthesiologist& acupuncturist
7/25/2019 acupuncture for cancer baraye 1.pptx
69/134
An R"# of 4:8 patients treated with acupuncture p
massage versus usual care showed decreased painI' and a decrease in
depressive mood B Y ):' in postoperative cancepatients
Mehling ;?, 3acobs 1, Acree M, et al)$ .ymptom management with massage aacupuncture in postoperative cancer patients$ a randomized controlled trial) 3 .ymptom Manage :: :'$ /I8=66, /J)
Dr Mehran Rezvani pain fellowship anesthesiologist& acupuncturist
A retrospective survey study $ Batients were refeacupuncture clinics for $
7/25/2019 acupuncture for cancer baraye 1.pptx
70/134
acupuncture clinics for $
Bain I:L',
Eerostomia :/L'
%ot 9ashes 6L'
2ausea(loss of appetite 6L'
G3ohnstone BA, Bolston FR, 2iemtzow R", et al)$ !ntegration of acupuncture in
oncology clinic) Balliat Med 46 :'$ /:I=5, //)K
.ixty percent of thepatients showed atleast :L improvem
their symptoms, andone=third had no chathe severity of symp
Dr Mehran Rezvani pain fellowship anesthesiologist& acupuncturist
7/25/2019 acupuncture for cancer baraye 1.pptx
71/134
Dr Mehran Rezvani pain fellowship anesthesiologist& acupuncturist
7/25/2019 acupuncture for cancer baraye 1.pptx
72/134
"MM2 B!2#.
Dr Mehran Rezvani pain fellowship anesthesiologist& acupuncturist
2ausea and vomiting
7/25/2019 acupuncture for cancer baraye 1.pptx
73/134
2ausea and vomiting
.#=:6 usanli
1=/4 ;eishu
1=/ Bishu
B"=6 2eiguan
"C 4/ hongwan
Dr Mehran Rezvani pain fellowship anesthesiologist& acupuncturist
2ausea and vomiting
7/25/2019 acupuncture for cancer baraye 1.pptx
74/134
2ausea and vomiting
Main point$ .#=:6 usanli bilateral'
Auxiliary ear points $ .henmen, Apex of ower
#ragus, 1rain, Middle ?ar, and .tomach
Dr Mehran Rezvani pain fellowship anesthesiologist& acupuncturist
Anorexia
7/25/2019 acupuncture for cancer baraye 1.pptx
75/134
.#=:6 usanli
1=/4 ;eishu
1=/ Bishu
B"=6 2eiguan
"C 4/ hongwan
.B=5 Qinling*uan
"C=6 ihai
Dr Mehran Rezvani pain fellowship anesthesiologist& acupuncturist
Dry mouth and tongue and mouulcers
7/25/2019 acupuncture for cancer baraye 1.pptx
76/134
ulcerso-=4 Qu
7/25/2019 acupuncture for cancer baraye 1.pptx
77/134
y.B=6 .anyin
7/25/2019 acupuncture for cancer baraye 1.pptx
78/134
p"C 4/ hongwan
.#=:6 usanli
.#=/I #ianshu.# :J .hang
7/25/2019 acupuncture for cancer baraye 1.pptx
79/134
g1=48 Fanshu
1=45 Danshu
1=/ Bishu
1=/4 ;eishu
@4=: #aixi
R=: #aichong
R=4+ imen
R=/ ingiian
B"=6 2eiguan
.B=6 .anyin
7/25/2019 acupuncture for cancer baraye 1.pptx
80/134
FC / 1aihui
1=/: .henshu .#=:6 usanli
.B=6 .anyin
7/25/2019 acupuncture for cancer baraye 1.pptx
81/134
