A Retrospective Review
Investigating the Feasibility of
Acupuncture as a Supportive Care
Agent in Children with Cancer
Kat...
Background
 Acupuncture is an ancient Chinese method of
healing and is a component of Chinese medical
treatment.
 Publis...
Acupuncture and Pediatrics
 Pediatrics has historically been part of
Chinese medicine and is widely used in
China.
 Reco...
Acupuncture and
Children with Cancer
 More consideration needed when giving
acupuncture to children already having
freque...
Strategies
 Fewer needles, thinner
gauge and shorter duration
of treatment
 Needles do not have to be
retained to have a...
Acupuncture and
Thrombocytopenia
 Many cancer patients encounter
thrombocytopenia at some point in their
therapy
 Recomm...
Program Description
 Acupuncture services were initiated in March 2005
 The primary oncologist of each patient is
approa...
Acupuncture Treatment
Description
 Treatment is integrated with outpatient and
inpatient treatments
 Appointments not ne...
Primary Objectives
 To describe the first year of the introduction
of an acupuncture program to children with
cancer.
 T...
Methods
 25 patient records of subjects between the age of 1
and 22 who were undergoing treatment for cancer
 Patient di...
Monitoring of Side-Effects
 Acute
 A thorough exam of the acusites was conducted
after each treatment session.
 Delayed...
Results
 Over a 6-month period, we provided 172
sessions of acupuncture to children ages
1– 22 undergoing treatment for c...
Demographic Data
Caucasian (15)
Hispanic (7)
Black, not
Hispanic (1)
Other (2)
Female (14)
Male (11)
N=25
Age Range: 1 to ...
Patient Diagnoses
0 1 2 3 4 5 6
SickleCell Anemia
AML
Rhabdomyosarcoma
Nasopharyngeal
Hodgkins Disease
Osteosarcoma
ALL
Ew...
Signs & Symptoms Treated
Pain Headache
Dry
Mouth
High Blood
Pressure
Fatigue /
Weakness
Cachexia
Nausea /
Vomit
Anxiety
We...
Side-Effects Associated with
Treatment with Acupuncture
 Out of 172 sessions of acupuncture, only two side
effects report...
0
2
4
6
8
10
12
14
Patient Platelet Counts
< 50 µMol/mL > 50 µMol/mL< 20 µMol/mL
Treatments Per Patient
0
5
10
15
20
25
30
35
#ofTreatments
Conclusions
 Provision of acupuncture is feasible and well-
accepted among children with diverse malignancies
and undergo...
Next Steps
 The descriptive nature of this study helped
identify potential areas where acupuncture
may have a role as a s...
Acknowledgements
 Staff of The Integrative Therapies Program for
Children with Cancer
 Kara Kelly, MD
 Elena J Ladas, M...
Upcoming SlideShare
Loading in …5
×

A Retrospective Review Investigating the Feasibility of ...

437 views

Published on

0 Comments
1 Like
Statistics
Notes
  • Be the first to comment

No Downloads
Views
Total views
437
On SlideShare
0
From Embeds
0
Number of Embeds
38
Actions
Shares
0
Downloads
3
Comments
0
Likes
1
Embeds 0
No embeds

No notes for slide

A Retrospective Review Investigating the Feasibility of ...

