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Adding Acupuncture to Touch/Relaxation for Pain in Wartime: A Randomized Controlled Trial
Eran Ben-Arye1, Jan Vagedes2, Sameer Kassem3
1Ruth and Bruce Rappaport Faculty of Medicine (E.B.A., S.K., O.L., V.Z., O.G.), Technion-Israel Institute of Technology, Haifa, Israel; Integrative Oncology Program, The Oncology Service (E.B.A., O.G.), Lin, Carmel, and Zebulun Medical centers, Clalit Health Services, Haifa, Israel.
Context And Objectives:
Patients with cancer living in war zones face significant quality of life (QoL)-related challenges. This study examined an integrative oncology (IO) intervention in northern Israel for pain and autonomic response.
Methods:
This prospective, randomized, controlled and pragmatic study examined an IO intervention with manual-relaxation, with acupuncture (Group A) or without (Group B). ESAS (Edmonton Symptom Assessment Scale), EORTC QLQ-C30 (European Organization for Research and Treatment of Cancer QoL Questionnaire), and MYCAW (Measure Yourself Concerns and Wellbeing) tools were used to examine QoL. Heart rate and variability (HRV) were measured at baseline and 15 minutes post-treatment, comparing frequency-domain variable changes (e.g., LN Power Total, Power HF, Power LF, Power VLF).
Results:
Of 125 patients, Groups A (67) and B (58) had similar demographic and cancer-related characteristics. ESAS pain scores improved in both groups post-treatment (A, P < 0.001; B, P = 0.002), as did anxiety, depression, and fatigue. At three weeks, Group B reported greater improvement on ESAS pain (P = 0.039) and MYCAW pain-related concerns (P = 0.025), both showing within-group improvement on EORTC pain. HRV showed greater change in Group A, with decreased LN Power Total (P = 0.006), LN Power LF (P = 0.02), and LN Power VLF (P = 0.026). While Relative Power HF increased marginally (P = 0.054), heart rate decreasing more significantly in Group B (P = 0.005).
Conclusions:
IO treatments led to reduced pain among patients with cancer living in a war zone, with no additive effect of acupuncture. HRV changes suggest enhanced parasympathetic activity, with acupuncture-treated patients showing additional frequency-domain changes attributed to decreased sympathetic tone.
