Graeme Donald

Evaluation of acupuncture in the management of chemotherapy-induced peripheral neuropathy.

Aim To clinically evaluate the effectiveness of acupuncture when used in the management of chemotherapy-induced peripheral neuropathy (PN). Background During cancer treatment, certain chemotherapies can cause varying degrees of PN. Patients’ quality of life can be seriously impaired through loss of sensation, pain or mobility problems. Conventional medications routinely used to manage neuropathic symptoms have poor side-effect profiles and there is little or no evidence justifying their use to treat chemotherapy-related neurotoxicities. There are studies suggesting that acupuncture may be an effective therapy in treating PN across a number of different aetiologies. Design A retrospective service evaluation. Method Patients (n=18) were referred for acupuncture by the medical staff and/ornurse specialists or they self-referred for treatment. A course of six weekly acupuncture sessions was offered to them, and their details were recorded on an evaluation form prior to session one. Points were selected by acupuncturists, based on patient presentation, and needles remained in situ for 30–45 min. Treatments took place in outpatient clinics, chemotherapy day case ward or a drop-in clinic based in a physiotherapy gym. The evaluation form was completed at the end of session 6 by a therapist who had not been involved in patient care. Results 82% (n=14) of patients reported an improvement in symptoms following their course of acupuncture; one patient with advanced disease died during the 6 weeks. Some patients derived additional benefits from the treatment including a reduction in analgesic use and improved sleeping patterns. The most common acupoints used were SP6 (n=18), ST36 (n=18) and LV3 (n=14). Conclusion Although these results are encouraging, they are uncontrolled. They suggest that acupuncture could be an option for these patients and controlled trials using validated patient-reported outcome measures are justified.

Medical students and acupuncture: a short sharp placement experience!

Background Acupuncture and other complementary therapies (CTs) have become increasingly popular, with patients calling for more integrated care. It is questionable whether doctors know enough about these therapies to provide balanced and informed advice to patients and, given that most will come across patients accessing CTs, this is an area of concern. Method This was an exploratory study of 40 students attending a placement at a CT service within an acute hospital trust in the UK. A questionnaire was given at the start of placement to record their scepticism towards CTs on a 0–10 scale and again, on placement completion. Result Of the students attending, 73% (n=29) completed the questionnaire. There was a statistically significant reduction in scepticism scores assessed before and after placement (p<0.001). Of the respondents, 90% (n=26) were shown or attempted acupuncture. 76% of students reported that the placement would definitely influence the rate of CT referrals in their future practice. Conclusion The placement experience provided students an opportunity to reconsider their attitudes towards CTs. The study was limited to one site and students independently elected to participate in the experience. Similar exposure could be of value to the wider medical student population, ultimately leading to more informed advice available to patients. Future research should include greater numbers, which could include a multi-site study.

Calming panic states in the Mould Room and beyond: A pilot complementary therapy head and neck cancer service

Purpose: The service was piloted in response to requests for assistance with patients experiencing severe anxiety undergoing head and neck radiotherapy. This paper describes the aims of the service, interventions provided and the recorded responses of patients to the support given. Data: Information about who referred, patient demographics, the interventions provided and patient feedback ( n = 112) was extracted from treatment records over a 15-month period. Findings: All referred patients successfully completed procedures and treatment. About 43 patients voluntarily disclosed past trauma, for example, sexual abuse, assault, childhood trauma, which they judged to have been linked to their claustrophobic responses. Advice and support was given to 40 patients also referred for smoking cessation; an additional three patients requested support when cravings returned. Conclusion: There is a paucity of information about the extent of the distress triggered by radiotherapy procedures and what interventions could be offered in practice. Further work is required to include an economic assessment and longer term effects on patient compliance with treatment and smoking cessation. Training needs for complementary therapists and radiotherapy staff at this centre were also identified; these are being addressed.

Providing therapies to the opposite sex: views of complementary therapists working in clinical and private practice settings.

AIM The study explored the experiences of working with the opposite sex as a therapists in a cancer care centre (CCC). METHODOLOGY Therapists (n = 17) participated in three focus groups. Audiotapes were transcribed verbatim and analysed. RESULTS Themes and sub-themes were identified; these related to maintaining safety, the relevance of location to how safe therapists felt when working with men, the therapeutic relationship, safety precautions and being vigilant. LIMITATIONS The participants were from one cancer care centre in the North West of England. Only two males participated. CONCLUSION This exploratory study identified that the majority of the participants in this study had concerns about safety related to the gender or sex of their patient or client. This was more of an issue in private practice with concerns centred on inappropriate sexual responses from male clients. This has implications for training and safety in establishing and maintaining a practice.