Non-Drug Therapy For Chemotherapy-Related Nausea Gets The Go Ahead For Large UK Trial

Main Category: Cancer / Oncology
Article Date: 23 Sep 2008 - 4:00 PDT

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The largest trial worldwide to assess the use of Sea-Band© acupressure wrist bands* for chemotherapy-related nausea, will start next month (October). The first of its kind to run in the NHS, the study is funded by the National Institute for Health Research Health Technology Assessment (NIHR HTA) programme.

75% of patients undergoing chemotherapy experience related nausea which negatively impacts on their quality of lifei, and this trial led by Professor Alex Molassiotis, specialist in cancer and supportive care at the University of Manchester, aims to provide improved control of this debilitating symptom through a drug-free addition to current anti-emetic therapy.

The multi-centre study of around 700 patients will measure the cost and clinical effectiveness of acupressure wrist bands in reducing and controlling nausea in men and women over 16 years of age, diagnosed with any type of cancer and undergoing chemotherapy. This will provide a definitive measure of which patient groups gain most benefit from the intervention.

Professor Molassiotis says 'This study may well provide the clinical and cost benefit data to support a NICE (National Institute for Clinical Excellence) recommendation. NICE have come under recent scrutiny, particularly in the area of cancer care, for their evaluation of new pharmaceutical treatments which are often very expensive. However, the acupressure wristbands may be a low cost, high benefit alternative with positive outcomes for both patients, carers and the NHS.'

'We are optimistic that we will find a significant benefit, given my recent pilot study in breast cancer patientsii showed a 43% reduction in chemotherapy-related nausea and vomiting when using acupressure wristbands as opposed to using anti-emetic drugs alone. It will allow patients to take more control of their symptom management and remove the need for additional drugs, where drug side effects are already problematic,' continues the Professor.

Developments in anti-emetic drugs have decreased the vomiting suffered by chemotherapy patients but nausea remains a debilitating and poorly controlled symptom. Patients rank nausea and vomiting amongst the most distressing chemotherapy side effects.iii,iv In some cases, poorly controlled symptoms can lead to patients stopping potentially curative treatment.v 'These symptoms have a very negative impact on a patient's quality of life. They contribute towards a loss of social life and prevent people from working. Through what is an already stressful period, this can lead to anxiety and depression. We look forward to the results and hope acupressure wristbands will provide welcome relief for this hard to manage symptom,' concludes Professor Molassiotis.

In addition to the personal impact, there are wider economical implications. Current anti-nausea medications are often expensive and mainly administered in a medical setting by a qualified healthcare professional. The medications have potential side effects that may initiate further consultations with a healthcare professional and subsequent management of these new symptoms. All of which has a substantial cost implication to the health service.

2 million people in the UK have been diagnosed with cancervi and over a quarter million people are newly diagnosed each year. vii Cancer patients undergoing chemotherapy have on average six cycles of the chemotherapy treatment, and approximately 75% will experience chemotherapy related nausea.

Data will be drawn from four universities and nine regional cancer centres led by the University of Manchester team with input from Dr Adam Garrow (Salford University), Professor Marie-Lloyd Williams (University of Liverpool) and Professor Janet Richardson (University of Plymouth).

Notes

- *Worn around the wrist, the Sea-Band© acupressure wristband exerts a constant, gentle pressure on a point on the inner wrist called the Pericardium 6 (P6) acupressure point. Some of the leading cancer patient support groups, such as Cancer Research UK, recognise the use of Sea-Band© for alleviating post-chemotherapy nausea. Acupressure is often recommended as an adjunct therapy; evidence is promising but not conclusive

- Sea-Band© was granted clearance by the FDA for the relief of motion sickness, morning sickness and post chemotherapy and post-operative nausea in 2004

- Drug-free, latex-free Sea-Band© does not cause side effects or interact with other anti-emetic medicines and is safe for patients taking prescription medications, pregnant women and children from aged three upwards. Used before or after symptom onset, Sea-Band© acupressure wristbands can reduce nausea within as little as five minutes.

- Sea-Band© is available from Lloydspharmacy, Superdrug, Tesco, Sainsbury, Waitrose, Morrisons, other pharmacies, and Penny Brohn Cancer Care (http://www.pennybrohncancercare.org). The recommended price is £7.99.

The HTA programme is a programme of the National Institute for Health Research (NIHR) and produces high quality research information about the effectiveness, costs, and broader impact of health technologies for those who use, manage and provide care in the NHS. It is the largest of the NIHR programmes and publishes the results of its research in the Health Technology Assessment journal, with over 400 issues published to date. The journal's 2007 Impact Factor (3.87) ranked it in the top 10% of medical and health-related journals. All issues are available for download free of charge from the website, http://www.hta.ac.uk The HTA programme is coordinated by the NIHR Coordinating Centre for Health Technology Assessment (NCCHTA), based at the University of Southampton.

To view the full details of this project visit http://www.hta.ac.uk/1723

References

i Roscoe JA, Morrow GR, Bennett JM, et al: Updates from a 7-year monitoring study of chemotherapy induced anticipatory and posttreatment nausea and vomiting. University of Rochester Cancer Center Second Annual Scientific Symposium, p 50, 1997.

ii Molassiotis A, Helin AM, Dabbour R, Hummerston S. The effects of P6 acupressure in the prophylaxis of chemotherapy-related nausea and vomiting in breast cancer patients. Complementary Therapies in Medicine, 2007,15;3-12.

iii Griffin AM, Butow PN, Coates AS, et al: On the receiving end. V: Patient perceptions of the side effects of cancer chemotherapy in 1993. Ann Oncol 7:189-195, 1996

iv Cooper S, Georgiou V: The impact of cytotoxic chemotherapy-perspectives from patients, specialists and nurses. Eur J Cancer 28A(suppl 1):536-538, 1992.

v Hoagland AC, Morrow,GR, Bennett JM, et al: Oncologists' views of cancer patient noncompliance. Am J Clin Oncol 6:239-244, 1983

vi Maddams J, Moller H and Devane C., Cancer prevalence in the UK, 2008 Thames Cancer Registry and Macmillan Cancer Support, 2008

vii http://publications.cancerresearchuk.org/WebRoot/crukstoredb/CRUK_PDFs/mortality/IncidenceMortalitySummaryRates.pdf (Accessed September 2008).

Health Technology Assessment