Radiography - The Best Kept Secret

Abstract

or sub-dermal loci called acupoints that correspond to specific anatomical points on nerve pathways or tissue fascia. Different combinations of acupoints have a wide range of effects on symptoms, the balance of the autonomic nervous system, degrees of inflammation, tissue regeneration as well as hormone and immunocyte levels. Acupuncture is utilized among palliative cancer patients for managing pain as it is known to be relatively free of harmful side effects. Opioid-based analgesia cause hindering side effects, which affect a patient’s quality of life. Patients are often reluctant to take opioids or may not achieve satisfactory pain control because of adverse effects. Oncology acupuncturists use acupuncture as an adjunctive intervention to treat physical and emotional symptoms of cancer. Cancer-induced bone pain (CIBP) is a unique pain state characterized by central sensitization and an ‘‘up-regulated’’ nociceptive system. Spontaneous pain from CIBP is not well controlled by opioid analgesia. Acupuncture is known to reduce pain transmission sensitization at peripheral and central sites, to normalize muscle tone and restore muscle balance as well as to provide sustained background analgesia and rapid onset analgesia for breakthrough pain. Acupuncture can also modulate emotional responses to pain such that patients feel relaxed as their pain is more tolerable. Acupuncture has been incorporated among the integrative therapies provided for cancer patients at Dana-Farber Cancer Institute in Boston, MA, to help manage symptoms or treatment-related side effects such as nausea, vomiting, pain, fatigue and anxiety. Evidence suggests that acupuncture relieves pain and dysfunction from xerostomia, arthralgia in breast cancer as well as hot flashes in breast and prostate cancer. All this evidence suggesting the effectiveness of acupuncture in treating CIBP and other side effects as well as the administration of acupuncture within a cancer centre leads to the question as to whether acupuncture can be used as a routine method for pain control in patients receiving radiation therapy for bone metastases. We propose a crossover study with a population of patients undergoing external beam radiation therapy (EBRT) for bone metastases and currently taking pain medication as well as interested in seeking acupuncture for pain management. Acupuncture will be administered concurrently during the five to ten fractions of EBRT to patients with a good performance status, a prognosis of greater than three months and with the absence of contraindications to acupuncture. The objective of this crossover study is to determine whether acupuncture with EBRT and medications is more effective in controlling pain than with EBRT and medications alone. Pain can be assessed using a Numeric Rating Scale. A secondary objective can look into producing an effective protocol for treating CIBP with acupuncture.