Electroacupuncture analgesia for cancer-related pain

Cancer-related pain remains a major clinical problem arising from both malignancy and its treatment. Current pharmacotherapies rely on opioids and adjuvant analgesics, which still provide unsatisfactory relief for the majority of patients. The use of complementary therapies for the management of cancer-related pain is growing, and acupuncture is increasingly incorporated into integrative cancer care. We explore the clinical and preclinical evidence base for the use of electroacupuncture in tumour-associated pain and treatment-associated pain, with an emphasis on experimental studies of cancer-induced bone pain and chemotherapy-induced pain.

Preclinical studies provide increasing biological plausibility for electroacupuncture analgesia by regulating peripheral and central neuroimmune and neuromodulatory nociceptive axes. Still, greater mechanistic alignment between preclinical and clinical studies is needed to understand how the mechanisms of acupuncture in rodents translate to humans. Clinical literature supports an analgesic effect of acupuncture; however, the magnitude and consistency of benefit vary considerably between studies. The biological activity of sham acupuncture further complicates the interpretation of conventional placebo-controlled trials and highlights the importance of incorporating objective physiological outcomes alongside patient-reported measures.

Improved standardisation and reporting, objective outcome measures, and adequately powered trials that distinguish cancer-related pain phenotypes and acupuncture modalities will be necessary to establish how acupuncture can be optimally integrated into evidence-based cancer-related pain care.