Acupuncture for Pain Management in a Geriatric Patient with Colorectal Cancer: A Case Report

Colorectal cancer (CC) causes pain, thereby affecting a patient's quality of life and functional status. Pain management with analgesics can cause adverse effects. Acupuncture is a nonpharmacological treatment that effectively manages cancer-related pain and provides a safer alternative. In this case report, battlefield ear acupuncture (BFA) and body acupuncture were used.

A 76-year-old female patient with right lower abdominal pain for the past 3 months prior to hospitalization. The pain was stabbing, intermittent, and worsened in the seated position, also bloating, reduced appetite, fatigue, weight loss, constipation, and bloody stools. Physical examination revealed conjunctival pallor, tenderness, and a palpable liver. Laboratory tests revealed anemia, elevated carcinoembryonic antigen tumor marker (CEA), and prolonged clotting times. Computed tomography revealed a malignant mass in the cecum and ascending colon. Histopathology confirmed low-grade adenocarcinoma. Modified BFA protocols were used with a combination of body acupuncture at LI4 (Hegu), ST36 (Zusanli), Sp6 (Sanyinjiao), GB34 (Yang Ling Quan), and LR3 (Taichong) bilaterally using filiform needle. Acupuncture therapy was administered daily with a retention time of 30 min for both body and ear acupuncture sessions.

After six therapy sessions, the pain level score (numeric rating scale [NRS]) decreased from 5 to 1, and the patient could sleep at night and also showed improvement for EQ-5D. There was a decrease in the use of paracetamol from a dose of 1000 mg and morphine immediate-release dose of 5 mg when experiencing pain until it was not given in the 6th session.

In this case, acupuncture therapy was helpful in managing the preoperative pain in a geriatric patient with colorectal cancer. Acupuncture may be considered to treat patients with pain and contraindications to pharmacologic therapies and can reduce the side effects of pharmacologic therapies. Further investigation of acupuncture therapy for cancer pain is warranted.