Acupressure for Chemotherapy-Induced Nausea and Vomiting

Pressure on P6 or Wristbands to Control Nausea

Acupressure, as an ancient Chinese practice for controlling nausea, is being studied for its possible benefit in reducing chemotherapy-induced nausea and vomiting. Since these symptoms are one of the most feared side effects of chemotherapy, learning of possible benefits, even when combined with other available treatment is of great importance. Acupressure to control nausea is performed by placing pressure over a point known as P6 on the wrist.

Nausea and Vomiting With Chemotherapy

When people think of chemotherapy-induced nausea and vomiting, they may imagine days of lying on the bathroom floor after every infusion. Yet, control of these symptoms has come a very long way in recent years, and many people are able to tolerate even the most nauseating chemotherapy medications with little or no nausea. That said, researchers are looking for additional methods of controlling nausea (in addition to medications), if only to reduce the amount of anti-nausea drugs (antiemetics) required to control this symptom.

Nausea and vomiting due to chemotherapy can be better understood by thinking about the mechanism of chemotherapy drugs. These medications are "cytotoxic" which means that they are meant to destroy all rapidly growing cells, including cancer cells. Some normal cells in the body also divide rapidly, such as hair follicles (resulting in hair loss), cells in the bone marrow (resulting in low blood counts), and cells in the digestive tract (resulting in nausea and vomiting). Chemotherapy can also cause nausea through other mechanisms.

It's important to stress that methods to control nausea and vomiting are being looked as an adjunct (along with) approach to treatment. The goal in studies is not to eliminate or substitute effective medications, but to more completely control nausea or reduce the need for these medications. Unfortunately, though medications work very well to reduce or eliminate vomiting, some people still cope with nausea.

Acupressure

Acupressure is an ancient Chinese practice similar to acupuncture, in which fingers (or a device such as a wristband) are used to apply pressure to a region of the body. Some people call it "acupuncture without the needles."

The Basics

The theory behind acupressure is that by applying pressure to specific points, (called "pressure points"), symptoms such as pain or nausea are improved. For nausea, it's thought that pressure placed on a point known as P6 (pericardium 6) or Nei Guan on the underside of the wrist may alter these signals.

How to Perform Acupressure for Nausea and Vomiting

Sometimes people elect to try acupressure themselves, while others opt to see an acupuncturist who is trained in locating these points on meridians.

To find the point used for improving nausea symptoms (the point called the P6 or PC6 point), sit quietly with your palm facing up. Place your thumb in the area where your hand meets your wrist (where it bends when you flex or extend your hand), and then move 2 fingerbreadths (roughly 3/4 of an inch) up your arm towards your elbow. The P6 point is located here in the region between the 2 large tendons.

Most acupuncturists recommend placing gentle but firm pressure on this area for 30 seconds to 2 minutes and repeating the pressure up to 5 times.

Effectiveness

Overall, studies have been inconclusive in determining whether or not acupressure plays a significant role in the reduction of chemotherapy-induced nausea and vomiting.

Some studies have found no overall improvements in symptoms for people doing acupressure.

Other studies have found that acupressure has a modest effect on some aspects of nausea, and at least reduces the amount of anti-nausea medications needed to control symptoms.

There have been many studies looking at this method and several clinical trials are in progress, suggesting that there are some people who believe acupressure may help with this annoying symptom. 

Limitations of Studies

People may wonder, why, with so many studies we don't we have a solid answer to this question. Some reasons include:

  • The number of people studied in most clinical trials looking at acupressure is small.
  • There are many aspects of nausea and vomiting, including "anticipatory nausea" (nausea felt before chemotherapy), acute nausea, delayed nausea, early vomiting, late vomiting, and more. Some studies have separated out these various types of symptoms, whereas others have not.
  • Nausea is a subjective symptom making it more difficult to assess.
  • There can be a placebo effect, even in clinical trials, since a "sham" form of acupressure is used in the control group.
  • Different methods are used. Some studies have used finger pressure, whereas others have used wristbands.
  • The procedure can vary tremendously depending on the skill of the person performing acupressure.

Risks and Complications

In general, acupressure is a fairly non-invasive procedure, and only gentle pressure is applied.

Possible risks include:

  • Discomfort from the pressure.
  • Infection: Infection could be a concern if pressure is applied directly to an open wound. The person performing acupressure should wash her hands thoroughly before applying acupressure.
  • Bleeding: With chemotherapy, some people develop a low platelet count (chemotherapy-induced thrombocytopenia) which could raise the risk of bruising or bleeding. Taking blood thinners could also increase this risk. Do not use acupressure if you are prone to bleeding.
  • If someone has had lymph nodes removed from their armpit and is at risk of lymphedema, any excessive pressure to that extremity should be avoided.

Other Alternative Therapies for Nausea

In addition to “allopathic medicine” or conventional medicine options (such as medications to control nausea), there are other alternative or complementary therapies that have been evaluated for nausea and vomiting due to chemotherapy. When used in a setting in which they are combined with traditional medical treatments, these are often referred to as "integrative" treatments, and many cancer centers now offer "integrative oncology" approaches.

Some of the therapies being evaluated in addition to acupressure include:

  • Ginger: Some studies have found that ginger supplements can reduce chemotherapy-induced nausea.
  • Acupuncture: According to the National Cancer Institute, there is strong evidence that acupuncture can help with chemotherapy-induced nausea. Precautions, such as the risk of infection with a low white blood cells count or risk with bleeding due to lower platelets must be considered.

It's important to note that, in the majority of studies looking at the possible benefit of alternative therapies on nausea, these therapies were used in addition to medications for chemotherapy-induced nausea.

Other integrative approaches ranging from meditation to massage may also be considered.

A Word From Verywell

Whether or not acupressure is effective, and even though there are few risks, it is still important to talk to your oncologist about any alternative therapies you wish to try. One reason is that medicine is constantly changing, and changing more rapidly than ever before. Your oncologist may be aware of new information either supporting or refuting the benefits of this therapy, or have learned about new information on possible side effects.

Perhaps the most important reason to talk with your oncologist is that there are very good treatments available for chemotherapy-induced nausea, and it's important not to forego therapies that have been extensively studied and confirmed effective, to try treatments that are of uncertain value. Each person is different, and your oncologist needs to know your particular symptoms in order to choose the best anti-nausea treatments for you.

Was this page helpful?
Article Sources