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A frequently asked question by patients undergoing cancer treatment is, "Can acupuncture help me?"

The issue then becomes: is there a place for acupuncture in the vast field of cancer with its diverse treatment modalities?

"Vast" since cancer is not one disease but over 300 different malignancies, each with its own unique histology, patho-physiology, and clinical behavior. 'Diverse" because of the different chemotherapeutic classes of agents, hormonal agents, types of High-energy particle beam generators, and various delivery systems for radiation treatment. "Diverse" also because it encompasses various types of surgical procedures, nutritional support, and the body-mind holistic approach.

The late 1970s saw the emergence of the holistic health care movement in this country. Holistic practice (holism comes from the Greek word "holos" or "whole") emphasized an attention to the whole person, including the physical, spiritual, psychological, and ecological dimensions of healing. Holistic health care incorporates practices and concepts of Eastern philosophy and diverse cultural traditions, including acupuncture and the use of herbs, massage, and relaxation techniques as well as conventional medical practices.26 It gained its greatest following among nurses.

However, many physicians, particularly those in the new specialty of family medicine, also became interested in this movement. The American Holistic Medical and Nurses Associations were formed, large professional and public conferences held, and a number of holistic medical clinics and holistic health centers opened.

Many studies in animals and humans have demonstrated that acupuncture can cause multiple biological responses. These responses can occur locally, i.e., at or close to the site of application, or at a distance, mediated mainly by sensory neurons to many structures within the central nervous system. This can lead to activation of pathways affecting various physiological systems in the brain as well as in the periphery.

A focus of attention has been the role of endogenous opioids in acupuncture analgesia. Considerable evidence supports the claim that opioid peptides are released during acupuncture and that the analgesic effects of acupuncture are at least partially explained by their actions. That opioid antagonists such as naloxone reverse the analgesic effects of acupuncture further strengthens this hypothesis. Stimulation by acupuncture may also activate the hypothalamus and the pituitary gland, resulting in a broad spectrum of systemic effects.

Alteration in the secretion of neurotransmitters and neurohormones and changes in the regulation of blood flow, both centrally and peripherally, have been documented. There is also evidence of alterations in immune functions produced by acupuncture. Which of these and other physiological changes mediate clinical effects is at present unclear.

Despite considerable efforts to understand the anatomy and physiology of the "acupuncture points," the definition and characterization of these points remain controversial. Even more elusive is the scientific basis of some of the key traditional Eastern medical concepts such as the circulation of Qi, the meridian system, and other related theories, which are difficult to reconcile with contemporary biomedical information but continue to play an important role in the evaluation of patients and the formulation of treatment in acupuncture.