Aug. 29, 2003 Cancer patients who expected acupressure wrist bands to ease the nausea they have from chemotherapy were much more likely to gain relief than either patients who were not given the bands or those who received them but didn't expect them to help.
That's the word from researchers at the James P. Wilmot Cancer Center, who carried out the largest scientific study yet of two products that some believe can reduce nausea. The results, which researchers say point to the power of the placebo effect, were published in the August issue of Pain and Symptom Management.
Scientists at the cancer center at the University of Rochester Medical Center compared the response in 700 cancer patients who received either two acupressure bands, an acustimulation band, or no band. Both the pressure and the stimulation bands are worn on the wrist, and several studies have shown them to be helpful in reducing nausea from seasickness, motion sickness, and morning sickness from pregnancy. The pressure band applies steady pressure to an acupuncture point on the inside of the wrist; the acustimulation band gives a mild electrical pulse to the same point. Such bands are sold at some drugstores but are not widely used in medicine.
Participants in the study wore the bands on the day of their chemotherapy treatment and the following four days. About 85 percent of the study participants were women being treated for breast cancer; most of the others had lymphoma or Hodgkin's disease.
Overall, acupressure patients reported 15 percent less nausea on the day of treatment, compared to patients who wore no band. Acupressure patients had roughly the same amount of nausea and vomiting as the others in the days following treatment.
When scientists analyzed the results more closely, they found that the acupressure bands were more helpful to patients who expected the device to ease their nausea. Patients who expected the bands to help rated their nausea 25 percent less severe than other patients on the day of treatment and approximately 13 percent less severe on subsequent days. They also reported having a higher quality of life on those days, and they used less anti-nausea medication. Acupressure patients who did not expect the bands to work did not show any benefit.
"A large number of patients who wore pressure bands found them to be quite helpful," says Joseph Roscoe, Ph.D., a research assistant professor and the leader of the study funded by the National Cancer Institute. "But we think that the effect of the pressure bands was primarily a placebo effect. It appeared that the bands themselves did little or nothing, just as a placebo pill does nothing by itself."
While there have been several studies noting positive anti-nausea results from pressure and stimulation bands, Roscoe had long wondered whether the effects could be due to the placebo effect – an improvement in a patient's condition from a treatment with no scientific basis for success.
"I think every physician understands that what your patient believes will happen is important. Most physicians try to set up as positive an expectancy as possible while still being realistic," says Roscoe. "It's good for the patient if you can make use of the placebo effect."
Among patients who received an acustimulation band, men but not women had less nausea on the day of treatment, and less nausea and vomiting overall. However, the study included a total of only 55 men, not enough to draw meaningful conclusions.
In addition to Roscoe, other authors from the Cancer Control Program of the Wilmot Cancer Center include Gary R. Morrow, Ph.D., Peter Bushunow, M.D., and Jane T. Hickok, M.D. The study was done through the Community Clinical Oncology Program, which specializes in improving the quality of life of people who have cancer by studying the symptoms of cancer and the side effects of treatment. The program is funded by the National Cancer Institute and is based at the university's James P. Wilmot Cancer Center.
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