Acupuncture in Cancer Care: Evidence, Safety, and Implementation in Oncology Practice

Symptom burden continues to be a significant challenge throughout the cancer care continuum, frequently persisting even when guideline-directed pharmacologic treatments are used. Acupuncture has emerged as a nonpharmacologic supportive care option with growing evidence of benefit in selected cancer-related symptoms and has been incorporated into multiple professional oncology guidelines. However, uncertainty about proper indications, safety issues, referral processes, and reimbursement structures has hindered its adoption into standard oncology practice. This review provides practical guidance for oncology clinicians about the roles of acupuncture in cancer care. We summarize clinical indications supported by guidelines, outline oncology-specific safety and risk stratification principles, and discuss implementation strategies within cancer centers, which include referral workflows, use of patient-reported outcomes, staffing and training considerations, and financial sustainability. When administered by oncology-trained practitioners and coordinated within multidisciplinary care teams, acupuncture is typically safe, provided that clinicians consider the patient's treatment phase, relevant laboratory and imaging results, presence of implanted devices, surgical scheduling, and extent of metastatic disease. Although insurance coverages for acupuncture in cancer care remains heterogenous in the United States, experience from mixed-payer environments demonstrates that services can be implemented using flexible delivery and staffing models, although financial sustainability remains influenced by payer mix and institutional support. For oncology professionals, familiarity with acupuncture referral criteria and available evidence can help broaden care options and support patient-centered symptom management.