Advances in Life Science and Technology www.iiste.org
ISSN 2224-7181 (Paper) ISSN 2225-062X (Online)
Vol.41, 2016
5
Acupressure for Chemotherapy Induced Nausea and Vomiting in
Breast-Cancer Patients: A Randomized, Placebo-Controlled
Clinical Trial
Zaida Mohamad Said¹ MSN Dr. Ayman Hussein ², PhD Dr. Aidah Alkaissi³*, PhD
1.An-Najah National University, Faculty of Higher Studies- Nablus- Palestine
2.An-Najah National University- Faculty of Medicine and Health Sciences- Nablus-Palestine
3.An-Najah National University- Faculty of Medicine and Health Sciences- Nursing & Midwifery Department-
Nablus- Palestine, PO. Box 7
This paper was presented in the Conference of Society for Acupuncture Research. International Conference.
Translational Research in Acupuncture: Bridging Science, Practice & Community, Chapel Hill, North Carolina,
USA.
Abstract
Introduction: Chemotherapy is an important treatment in cancer (CA) care and is associated with numerous side
effects. Early studies reported that patients cited nausea and vomiting as the most distressing symptoms when
receiving chemotherapy. Despite continuing improvements in antiemetic therapies, nausea and vomiting
following chemotherapy treatment for CA remains a significant clinical problem for many patients and there is
correlation between the intensity of anticipatory nausea in the clinic prior to their treatment infusion and
subsequent post treatment of nausea and vomiting.
Since pharmacological treatments have failed to completely manage nausea and vomiting, exploring the
complementary, non-pharmacological, approaches that can be used in addition to pharmacological approaches
becomes paramount. Acupressure at the P6 point is a value-added technique in addition to pharmaceutics;
management for women undergoing treatment for breast cancer to reduce the incidence and intensity of delayed
chemotherapy induced nausea and vomiting (CINV), since up to 60% of patients had been reported nausea
despite the use of antiemetics Aims: The first aim is to examine the efficacy of P6-acupressure in preventing
chemotherapy induced nausea and emesis associated with highly emetogenic chemotherapy (i.e. doxorubicin as
adjuncts to standard 5-HT3 antiemetics (granisetron) and dexamethasone antiemetic given as part of routine care
in reducing acute nausea (during the day of treatment) and delayed nausea (2-5 days) following the day of
chemotherapy. The second aim is to examine the efficacy of the acupressure bands in reducing vomiting and in
maintaining Quality of Life (QOL). Patients and methods: A randomised, double-blind, placebo controlled trial.
One group received acupressure with bilateral stimulation of P6 (n=42), a second group received bilateral
placebo stimulation, (n=42) and a third group received no acupressure wrist band and served as a control group,
(n=42). Acupressure was applied using a Sea-Band (Sea- Band UK Ltd., Leicestershire, England) which had to
wear for the 5 days following the chemotherapy administration. Assessments of acute and delayed nausea and
emesis, OOL, patients' satisfaction, recommendation of treatment and requirement of rescue antiemetic were
obtained. Results: No significant differences were found in the incidence of acute nausea or emesis 24- h
following chemotherapy by treatment groups. Significant difference was found in the severity of early nausea (0-
6 scale) in the acupressure group M (SD) 1.62 (2.04) as compared to placebo group 2.17 (2.09), p=, 0006.
The acupressure group had a statistically significant reduction in the incidence of delayed nausea 40%
(17/42) as compared to the control group 62% (26/42) (p= ,0495). Further analyses indicated that significant
difference existed in the intensity of delayed nausea by acupressure group mean (SD) 1.45 (1.73), p=, 0002 as
compared to control 2.03 (1.91). Significant difference also existed in the intensity of delayed nausea by placebo
group 1.33 (1.66), p=, 0010 as compared to control 2.03 (1.91). Here we noted a placebo effect.
The percentage of the patients who had delayed moderate to very severe nausea day 2-5 (≥3 on 0-6
scale) in the acupressure group is 55% (23/42 (p= 0206), in the placebo group 52% (22/42) (p= 0116), a
statistically significant reduction existed as compared to control 79% (33/42). Here we noted a placebo effect.
The incidence of delayed vomiting episodes day 2-5 was 48% (20/42), 64% (27/42), and 57% (24/42)
in the acupressure, placebo and control group respectively. No significant differences were found between the
groups.
The mean of number of delayed emetic episodes day 2-5 was significantly less in the acupressure group
2.7 (1.87) as compared to placebo 3.3 (1.91), p=,0022 and control groups 2.07(1.20), P= ,0005. Requirement of
rescue antiemetic was significantly lower in P6-acupressure (55%, 23/42), as compared to control group (76%,
32/42) (p= 0389).
81% (35/42)) of the patients in acupressure group were significantly satisfied with P6-acupressure as
compared to placebo group 64% (27/42), p= 0.0471. 79% (34/42)) of the patients in acupressure group would
Advances in Life Science and Technology www.iiste.org
ISSN 2224-7181 (Paper) ISSN 2225-062X (Online)
Vol.41, 2016
6
recommend P6-acupressure to another patients as compared to placebo group 62% (26/42), p= 0,0533 .
No statistically significant differences between groups were observed for the overall items response rate
of the FACT-Scale which were 74/108, 67/108, 69/108 in the acupressure, placebo and control group
respectively. Conclusion: P-6 Acupressure is efficacious for control of delayed chemotherapy related nausea and
emesis and is a value-added method in addition to pharmaceutical management for women undergoing treatment
for breast cancer. Placebo effect of acupressure decreased severity of delayed nausea day 2-5 but the mean of
number of delayed emetic episodes and need of rescue antiemetics were reduced only by acupressure with the
correct P6 point stimulation.
Keywords: breast cancer, chemotherapy, nausea, vomiting, acupressure.

Title

Journal of Health, Medicine and Nursing

Publisher

www.iiste.org

Publisher Country

Bulgaria

Publication Type

Online only

Volume

41

Year

2016

Pages

1-19