It turns out that not all placebos are the same.
In a new study testing alternative therapies to treat hot flashes, fake acupuncture easily outperformed a sugar pill — and actually helped women even more than a real drug.
“These effects appear not only to be very powerful, but also very sustained,” said Jun Mao, the director of integrative oncology initiative at Penn and the lead author of the work. “This could be a very useful clinical effect that clinicians can harness.”
The randomized control trial specifically evaluated hot flashes in breast cancer survivors, who are prevented from taking the standard hormone replacement therapy because of their tumor history.
In the study, about 60 women received gabapentin, a drug previously shown to be effective for hot flashes, or electroacupuncture, a form of the ancient Chinese medicine incorporating small bursts of electrical current. The other half received matching placebos.
After two months of treatment, the real and fake acupuncture reduced the frequency and severity of hot flashes by 48 and 45 percent, respectively. In comparison, symptoms fell by 39 percent for those taking the drug and 22 percent for those getting the placebo pill. The patients who had received real or sham acupuncture still reported about a 50 percent improvement three months after stopping therapy.
In addition to working better than the hot flash drug, women receiving acupuncture also had fewer side effects.
The results were published in the Journal of Clinical Oncology.
The experiment was too small to definitively show that electroacupuncture worked better than the fake version, even though it outperformed the sham in two out of the three time points.
Indeed, demonstrating that acupuncture works above and beyond any placebo effects has been difficult, and hinges on an appropriate mock technique.
“Designing fake acupuncture is probably one of the most challenging parts of acupuncture research,” said Mao.
In this case, the Penn team used specialized instruments known as Streitberger needles, which act like stage daggers and retract into the handle when pushed against skin.
“From a patient’s perspective, they see the needle get shorter and so they think the needles may actually go in,” said Mao.
The points are sharp enough to pierce skin, he added, so it’s very convincing.
Based on previous surveys, Mao said as many as 50 percent of women with breast cancer express an interest in acupuncture. After successfully battling the disease, many prefer not to take any more medication.