Acupuncture, how to decide?

Okay so I was going to post this in the more pointless research but I thought this would be best under a new topic.

My understanding is Acupuncture doesn't work better than a palcebo.
I am in a discussion about this with a friend and she pointed tohttp://www.cancer.gov... . I checked out quack watch and Dr. Barrett refutes alot of information. If I was totally oblivious to medicine and read the link I could very well see me asking my doctor about acupuncture, if I had cancer.

How in the world does one decide who to believe? I went and tried to look at the studies they reference at the site all I saw was the Abstract. This seemed to help validate the point that Acupuncture works even though I could not see the study. I was thinking well I can't see the study but there is one and the NCI seems to think the study says acupuncture helps.

The acupuncture hypothesis is highly implausible.

A more realistic explanation may be that inserting needles into the skin acts as a counter-irritant (the Ben-Gay hyposthesis), an effect that may distract people from their nausea. Some skeptics predict that with better experimental protocols, this effect will not stand up against placebo needling.

Be wary of any practice that claims to fight cancer by stimulating immune activity. The immune system is good for going after wonky cells, but it?s my understanding that it doesn?t recognize any established cancer as foreign.

Perhaps the most shameful promotion of acupuncture was done through an NIH consensus group (see below).

Here are some resources that can help you with questions about CAM:

http://www.acuwatch.o...
Critique of the NIH Consensus Conference on Acupuncture
Wallace I. Sampson, MD, FACP
[Wally is edtor of The Scientific Review of Alternative Medicine]

http://www.sram.org/...
The Scientific Review of Alternative Medicine (SRAM) is the only peer-reviewed journal devoted exclusively to objectively analyzing the claims of "alternative medicine." This is a publication of CSI (CSICOP) and Prometheus.

http://www.quackwatch...
Healthfraud Discussion List (run by Steve Barrett, M.D., of Quackwatch).
Ask questions here.

http://www.cochrane.o...
Cochrance Collaboration (reviews research; usually very reliable)

Yeah I don't think Acupuncture works and I definately wouldn't use it to treat cancer.

I looked at this as if I wasn't a skeptic. How in the world would I know that the NCI was wrong?

Also with this conversation between my friend how am I to say Well the NCI is wrong about acupuncture? All I can do is point to the link you have up there and let them decide. I already gave them quackwatch's article about acupuncture. I think he makes a very good arguement with how many studies are truely inconclusive because proper procedures such as blinding and randomizing etc. it was also updated at the end of 2007.

I don't see that NCI is endorsing acupuncture for anything here. Look closely at what NCI is saying about these five studies, one of which they apparently can only judge by it's abstract :

The findings of these studies suggest that acupuncture may be effective in treating cancer-related symptoms and cancer treatment?related disorders and that acupuncture may be able to activate immune functions [1-3] and regulate the autonomic nervous system.[4,5] Only one study reported a decrease in tumor volume in animals treated with acupuncture compared with control animals; however, the scientific value of this report is limited because of insufficient information about the research methodology.

A practice that merely "suggests" an effect would need considerably more testing and evidence.

A skeptic can look at this NCI webpage and see that there's not much to the extant research. A CAM proponent will see evidence that acupuncture works and NCI is telling the world about it.

You are most definitely right these things need to be read carefully. look at the second paragraph they have

The four ex vivo studies suggested that acupuncture is useful in anticancer therapy either by actively stimulating immune activity or by preventing chemotherapy suppression of immune activity.

Again the word suggests is used but I personally feel this writing leans more to supporting acupuncture. If I was writing this for the NCI I would strongly emphasis that the studies were inconclusive and more studies are needed to pin down the effectiveness of acupuncture. I think they are being a little irresponsible because this is a site that I would image people are coming to get information, some of which have been diagnosed with cancer. The recently diagnosed may not be thinking rationally and reading carefully.

When they talk about the studies all of them seem to show that acupuncture had some effect. Could they not find any studies that have no effect as the conclusion? I was last modified on 1/11/2008.