?nrich Qin and clear %eat, *uiet the %eart and .pirit)
FC=4+ Dazhui.!=: %ouxi
%# =6 Qinxi
@!=: #aixi
.B=6 .anyin
7/25/2019 acupuncture for cancer baraye 1.pptx
82/134
1=4: 0eishu
1=+: Faohuang .#=:6 usanli
"C=+ Fuanyuan
1=/ Bishu
-=5 #aiyuan
Dr Mehran Rezvani pain fellowship anesthesiologist& acupuncturist
%emoptysis
7/25/2019 acupuncture for cancer baraye 1.pptx
83/134
1=4: 0eishu
-=4 hongfu
FC 4+ Dazhui
-=6 @ongzui
-=I "hize
!=+ %egu
Dr Mehran Rezvani pain fellowship anesthesiologist& acupuncturist
%?MA#-R!A
7/25/2019 acupuncture for cancer baraye 1.pptx
84/134
1=/8 Bangguangshu
"C =: hong
7/25/2019 acupuncture for cancer baraye 1.pptx
85/134
FC 4+ Dazhui
1=4: 0eishu -=4 hongfu
"C 4J Danzhong
B"=6 2eiguan
-=I "hize .B=5 Qinling*uan
1=/ Bishu
Dr Mehran Rezvani pain fellowship anesthesiologist& acupuncturist
Ascites
7/25/2019 acupuncture for cancer baraye 1.pptx
86/134
.# /I #ianshu
"C=6 ihai "C 4/
hongwan
.#=:6 usanli
.B=5 Qinling*uan
"C=:hong
7/25/2019 acupuncture for cancer baraye 1.pptx
87/134
.B=6 .anyin
7/25/2019 acupuncture for cancer baraye 1.pptx
88/134
.B=6 .anyin
7/25/2019 acupuncture for cancer baraye 1.pptx
89/134
%?A# "2.#!BA#!2
1=/I Dachangshu .#=/I #ianshu
#1=6higou
.# :J .hang
7/25/2019 acupuncture for cancer baraye 1.pptx
90/134
"2.#!BA#!2 D-? # ! .#AF2A#!2
1=/I Dachangshu.#=/I #ianshu
#1=6 higou
.# + 0englong
.# /5 Fuilai
R=:#aichong
"C 4/ hongwan
1=// .an
7/25/2019 acupuncture for cancer baraye 1.pptx
91/134
! D?0!"!?2"Q
1=/I Dachangshu.#=/I #ianshu
.#=:6 usanli
"C =+ Fuanyuwan
.#=:J .hang
7/25/2019 acupuncture for cancer baraye 1.pptx
92/134
1D D?0!"!?2"Q
.# /I #ianshu.# :6 usanli
1=/ Bishu
.# + 0englong
.B=: #aibai
1=4J Feshu
.B=6 .anyin
7/25/2019 acupuncture for cancer baraye 1.pptx
93/134
"D "2.#!BA#!2
1=/I Dachangshu.#=/I #ianshu
#1=6 higou
.#=+ 0englong
"C=8 .hen*ue
"C=6 ihai
FC + MingmenDr Mehran Rezvani pain fellowship anesthesiologist
& acupuncturist
7/25/2019 acupuncture for cancer baraye 1.pptx
94/134
BainDr Mehran Rezvani pain fellowship anesthesiologist
& acupuncturist
7/25/2019 acupuncture for cancer baraye 1.pptx
95/134
%?ADA"%?
Dr Mehran Rezvani pain fellowship anesthesiologist& acupuncturist
%?ADA"%?
7/25/2019 acupuncture for cancer baraye 1.pptx
96/134
;!2D="D 1.#R-"#!2
F1=/ 0engchi ?E=%2=I #aiyang
FC 4+Dazhui
!=+ %egu
#1=I ;aiguan
Dr Mehran Rezvani pain fellowship anesthesiologist& acupuncturist
%?ADA"%?
7/25/2019 acupuncture for cancer baraye 1.pptx
97/134
D?0!"!?2"Q 0!R? BA##?R2
F1=/ 0engchi ?E=%2=I #aiyang
FC 4+ Dazhui
!=+ %egu
!=44 uchi R=: #aichong
Dr Mehran Rezvani pain fellowship anesthesiologist& acupuncturist
%?ADA"%?
