Acupuncture & risk of lymphoedema

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Has anyone ever been offered acupuncture in the arm at risk of lymphoedema? And have you taken it? With what effects?

I was diagnosed in Oct 07 and finished treatment a year ago (6xFEC; WLE; mastectomy; 6xTaxotere; radiotherapy). Now on tamoxifen and back at work.

I started a course of acupuncture in September, with the intention of increasing my energy levels. It is very helpful for fatigue as well as hot flushes. The holistic nature of Chinese medicine lends itself to dealing with a range of problems and the acupuncturist is very keen to sort out the various side effects I’m living with at the moment, including joint pains, menopausal symptoms and fatigue.

One of these is stiffness and pain in my shoulder, which the acupuncturist is confident he could treat by putting needles in my affected arm. He has consulted some senior colleagues who suggest that it is safe to use acupuncture needles in an “at risk” arm as they would be so superficial (in comparison with IV needles, insect bites and so on). But having avoided lymphoedema so far, I am reluctant to let him do so without evidence that acupuncture carries a low risk. On the other hand, I might be denying myself something that could make a significant improvement to my life.

So this is a very long and rambling request to anyone who has had acupuncture - I would be really interested to hear of your experiences. I have a good relationship with the acupuncturist who has been fine about avoiding the affected arm. So far it’s been such a positive experience for me and I want to get as many benefits as I can from it.

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I have had acupuncture and the needles are placed very slightly in the skin that they don’t even cause bleeding. I am not an expert at all, but from my experience I would doubt they would affect your arm as they are so superficial, unlike an vaccination, for example which penetrates the skin and goes into the muscle which clearly is not good for lymphoedema. The benefits of acupuncture helping your mobility is probably much less risky than an arm that is stiff to use and therefore more likely to suffer from swelling etc.

Acupuncture is a ancient treatment and well recognised to be beneficial for certain conditions. I had it done just after surgery and as with most alternative therapies, it is really hard to know if they “work” but I felt much better whilst having it. If you have a registered practitioner from a reputable college, I believe they have to do many years training so will be well informed about contraindications.

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Hi Frannie

I understand that acupuncture in an ‘at-risk’ arm is not recommended.

The reason is that it doesn’t really matter how big the needles are or how deep they go; the risk comes from puncturing the skin - your main barrier to infection.

Any break in the continuity of the skin gives airborne bacteria the opportunity to enter - and enter at points where your lymphatic system is already compromised.

The (LSN) Lymphoedema Support Network lymphoedema.org/lsn), the British Lymphology Society (thebls.com) or your local NHS lymphoedema clinic might be able to give you more detailed advice. You might also find this link interesting:

breastcancer.org/treatment/comp_med/ask_expert/2007_03/question_09.jsp

I think stiffness and pain in the shoulder is a recognised side effect from bc treatment, which doesn’t mean you have to just put up with it, of course. Have you thought about consulting a private physio who specialises in hands, arms and shoulders?

However, you do need to make sure that anyone who treats you understands just what is and isn’t good practice with an ‘at-risk’ arm. And you have to stand your ground if they want to do something that you yourself already know could lead to problems. Printing out the NHS guidelines on lymphoedema avoidance and taking them with you can be helpful.

That said, I think the risk is small, but very real. You don’t want to be in the unlucky minority.

Lymphoedema awareness, even among medical people, is poor. Surgeons and oncologists (two groups you might have expected better of) often know very little about it too, especially in terms of risk avoidance or management.

As someone with bilateral lymphoedema who is just getting over my first (and last, I sincerely hope) attack of cellulitis (got in through a fingernail, I think), I wouldn’t wish any of this on anyone…

X

S

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Thank you both for your replies. My instinct is to continue to refuse unless he can show me evidence of its safe use, and just carry on with the treatment in other areas.

Thanks again

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Hi Frannie,

You’ve already had some good advice from Bahons….just wanted to add that I had several sessions of acupuncture to help with the side effects of chemo. (I’d had an SNB with 5 nodes removed.) This was at the BC Haven in London.

The acupuncturist there is quite well regarded and he certainly helped me. Anyway, he never went anywhere near my affected arm. I got the feeling that he just saw it as a challenge which he had to work around….obviously women at risk of lymphoedema make up a big percentage of his clients.
Also, we had a discussion about different ‘styles’ of acupuncture. His style follows Japanese teachings which he said was a bit more refined than the more common Chinese style…so maybe you could try getting a second opinion form anther therapist? Good luck…I’m thinking about having some more sessions as I’ve got some the same issues as you…let us know how you get on!

Lomalinda x

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I also had acupuncture during and after chemo and the lovely Chinese lady that did it didn’t use my affected arm during the sessions.

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Hi Frannie

I’ve been having acupuncture but not in my ‘at risk’ arm. In fact I’ve not had in either arm as I’d had a blood clot in the other arm. I asked my acupuncturist if this caused her problems. She said it didn’t because they can always work on the meridiens in other parts of the body.

My gut feeling is not to take the risk. I’m having physio via my GP practice for back, neck and shoulder stiffness and will probably have acupuncture from my physio there. Again not in my ‘at risk’ arm.

take care
Elinda x