Maybe, it is a good thing I didn't write this page but, I would like them to take a stronger stance against acupuncture to treat cancer.

I will write them and ask.

Without even going into the research here are some gut level observations that seem to work against the acupuncture hypothesis.

If it worked, it would be part of the standard of care by now. Acupuncture has been around in the East for what? Hundreds if not thousands of years? and it has been in the US since like the 70s. I would be hard pressed to believe that people are just now starting to look at it as a cancer treatment.

Chemotherapy is NASTY! It screws up your immune system, makes you lose your hair, causes severe nausea, causes mucositis and on and on and on. If acupuncture worked, what kind of sadistic doctor would put their patient through all this misery when a little acupuncture would do the trick.

Conventional cancer treatment is also expensive as hell. If acupuncture worked, insurance companies would be all over it, and again what kind of sadist would put this kind of financial burden on their patient if some relatively inexpensive acupuncture would do the trick.

And just a quick observation on the research presented: Why, if you were testing the hypothesis that acupuncture is an effective antiemetic, would you test it in conjunction with even subeffective doses anti emetic drugs? Wouldn't you want to test it against anti emetic drugs? and against no drugs at all? Am I wrong here or does that make no sense?

My brother tried acupuncture as well as some kind of herbal cocktail mix for up to a year, for prostate cancer. He was told by the acupuncture practitioner that he had nothing to worry about, as it was deemed that the treatment was successful. Of course, the whole time he was monitored with blood tests and complete body scans of various kinds. He had very excellent Health Insurance. During this time, there was no growth in the cancer, but after a year, he decided at the urging of his M.D. to choose from several different options with the attempt to completely eradicate the cancer, without surgery. He really had a strong belief in rather Cultish ways of healing from being hooked up to a Guru figure and practices that would supposedly bring about reversals in bad karma, etc.

Now he reports, after following his M.D.'s advice, that he is completely cancer free, although there were some complications with a return of enlarged prostate and some difficulty urinating, impotence.

What is amazing, is that he still clings to the same Cultic belief system that did nothing. It is a difficult one to understand. What is the Latin for "I have believed it for such a long time, therefore it must be the Truth." Or "I dreamt it was real, therefore it is real." Vivid dreams seem to sometimes be more convincing than ordinary reality I guess.

On the other hand, I have tried acupuncture myself, and have definitely felt the placebo effect, sometimes not, but the endorphine response was very real, especially for sinus congestion and sinus pain. This of course does not prove the theories behind Acupuncture, but is still interesting, in the sense that a placebo effect may have a lot to do with a positive social interaction with someone in an apparent position of authority, kindly and with a degree of warmth. I'm sure this at least has been studied in the field of psychology and psychotherapy. Who wants to see a practitioner who leaves you feeling sad, hopeless, and anxious? Too much of that in real life anyway, too many crazies. I'm all for social evolution in the direction of more compassion, for sure.

Course, it could be true that a facial massage may be just as helpful, or a hot moist towel wrap. That would make a good easy study as well.

Hey all. Just found this group today, and thought I'd chime in. I actually AM an acupuncturist, the most skeptical acupuncturist in the land in fact. Mistakes have been made people, but I won't go into that now. Suffice to say that I don't practice acupuncture for ethical reasons, and am back in undergraduate land, preparing to apply to medical school next year.

So, that said consider this an argument from authority.

There is LOTS of "research" out there indicating that acupuncture is effective for a variety of conditions, from gastro-esophageal reflux to migraines to sinus infections. The problem is that the overwhelming majority of this research is GARBAGE. It's unfortunate that most laypeople, myself included up until not long ago, are unable (or unwilling) to distinguish between what is and is not credible and properly performed clinical research. Even more unfortunate is that the shitty research far outweighs the legitimate in regards to volume. What one finds is that the better the study, the more negative the result in regards to the efficacy of acupuncture. However, due to the disproportionate amount of bunk research, the perception of many, the media included, is that acupuncture works for all kinds of ailments. Not so. In fact, as far I know there is very (very very) limited evidence to suggest that acupuncture may be moderately effective in treating pain and nausea. Some large, properly conducted studies need to be done. I'd love to be a part of such studies if anyone here knows any research scientists!