7/25/2019 acupuncture for cancer baraye 1.pptx
98/134
B%?FM #-R1!D!#Q
F1=/ 0engchi ?E=%2=I #aiyang
.#=+ 0englong
?E=%2=: Qintang
-=J ie*ue .B=+ Fongsun
Dr Mehran Rezvani pain fellowship anesthesiologist& acupuncturist
%?ADA"%?
7/25/2019 acupuncture for cancer baraye 1.pptx
99/134
1D .#A.!.
F1=/ 0engchi ?E=%2=I #aivang
!=+ %egu
FC=/ 1aihui
.B=4 Euehai R=: #aichong
.B=6 .anyin
7/25/2019 acupuncture for cancer baraye 1.pptx
100/134
! A2D 1D D?0!"!?2"Q
FC /: .hangxing.B=4 Euehai
.B=6.anyin
7/25/2019 acupuncture for cancer baraye 1.pptx
101/134
"ommonly used acupuncture points
frontal headache$ F1=4+ Qangbai and !=+ %egu
migraine$ #1=/ 3iaosun, F1=/ 0engchi and #1=I;aiguan
occipital headache $ F1=/ 0engchi and 1=6 @u
headache at the vertex$ FC / 1aihui and R=: #
Dr Mehran Rezvani pain fellowship anesthesiologist& acupuncturist
7/25/2019 acupuncture for cancer baraye 1.pptx
102/134
"%?.# BA!2
Dr Mehran Rezvani pain fellowship anesthesiologist& acupuncturist
"%?.# BA!2
7/25/2019 acupuncture for cancer baraye 1.pptx
103/134
B%?FM=%?A# "2F?.#!2F #%? -2F.
"C=4J Danzhong !=44 uchi
B"=I 3ianshi
!=+ %egu
.#=+ 0englong .B=6 .anyin
7/25/2019 acupuncture for cancer baraye 1.pptx
104/134
A""-M-A#!2 A2D 1.#R-"#!2 0 B%?FM
#-R1!D!#Q .B=5 Qinling*uan
.#=+ 0englong
B"=6 2eiguan
.B=+ Fongsun
"C=44
7/25/2019 acupuncture for cancer baraye 1.pptx
105/134
! .#AF2A#!2 A2D 1D .#A.!.
"C=4J Danzhong -=4 hongfu
#1=6 higou
R=: #aichong
Dr Mehran Rezvani pain fellowship anesthesiologist& acupuncturist
"%?.# BA!2
7/25/2019 acupuncture for cancer baraye 1.pptx
106/134
! A2D Q!2 D?0!"!?2"Q
.#=:6 usanli .B=6 .anyin
7/25/2019 acupuncture for cancer baraye 1.pptx
107/134
A1DM!2A BA!2
Dr Mehran Rezvani pain fellowship anesthesiologist& acupuncturist
A1DM!2A BA!2
7/25/2019 acupuncture for cancer baraye 1.pptx
108/134
"2F?A!2F A2D .#AF2A#!2 0 BA#%F?2!" "
"C=4/ hongwan .#=:6 usanli
.B=+ Fongsun
"C=8 .hen*ue
"C=+ Fuanyuan
Dr Mehran Rezvani pain fellowship anesthesiologist& acupuncturist
A1DM!2A BA!2
7/25/2019 acupuncture for cancer baraye 1.pptx
109/134
!2#?R2A 1.#R-"#!2 0 DAMB%?A#
#1=6 higou .!=+ ;angu
.B=5 Qinling*uan
.# :6 usanli
.B=+ Fongsun
Dr Mehran Rezvani pain fellowship anesthesiologist& acupuncturist
A1DM!2A BA!2
7/25/2019 acupuncture for cancer baraye 1.pptx
110/134
! .#AF2A#!2 A2D 1D .#A.!.
