I saw this headline in my Google News feed this morning: “Acupuncture Reduces Pain in Lung Cancer Patients – New Findings” [1]. The article was posted on a credulous site that promotes acupuncture, a practice that has never been proven to yield any benefit over the placebo effect.
So I thumbed through the news article. It claimed:
The focus of the study was the evaluation of acupuncture and its effect on lung cancer related symptoms such as nausea, anxiety, pain, depression and a sense of not
feeling well. A total of 33 lung cancer patients received 45 minute acupuncture treatments at a rate of 1 – 2 times per week for at least 4 treatments. The results demonstrated that acupuncture effectively reduced pain levels in over 60% of patients. Additionally, 30% of patients noted improvements with a sense of well-being with at least 4 acupuncture treatments. This number jumps to a 70% improvement in well-being when patients received 6 or more acupuncture treatments. [1]
The original paper making the claim of such findings is references in [2]. A read through the abstract of the paper reveals that the news site summarized it appropriately. Reading the abstract also reveals a set of major scientific flaws:
- There is no placebo control group in the study.
- There is no group that receives the best known and possible medical pain intervention for lung cancer patients.
The placebo effect is a powerful, built-in effect wherein belief about outcome affects outcome. If a patient receives a sham, non-medical treatment, but the treatment provider believes it’s effective and the patience believes it’s effective, then the patient can get better even though no medical intervention actually occurs. It must be controlled for before declaring a treatment successful. Degree of belief determines outcome, independent of the activity of the treatment.
While for acupuncture it is difficult to provide a sham control procedure, in fact sham acupuncture (where the needles press against, but never puncture, the skin) exists and has been used in properly controlled studies of acupuncture. Those independent studies have shown no effect of acupuncture over placebo. At best, a patient is paying for the privilege of being deceived.
This study [2] is bad science. Without a control group, the most accurate and scientifically honest interpretation is that the patients experienced the placebo effect. Studies of placebo have shown that “more sham intervention equals faster positive outcome,” because the belief is that more treatment means more healing. The results – more acupuncture led to more reports of pain relief – are consistent with the null hypothesis. That is, the data are consistent with acupuncture behaving as a placebo, where more placebo speeds the placebo effect.
You can find lots of good information about the amazing placebo effect, and understand why it’s critical to control for it, in ref [3]. What is most scientifically DISHONEST about this paper is that the study fails to do the most important thing: compare against the BEST POSSIBLE TREATMENT. It’s not enough to test against nothing (e.g. placebo) and then claim your treatment is equal to or better than doing nothing – it’s medically and scientifically honest to test against the best pain control interventions.
[1] http://www.healthcmi.com/acupuncturist-news-online/813-lungcancerli4lv3
[2] Kasymjanova, G., M. Grossman, T. Tran, R. T. Jagoe, V. Cohen, C. Pepe, D. Small, and J. Agulnik. “The potential role for acupuncture in treating symptoms in patients with lung cancer: an observational longitudinal study.” Current Oncology 20, no. 3 (2013): 152.
[3] David Moermon. “Cultural Variations in the Placebo Effect: Ulcers, Anxiety, and Blood Pressure”. Medical Anthropology Quarterly. Vol 14, Issue 1. 2008
2 thoughts on “Bad Science Watch: acupuncture and lung cancer pain”
Acupuncture is a way of managing our energy flow. It was practiced from ancient times and it has proven to be effective in solving problems related to pain and stress. It’s effect on lung cancer needs to be reviewed as this treatment is an effective solution to many diseases. I did acupuncture treatment for my body pain from a clinic in Markham and it proved to be effective.
Hi Donald,
The Chinese practiced something that can best described of as “needling.” The business about “energy” was invented by a Frenchman named Morant about 100 years ago (http://www.sciencebasedmedicine.org/the-forefather-of-acupuncture-energetics-a-charlatan/). He mis-translated actual Chinese medical texts and swapped words like “blood vessels” for all this made-up business about energy flow in the body. China banned needling, due to its inefficacy, shortly before Morant introduced to Europe what we now call “acupuncture.” It’s just Morant’s twisted misunderstand of needling. When the Chinese abandoned such fake medicine and embraced science-based health systems, they doubled their lifespans in less than 100 years (from about 30 years to just over 70 years).
There is no reliable scientific evidence that acupuncture can treat serious illness, and for very subjective disorders (like “pain,” which cannot be objectively measured yet by a medical device) it works, but no better than placebo (sham acupuncture, where all the ritual occurs but no actual skin penetration of the needle happens – although the patient doesn’t know that, so they think they are getting “the real deal.”) Go check out reviews in the medical literature (meta-analyses) of acupuncture studies to see these results; please only use peer-reviewed, well-established medical journals. There are lots of fake medical journals created by acupuncture supporters that only ever get the results they seek. That is pseudoscience.
There is a real medical effect – the placebo effect – well-documented, well-established, and used routinely in studies of new medical treatments to test their claims. People who believe they are receiving a serious medical intervention can, but unreliably so, get better. For instance, two saline injections (no medical benefit) have been shown to work better than 2 sugar pills (no medical benefit) in double-blind, randomized controlled medical trials. None of them is medicine, but people who get jabbed with a needle think they are receiving a stronger medical intervention and respond more favorably. Once the trick is revealed, they tend to respond far less favorably.
This is what happens with acupuncture. However, placebo is unreliable person-to-person and disease-to-disease, so the medical community doesn’t prescribe placebo as treatment because it’s highly unethical. It relies on deceiving the patient with pomp and circumstance, but no actual medicine.
I have no doubt you, a single individual, could have responded favorably to acupuncture. Lots of people every day respond favorably to non-medical interventions – that’s the power of placebo. But the science say it’s unreliable, it’s a sham, and you’re paying for fake medicine. It’s your choice to pay for it; but be aware that the best science, which has produced the best treatments for pain, lung cancer, etc. (all of which beat acupuncture handily), says acupuncture is no better than placebo for measurable diseases. You’re paying for an expensive placebo.
Sincerely,
Steve