Cancer related fatigue (CRF) is a common problem suffered by many cancer survivors, including men with advanced prostate cancer. Whether the fatigue is a result of the cancer or of the treatment doesn’t really matter. What matters is that you are fatigued and unable to live your life as you wish.

CRF can affect us before, during, and after our treatment. Men with advanced prostate cancer will go on and off treatment, but somehow we seem to always be affected by fatigue. According to the National Comprehensive Cancer Network (NCCN), “Fatigue is by far the most common—and for many the most distressing—symptom affecting people with cancer. At its worst, cancer-related fatigue is a draining, unrelenting exhaustion that impedes the ability to enjoy life and carry out daily activities.” (Fighting Cancer Fatigue. National Comprehensive Cancer Network Web site. .)

How to help control CRF is a constant issue in the care of cancer survivors. One possibility worthy of consideration is using acupuncture combined with holistic education to relieve CRF.

A very small study was published in BMC Complementary and Alternative Medicine (Johnston MF, Hays RD, Subramanian SK, et al. Patient education integrated with acupuncture for relief of cancer-related fatigue randomized controlled feasibility study. BMC Complement Altern Med. 2011;11:49) which studied breast cancer survivors in a pilot randomized controlled trial.
The researchers studied 12 participants: 5 participants for the treatment group and 7 participants for the control group (the study was small because of the researchers difficultly accruing participants)!

The study participants were 18 to 65 years (mean age of the participants was 54 years), finished with their primary therapy and free of breast cancer, and experiencing cancer-related fatigue with a score of 4 or greater on the Brief Fatigue Inventory. Persons with depression, severe anemia at intake, or severe limitations in physical functioning were excluded; however, persons with other potential causes of fatigue, such as hepatitis or hypothyroidism, were not excluded.

In the study a clinician taught all the participants how to enhance their well being with exercise, relaxation techniques, and nutrition and dietary advice in four weekly education sessions.

The treatment group also received weekly acupuncture sessions for 8 weeks. There were no adverse effects from the acupuncture; there was no bruising, infection, and no incidences of fainting, panic, or disorientation. The control group received standard care. Both patient groups continued to see their personal physicians and receive pharmacologic and nonpharmacologic treatments as previously scheduled.

The results of the study showed that CRF was reduced by 66% among the study participants in the treatment group. The researchers believe that the intervention they used, which included patient education, was more beneficial than a treatment limited to acupuncture alone because effective self-care leads to significantly improved health.

Clearly, we need a larger study before concluding that a holistic approach joined with acupuncture can have a significant effect on CRF. However, to use acupuncture now should not cause any harm and might help relieve cancer related fatigue.

Joel T Nowak, M.A., M.S.W.