Anyway, I'm short on time but want to make a quick point or two.
While it's generally safe to assume that the best medical treatments are part of the "mainstream" of medicine, this isn't always the case, and really should not be the barometer of whether or not a treatment is legitimate. Acupuncture is still very much a part of mainstream medicine in certain parts of China, and is used in a lot of hospitals alongside "western" medicine. Also, I understand that homeopathy is way big in jolly-old England. Boo.

Okay, I need to run to school. Hooray for cell biology, boo alternative medicine.
Also, "Hi everyone." I'm Matthew. Maybe I'll make it to the meetup this month and become a part of the skeptical community for real! Neato.
Cheers!

Welcome to the group MBoaz!

As skeptics (of the scientific sort) it'd be wrong of us to dismiss any treatment out of hand because it didn't originate in the west, so that point of yours is well-taken.

Also, just because some practitioners are overselling it or even defrauding patients has little to do with whether or not acupuncture is real. That point too is well-taken.

As you might guess as you dip your toe into modern skepticism, the only reliable measure of acupuncture's efficacy (or lack thereof) is testing through controlled clinical trials which eliminate the influence of bias, placebo, expectations, etc. where the results can be replicated even by acupuncture's staunchest critics.

Are you familiar with the recent published studies that attempt to double-blind the testing with 'sham' needles, such as the one that Orac (Dr David Gorski) mentioned last month: http://scienceblogs.c...

Reed

Hey Reed!

Let me start by saying that I completely and wholeheartedly agree with you that "the only reliable measure of acupuncture's efficacy (or lack thereof) is testing through controlled clinical trials which eliminate the influence of bias, placebo, expectations, etc. where the results can be replicated even by acupuncture's staunchest critics." This is just the fundamental method of any legitimate clinical trial. The vast majority of acupuncturists and "CAM" proponents would rather bury their heads in the sand or move goal posts around than face the cold, objective truth.

That being said, I have an issue with Dr. Gorski stating that "many investigators conflate electroacupuncture which is in reality nothing more than the "conventional" modality of transcutaneous electric nerve stimulation rebranded, with acupuncture itself (unless the ancient Chinese knew how to make electrical nerve stimulation devices, which I highly doubt)." I understand the point being made, but I think it represents, arguably, a subtle moving of goalposts by Gorski.
So, since electroacupuncture is a relatively new method of treatment within the field of acupuncture (several decades), it "doesn't count" as acupuncture. I partly agree. Obviously e-stim wasn't around 2500 years ago. But these trials are not testing the legitimacy of traditional Chinese medical theory. We can pretty safely discard the theoretical stuff as pure voodoo magic (medical anthropology if you're feeling diplomatic). Trials using "electroacupuncture," or "transcutaneous electric nerve stimulation," or "intramuscular stimulation" (whatever you wanna call it; we can debate subtle differences another time) are testing the efficacy of a specific technique that IS offered by, and is within the scope of practice of, acupuncturists (though only by the name "electroacupuncture"). So, I agree with Gorski if he is saying that studies purporting to prove acupuncture's efficacy by testing electroacupuncture are misleading (and intentionally so, I'm sure). However, the fact remains that this is still an "acupuncture treatment" in the sense that acupuncturists are qualified to competently provide this service (in most cases). That said, I think Gorski's argument on this point is a semantic one.

I'd love to comment on that article from the Clinical Journal of Pain. However, let me do so tomorrow or the following day. My access to this journal through my university is currently blocked because I owe my school's library $4 (I was late returning Dawkins "Blind Watchmaker", great book!) So, I don't wanna comment having just read the abstract. My first impression was, "what the fuck is 'arm pain due to overuse'," but I don't wanna jump to conclusions. The use of "stage-dagger" needles is, I think, a great control method, though not without its flaws too. I could talk about this shit all day, but I'll spare you for now sir!
Thanks for the interesting (at least to me) discussion.
~matthew