An important article was recently published in the Journal of Clinical Oncology examining the effectiveness of acupuncture for the treatment of Cancer-Related Fatigue. One thing I particularly like about this study is that it compares acupuncture treatment to standard care rather than to a “placebo” control. Placebo controls are relatively easy to implement in a drug trial where you can give one group the drug and the other group pills made from something known to be relatively inert—sugar, for example.
The task of designing a placebo becomes much more difficult, however, when you are dealing with a hands-on modality like acupuncture. Some studies use very shallow insertions, where the needle barely breaks the skin, others use blunt needles that merely press against the skin. The problem with both of these approaches is that they are not truly inert. Shallow insertion is used extensively in Japanese-style acupuncture and acupressure—pressing on acupuncture points—is a popular and effective form of self-care. Because these placebos are not inert, they skew the results of the studies. Imagine a clinical trial for a new painkiller where one group got the new drug and the control group got aspirin.
Another positive thing about studies like this one that compare acupuncture with standard care is that they are very useful clinically. Acupuncture existed as the primary medical modality for a very large country for literally thousands of years. Consequently treatments were developed to address a vast array of ailments. Just because a treatment strategy exists, though, doesn’t mean it is optimally effective. Like any form of medicine, acupuncture has some pathologies that it treats extraordinarily well, others that it treats moderately well and others where it is fairly ineffective.
Studies like this one help us as professionals to determine what the best course of care would be for our patients. Would they benefit more from acupuncture, standard care or a combination of both? Studies like these help us answer these questions so that we can guide patients towards the most effective road back to well-being.