Acupuncture Eases Radiation-Induced Dry Mouth

Cancer Newsline - July 2009

Ancient Technique Shows Promise

The traditional Chinese medical technique of acupuncture may safely help patients whose radiation treatments cause extreme dry mouth, or xerostomia.

M. D. Anderson researchers reported the results of the pilot study in the April online edition of Head and Neck.

Significance of study

"The quality of life in patients with radiation-induced xerostomia is impaired profoundly," says Mark Chambers, D.M.D., professor in the Department of Dental Oncology and the study's senior author. "Conventional treatments have been less than optimal, providing short-term response at best."

Symptoms can include difficulty with speaking, eating and swallowing; infections of the tissues of the mouth; altered taste sensation; and tooth decay.

Xerostomia develops after the salivary glands are exposed to repeated doses of therapeutic radiation. Treatment for cancers of the head and neck typically involve large cumulative doses, rendering the salivary glands unable to produce enough saliva.

Saliva substitutes like lozenges and chewing gum bring only temporary relief, Chambers says, and the commonly prescribed medication, pilocarpine, has short-lived benefits and bothersome side effects.

M. Kay Garcia, D.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 also may develop irreversible nutritional deficits.

Research methods

The 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.

Acupuncture points were on the:

Ears
Chin
Index finger
Forearm
Leg

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 four weeks of acupuncture
After eight weeks of acupuncture

Primary results

The twice-weekly acupuncture treatments produced statistically significant improvements in symptoms.

Measurement tools included:

Xerostomia Inventory, which asks patients to rate:

Mouth dryness
Related symptoms

Patient Benefit Questionnaire, which inquires about issues including:

Mouth and tongue discomfort
Speaking, eating and sleeping difficulties
Use of oral comfort aids

Quality-of-life assessments conducted at weeks five and eight showed significant improvements over quality-of-life scores recorded at the outset of the study.

What’s next?

The study holds promise, according to Chambers.

"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," he says.

Garcia says a Phase III placebo-controlled trial is under review.

In other studies, M. D. Anderson researchers are examining whether acupuncture can prevent — not just treat — xerostomia in patients treated for head and neck cancer.

Adapted by Mary Brolley from an M. D. Anderson news release.