  1. 1. A Retrospective Review Investigating the Feasibility of Acupuncture as a Supportive Care Agent in Children with Cancer Kathy Taromina, MS, LAc, Diane Rooney, MS, LMT, LAc, Elena J. Ladas, MS, RD, Deborah Hughes, Kara Kelly, MD Integrative Therapies Program for Children with Cancer, Columbia University, Division of Pediatric Oncology, New York, NY, United States, 10032
  2. 2. Background  Acupuncture is an ancient Chinese method of healing and is a component of Chinese medical treatment.  Published reports have cautioned against the use of acupuncture in the pediatric population  Clinical trials have suggested that acupuncture may have a role as a supportive care agent in adults undergoing treatment for cancer  No clinical trials have been published for children undergoing treatment for cancer.
  3. 3. Acupuncture and Pediatrics  Pediatrics has historically been part of Chinese medicine and is widely used in China.  Recommended for children of all ages and conditions  Adjustments need to be made to treatment and delivery
  4. 4. Acupuncture and Children with Cancer  More consideration needed when giving acupuncture to children already having frequent needle exposure.  Developmental Stage  Difficult to avoid toddlers from moving around or grabbing at needles  Body image concerns with adolescents
  5. 5. Strategies  Fewer needles, thinner gauge and shorter duration of treatment  Needles do not have to be retained to have a therapeutic effect  Gently inserting needles and coordinating breathing exercises with insertion can minimize the sensation of the needle being placed.  Private room option
  6. 6. Acupuncture and Thrombocytopenia  Many cancer patients encounter thrombocytopenia at some point in their therapy  Recommendations from the acupuncture community are practitioner-dependent  Theoretical concern in patients with < 50 µMol/mL
  7. 7. Program Description  Acupuncture services were initiated in March 2005  The primary oncologist of each patient is approached by the director of the program prior to acupuncture treatment  Upon physician approval, patient/guardian consent is obtained per NY State Guidelines
  8. 8. Acupuncture Treatment Description  Treatment is integrated with outpatient and inpatient treatments  Appointments not necessary  Acupuncturist makes daily rounds in outpatient center and inpatient unit
  9. 9. Primary Objectives  To describe the first year of the introduction of an acupuncture program to children with cancer.  To describe the feasibility, patient acceptance, symptoms addressed, and overall experience of an acupuncture program provided to children undergoing treatment for cancer.
  10. 10. Methods  25 patient records of subjects between the age of 1 and 22 who were undergoing treatment for cancer  Patient diagnosis, gender, age, chief complaint, number of treatments, acceptance, outcome, and adverse events were recorded over a 6-month period.  Patient treated with acupuncture at the same time as receiving conventional therapies
  11. 11. Monitoring of Side-Effects  Acute  A thorough exam of the acusites was conducted after each treatment session.  Delayed  Acusites were examined during the patient’s routine visit to monitor for any delayed side- effects.
  12. 12. Results  Over a 6-month period, we provided 172 sessions of acupuncture to children ages 1– 22 undergoing treatment for cancer  The provision of services was feasible to a wide range of diagnoses and ages and in both the inpatient and outpatient settings
  13. 13. Demographic Data Caucasian (15) Hispanic (7) Black, not Hispanic (1) Other (2) Female (14) Male (11) N=25 Age Range: 1 to 22 years Race Gender
  14. 14. Patient Diagnoses 0 1 2 3 4 5 6 SickleCell Anemia AML Rhabdomyosarcoma Nasopharyngeal Hodgkins Disease Osteosarcoma ALL Ewings BrainTumor # of Patients
  15. 15. Signs & Symptoms Treated Pain Headache Dry Mouth High Blood Pressure Fatigue / Weakness Cachexia Nausea / Vomit Anxiety Well-Being Thrombocytopenia
  16. 16. Side-Effects Associated with Treatment with Acupuncture  Out of 172 sessions of acupuncture, only two side effects reported  Two patients reported a small hematoma at the acupoint site  16-year old male with relapsed Ewings Sarcoma. Patient was receiving high-dose dexamethasone and developed a hematoma at one acusite after one treatment.  11-year old female with relapsed Ewings Sarcoma. Patient suffered chronic thrombocytopenia and developed a hematoma at one acusite after one treatment.
  17. 17. 0 2 4 6 8 10 12 14 Patient Platelet Counts < 50 µMol/mL > 50 µMol/mL< 20 µMol/mL
  18. 18. Treatments Per Patient 0 5 10 15 20 25 30 35 #ofTreatments
  19. 19. Conclusions  Provision of acupuncture is feasible and well- accepted among children with diverse malignancies and undergoing stem cell transplantation  Provision of acupuncture is feasible in both the in/out-patient settings  Acupuncture is well-accepted by a wide age range of patients  Acupuncture may be a supportive care agent for a variety of therapy-related side-effects; however, this needs to be confirmed in future clinical trials
  20. 20. Next Steps  The descriptive nature of this study helped identify potential areas where acupuncture may have a role as a supportive care agent.  Future randomized, controlled trials in a homogenous patient population will aid investigators in identifying the role of acupuncture in pediatric oncology
  21. 21. Acknowledgements  Staff of The Integrative Therapies Program for Children with Cancer  Kara Kelly, MD  Elena J Ladas, MS, RD  Deborah Hughes, BA  Diane Rooney, L.Ac  Christine Grimaldi, PhD The patients treated at the Division of Pediatric Oncology, Columbia University Medical Center

×