R=: #aichong "C=6 ihai
.B=6 .anyin
7/25/2019 acupuncture for cancer baraye 1.pptx
111/134
D?0!"!?2"Q "D 0 #%? .B??2 A2D .#MA"%
1=/ Bishu 1=/4 ;eishu
"C 4/ hongwan
"C=6 ihai
.# :6 usanli
.B=6 .anyin
7/25/2019 acupuncture for cancer baraye 1.pptx
112/134
BA!2 !2 #%? %QB"%2DR!
Dr Mehran Rezvani pain fellowship anesthesiologist& acupuncturist
BA!2 !2 #%? %QB"%2DR!-
7/25/2019 acupuncture for cancer baraye 1.pptx
113/134
1D .#A.!. 1.#R-"#!2F #%? 2?#;R@ C?.
#1=6 higou F1=:+ Qangling*uan
1=4J Feshu
Dr Mehran Rezvani pain fellowship anesthesiologist& acupuncturist
BA!2 !2 #%? %QB"%2DR!-
7/25/2019 acupuncture for cancer baraye 1.pptx
114/134
D?BR?..!2 A2D 1!2D!2F 0 !C?R !
1=48 FanshuR=4+ imen
Dr Mehran Rezvani pain fellowship anesthesiologist& acupuncturist
BA!2 !2 #%? %QB"%2DR!-
7/25/2019 acupuncture for cancer baraye 1.pptx
115/134
DAMB=%?A# !2 #%? !C?R A2D FA1ADD?R
R=4+ imen#1=6 higou
R : #aichong
.B=6 .anyin
7/25/2019 acupuncture for cancer baraye 1.pptx
116/134
A""-M-A#!2 0 B%?FM=0-!D.
R=4: hangmen "C 4/ hongwan
1=/ Bishu
1=/4 ;eishu
.#=:6 usanli
F1=:+ Qangling*uan
Dr Mehran Rezvani pain fellowship anesthesiologist& acupuncturist
BA!2 !2 #%? %QB"%2DR!-
!2.-00!"!?2"Q 0 !C?R Q!2%# 6 Qi i
7/25/2019 acupuncture for cancer baraye 1.pptx
117/134
!2.-00!"!?2"Q 0 !C?R=Q!2%#=6 Qinxi
1=4I Einshu .B=4 Euehai
.B=6 .anyin
7/25/2019 acupuncture for cancer baraye 1.pptx
118/134
;?R 1A"@ BA!2
Dr Mehran Rezvani pain fellowship anesthesiologist& acupuncturist
;?R 1A"@ BA!2
"2F?A!2F A2D A""-M-A#!2 0 "D DAM
7/25/2019 acupuncture for cancer baraye 1.pptx
119/134
"2F?A!2F A2D A""-M-A#!2 0 "D=DAM
1=:/ "iliao FC/ Qaoshu
1+ ;eizhong
1=6 @unlun
Dr Mehran Rezvani pain fellowship anesthesiologist& acupuncturist
;?R 1A"@ BA!2
DAMB %?A#
7/25/2019 acupuncture for cancer baraye 1.pptx
120/134
DAMB=%?A#
1=:4 to 1=:+ 1aliao .# + 0englong
1=+ ;eizhong
Dr Mehran Rezvani pain fellowship anesthesiologist& acupuncturist
;?R 1A"@ BA!2
1D .#A.!.
7/25/2019 acupuncture for cancer baraye 1.pptx
121/134
1D .#A.!.
1=:4 to 1=:+ 1aliao 1=+ ;eizhong
!=+ %egu
1=/: .henshu
FC : Qaoyangguan
Dr Mehran Rezvani pain fellowship anesthesiologist& acupuncturist
;?R 1A"@ BA!2
@!D2?Q D?0!"!?2"Q
7/25/2019 acupuncture for cancer baraye 1.pptx
122/134
@!D2?Q D?0!"!?2"Q
1=/: .henshu FC + Mingmen
@!=: #aixi
1=I/ hishi
Dr Mehran Rezvani pain fellowship anesthesiologist& acupuncturist
1RA"%!A B?E-.
