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Acupuncture for hot flashes in breast cancer patients: Story left out past study findings

Rating

3 Star

Categories

Acupuncture May Ease Hot Flashes for Breast Cancer Patients

Our Review Summary

Treatment by acupuncture. The doctor uses needles for treatment of the patient.The story focuses on a recent study published in the Journal of Clinical Oncology that finds female breast cancer patients who use acupuncture therapy in conjunction with “enhanced self-care” had fewer problems with hot flashes than patients who used only enhanced self-care.

The story does a good job of explaining the study’s design, and includes an independent source. However, it fell short when quantifying the benefits, and it did not discuss potential harms or the already existing body of work related to acupuncture’s use to ameliorate hot flashes in breast cancer patients.

 

Why This Matters

Breast cancer is extremely common, affecting more than 224,000 women in the U.S. in 2012, according to the CDC. And a 2007 study notes that “Approximately two thirds of breast cancer patients report hot flashes and 60% of these (ie, 40% of all patients) rate their problem as moderately or extremely severe.” In short, this is a health-related quality of life issue that affects many women each year. That makes it worth covering. What’s problematic here–and we’ll go into this at greater length below–is that the paper discussed in the story is only the most recent study evaluating acupuncture as a means of addressing hot flashes in breast cancer patients. How does this study differ from all the others? The story doesn’t tell us, and that sort of context is important for readers.

Criteria

Does the story adequately discuss the costs of the intervention?

Not Satisfactory

The story does address cost, but doesn’t say how much that cost might be. As the story states: “[the researcher] didn’t know how much American patients might have to pay for such treatment, but added, ‘Compared to other effective treatments such as antidepressants, (acupuncture) should be less expensive, and, for sure, more safe and feasible.'”

While we always try to give the benefit of the doubt in cases where the story at least attempts to address cost, the characterization here seems debatable enough to merit a Not Satisfactory rating.

A quick internet search finds that acupuncture therapy costs anywhere from $50 to more than $120 per session. That’s not insignificant (and it wasn’t hard to look up). Given that the study in the story had patients go through 10 acupuncture sessions, this could cost a patient at least $500, and possibly more than $1,200.

Also, while other methods for treating hot flashes, such as medication, are covered by health insurance, acupuncture is not necessarily covered.

Does the story adequately quantify the benefits of the treatment/test/product/procedure?

Not Satisfactory

The story’s only quantified assessment is “by the end of the treatment period, those in the acupuncture group were found to have hot flash scores that were 50 percent lower than those in the non-acupuncture group.” That’s not enough to merit a Satisfactory rating, for several reasons, including:

  • The story doesn’t really explain what “hot flash scores” are. The paper itself explains that a patient’s hot flash score “was calculated by multiplying the mean number of daily hot flashes that occurred during the week before assessment by the mean daily severity (1, mild; 2, moderate; 3, severe).”
  • Also, what does it mean to cut that score in half? Were there fewer hot flashes? Or just less severe ones? Did the difference make the hot flashes significantly more manageable? Even if the study design didn’t address this, they’re questions worth asking. And if the answers aren’t clear, it’s OK to tell readers that.

Does the story adequately explain/quantify the harms of the intervention?

Not Satisfactory

Potential harms aren’t mentioned at all. The Mayo Clinic notes that risks associated with acupuncture range from soreness to infection to organ injury. Further, the clinic warns that some patients are at higher risk than others, such as patients who have pacemakers or bleeding disorders.

Does the story seem to grasp the quality of the evidence?

Satisfactory

This is a strong point for the story, which does a nice job of describing the study.

However, the story ideally would have discussed how the the control group wasn’t really comparable in intensity to what the acupuncture group received. It’s possible that the acupuncture benefits reflect a placebo effect. A more rigorous design would have compared acupuncture to a sham acupuncture treatment to minimize this.

Does the story commit disease-mongering?

Satisfactory

No disease mongering here, as hot flashes associated with breast cancer treatments can negatively impact a woman’s quality of life, and treatment decisions.

Does the story use independent sources and identify conflicts of interest?

Satisfactory

The story does cite one independent source, and there don’t appear to be any conflicts of interest.

Does the story compare the new approach with existing alternatives?

Not Satisfactory

NIH lists a number of approaches to dealing with hot flashes in cancer patients, ranging from pharmaceutical interventions to hypnosis. The story mentions only those discussed in the study. We would like to see at least a mention of other techniques. And going a step further, it would be useful to compare the side effects of acupuncture to pharmaceutical solutions and other non-traditional approaches.

Does the story establish the availability of the treatment/test/product/procedure?

Satisfactory

One can infer from the story that acupuncture treatment is available for breast cancer patients, particularly given that the independent source says her patients have used acupuncture in the past. And because most people are generally aware that acupuncture is available, we’re giving this a Satisfactory rating.

But, the story would have been stronger if it had told readers whether any certified acupuncturist can provide the relevant therapy, or if a specialist in hot flashes is necessary.

Does the story establish the true novelty of the approach?

Not Satisfactory

This is the weakest spot for the story. We found three other papers that evaluated acupuncture as a means of addressing hot flashes for cancer patients: this one from 2007, one from 2009, and another from 2009. The findings from the studies are not all in agreement (with each other, or with the study being discussed in this story).

What does it tell us that we didn’t already know? Does it build on previous work? Looking at all of the work on this subject, what do we know about this form of treatment? Those are good questions–important questions–and this story doesn’t address them.

Does the story appear to rely solely or largely on a news release?

Satisfactory

The story does not appear to be based on a news release, and clearly involves some original reporting.

Total Score: 5 of 10 Satisfactory

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