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While chronic pain is not uncommon for patients with cancer, neither is opioid-induced constipation (OIC) caused by the opioids used to alleviate the pain. However, electroacupuncture (EA) might be a way to reduce the risk of OIC.¹

A team, led by Weiming Wang, MD, PhD, Department of Acupuncture and Moxibustion, Guang’anmen Hospital, China Academy of Chinese Medical Sciences, determined the efficacy of electroacupuncture for OIC in patients with cancer.

Opioid Use

Opioids are often used to treat chronic pain following cancer treatments, where 28% of patients with cancer and 33-40% of cancer survivors have chronic pain.

Opioid-induced constipation is common for patients treated with opioids to help alleviate cancer pain. However, there continues to be a need for safe and effective therapies for OIIC for patients with cancer.

In the randomized, clinical trial, the investigators examined 100 patients with cancer at 6 tertiary hospitals in China. Each participant was screened for OIC and enrolled in the study between May 1, 2019 and December 11, 2021. Each patient was randomized to receive either 24 sessions of EA or sham electroacupuncture over 8 weeks, followed by 8 weeks of follow-up. The mean age was 64.4 years.

Outcomes

The investigators sought primary outcomes of the proportion of overall responders, defined as patients who had at least 3 spontaneous bowel movements per week and an increase of at least 1 SBM from baseline in the same week for at least 6 of the 8 weeks of the treatment period.

The final analysis included 44 patients in the EA group and 42 participants in the sham acupuncture group received at least 20 sessions of treatment.The results show the proportion of overall responders at week 8 was 40.1% (95% confidence interval [CI], 26.1-54.1%) in the EA group, compared to just 9% (95% CI, 0.5-17.4%) in the sham acupuncture cohort (difference between groups, 31.1 percentage points; 95% CI, 14.8-47.6 percentage points; P < .001).

EA also resulted in a greater relief for the majority of OIC symptoms and improved the quality of life for this patient population and had no effects on cancer pain and its opioid treatment dosage.

For safety, EA-related adverse events were rare, but mild and transient when they occurred.

“This randomized clinical trial found that 8-week EA treatment could increase weekly SBMs with a good safety profile and improve quality of life for the treatment of OIC,” the authors wrote. “Electroacupuncture thus provided an alternative option for OIC in adult patients with cancer.”

References:

Wang W, Liu Y, Yang X, et al. Effects of Electroacupuncture for Opioid-Induced Constipation in Patients With Cancer in China: A Randomized Clinical Trial. JAMA Netw Open. 2023;6(2):e230310. doi:10.1001/jamanetworkopen.2023.0310