7/25/2019 acupuncture for cancer baraye 1.pptx
123/134
1RA"%!A B?E-.2?-RAF!A
Dr Mehran Rezvani pain fellowship anesthesiologist& acupuncturist
1RA"%!A B?E-. 2?-RAF
1=4 #ianzhu
7/25/2019 acupuncture for cancer baraye 1.pptx
124/134
1 4 #ianzhu
FC 4+ Dazhui
1=44 Dazhu
.!=4: uyuan
!=4I 3ianyu
!=44 uchi
#1=I ;aiguan
.!=: %ouxi
R=8 u*uan
@!=: #aixi
Dr Mehran Rezvani pain fellowship anesthesiologist& acupuncturist
BA!2 A0#?R AMB-#A#!
7/25/2019 acupuncture for cancer baraye 1.pptx
125/134
BA!2 A0#?R AMB-#A#!
Dr Mehran Rezvani pain fellowship anesthesiologist& acupuncturist
BA!2 A0#?R AMB-#A#!2
Main points $
7/25/2019 acupuncture for cancer baraye 1.pptx
126/134
Main points $
!=+ %egu
R=: #aichong all bilateral
.B=6 .anyin
7/25/2019 acupuncture for cancer baraye 1.pptx
127/134
Auxiliary points$
0or amputation of the ngers, add the correspondwell' points
.!=4 .haoze
#1=4 Fuanchong
!=4 .hangyang
%#=5 .haochong,
-=44 .haoshang, or B"=5 hongchong
Dr Mehran Rezvani pain fellowship anesthesiologist& acupuncturist
BA!2 A0#?R AMB-#A#!2
Auxiliary points$
7/25/2019 acupuncture for cancer baraye 1.pptx
128/134
Auxiliary points$
0or amputation of the forearm, add#1=I ;aiguan
!=4 .housanli
Dr Mehran Rezvani pain fellowship anesthesiologist& acupuncturist
BA!2 A0#?R AMB-#A#!2
Auxiliary points$
7/25/2019 acupuncture for cancer baraye 1.pptx
129/134
Auxiliary points$
0or amputation of the upper arm, add !=4I 3ianyu
!=4+ 1inao
Dr Mehran Rezvani pain fellowship anesthesiologist& acupuncturist
BA!2 A0#?R AMB-#A#!2
Auxiliary points$
7/25/2019 acupuncture for cancer baraye 1.pptx
130/134
y p
0or amputation of the toes, add the Ncorresponding well' points
F1=++ u*iaoyin
.#=+I idui
1=6J hiyin
.B=4 Qinbai R=4 Dadun
@!=4 Qong*uan
Dr Mehran Rezvani pain fellowship anesthesiologist& acupuncturist
BA!2 A0#?R AMB-#A#!2
Auxiliary points$
7/25/2019 acupuncture for cancer baraye 1.pptx
131/134
y p
0or amputation below the nee
7/25/2019 acupuncture for cancer baraye 1.pptx
132/134
y p
Foramputation below the hip joint, add
ST-31 Biguan
ST 32 Futu
Dr Mehran Rezvani pain fellowship anesthesiologist& acupuncturist
.#-MB BA!2
7/25/2019 acupuncture for cancer baraye 1.pptx
133/134
.#-MB BA!2
Dr Mehran Rezvani pain fellowship anesthesiologist& acupuncturist
.#-MB BA!2
#echni*ue $
7/25/2019 acupuncture for cancer baraye 1.pptx
134/134
*
!nsert the needles deeply into local points the r.hu'
!f there is no transport point available, select onepoint on each of the six channels three Qin and
Qang channels' and insert the needle obli*uely uat an angle of about +I[ to the sin surface'
Dr Mehran Rezvani pain fellowship anesthesiologist& acupuncturist