Acupuncture eases radiation-induced dry mouth in cancer patients
M. D. Anderson research shows improved quality of life and well being after needle-based therapy
HOUSTON -- Twice weekly acupuncture treatments relieve debilitating symptoms of xerostomia - severe dry mouth - among patients treated with radiation for head and neck cancer, researchers from The University of Texas M. D. Anderson Cancer Center report in the current online issue of Head & Neck.
Xerostomia develops after the salivary glands have been exposed to repeated doses of therapeutic radiation. People who have cancers of the head and neck typically receive large cumulative doses, rendering the salivary glands incapable of producing adequate saliva, said Mark S. Chambers, M.S., D.M.D., a professor in the Department of Dental Oncology. Saliva substitutes, lozenges and chewing gum bring only temporary relief, and the commonly prescribed medication, pilocarpine, has short-lived benefits and bothersome side effects of its own.
"The quality of life in patients with radiation-induced xerostomia is profoundly impaired," said Chambers, the study's senior author. "Symptoms can include altered taste acuity, dental decay, infections of the tissues of the mouth, and difficulty with speaking, eating and swallowing. Conventional treatments have been less than optimal, providing short-term response at best."
M. Kay Garcia, LAc, Dr.P.H., a clinical nurse specialist and acupuncturist in M. D. Anderson's Integrative Medicine Program and the study's first author, noted that patients with xerostomia may also develop nutritional deficits that can become irreversible.
Garcia, Chambers and their team of researchers conducted a pilot study to determine whether acupuncture could reverse xerostomia. Acupuncture therapy is based on the ancient Chinese practice of inserting and manipulating very thin needles at precise points on the body to relieve pain or otherwise restore health. In traditional Chinese medicine, stimulating these points is believed to improve the flow of vital energy through the body. Contemporary theories about acupuncture' s benefits include the suggestion that needle manipulation stimulates natural substances that dilate blood vessels and increase blood flow to different areas of the body.
The M. D. Anderson study included 19 patients with xerostomia who had completed radiation therapy at least four weeks earlier. The patients were given two acupuncture treatments each week for four weeks. The acupuncture points used in the treatment were located on the ears, chin, index finger, forearm and lateral surface of the leg. All patients were tested for saliva flow and asked to complete self-assessments and questionnaires related to their symptoms and quality of life before the first treatment, after completion of four weeks of acupuncture, and again four weeks later.
The twice weekly acupuncture treatments produced highly statistically significant improvements in symptoms. Measurement tools included: the Xerostomia Inventory, asking patients to rate the dryness of their mouth and other related symptoms; and the Patient Benefit Questionnaire, inquiring about issues such as mouth and tongue discomfort; difficulties in speaking, eating and sleeping; and use of oral comfort aids. A quality-of-life assessment conducted at weeks five and eight showed significant improvements over quality-of-life scores recorded at the outset of the study.
"In this pilot study, patients with severe xerostomia who underwent acupuncture showed improvements in physical well-being and in subjective symptoms," Dr. Chambers said. "Although the patient population was small, the positive results are encouraging and warrant a larger trial to assess patients over a longer period of time."
Garcia said that a phase III, placebo-controlled trial is planned and is currently under review. She also noted that in other studies, the M. D. Anderson researchers are examining whether acupuncture can prevent xerostomia in patients treated for head and neck cancer, not just treat it.
"Recently, we completed a study at Fudan University Cancer Hospital in Shanghai, China that compared acupuncture to usual care to prevent xerostomia. We have now started a two-arm placebo-controlled pilot trial in Shanghai. In the prevention trials, acupuncture is performed on the same day as the radiation treatments," Garcia said.
Mayo Clinic Study Finds Anemia Might be Associated With Development of Parkinson's Disease
ROCHESTER, Minn. — Results of a new Mayo Clinic study support an association between anemia experienced early in life and the development of Parkinson's disease many years later. The findings will be presented at the American Academy of Neurology Annual Meeting in Seattle on April 30, 2009.
VIDEO ALERT: Additional audio and video resources, including excerpts from an interview with Dr. Rocca describing the research, are available on the Mayo Clinic News Blog.
"We were surprised to discover that chronic anemia or low levels of hemoglobin were linked to the risk of Parkinson's disease 20-30 years later," says Walter Rocca, M.D. an author of the study and a neurologist at Mayo Clinic.
Hemoglobin is the protein that transports oxygen in the blood, an essential element for life. "We looked at both anemia as diagnosed by a physician and low hemoglobin values," Dr. Rocca says. "Both were associated with an increased risk of Parkinson's disease. This might indicate that Parkinson's disease actually starts 20--30 years before we see any motor changes in the body."
The case-control study included 196 people who developed Parkinson's disease in Olmsted County, Minn., from 1976 through 1995. Each case was matched by age and sex to a general population control subject who was not affected by Parkinson's disease. The medical records of cases and controls were reviewed using the resources of the Rochester Epidemiology Project to determine if there was a link between anemia or low hemoglobin levels and the risk of developing Parkinson's disease many years later. Anemia was significantly more common in the history of cases than in the history of controls.
Dr. Rocca and his team hope to replicate these results in another population group. "We first need to confirm the study results. If the findings are replicated, we will try to understand what are the underlying mechanisms. Understanding the mechanisms may lead to new ways to prevent or treat Parkinson's disease," Dr. Rocca says.