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Using Acupressure to Manage Anxiety, Depression, and Pain in Breast Cancer Survivors: An Interview With Suzanna Zick, ND, MPH

Suzanna M. Zick, ND, MPH

Breast cancer survivors are at an increased risk of developing a myriad of symptoms, including anxiety, depression, pain, and fatigue. Acupressure has been practiced for thousands of years as part of traditional Chinese medicine. In a recent study, Suzanna Zick, ND, MPH, and colleagues have demonstrated that acupressure decreases symptoms of depression, anxiety, pain, and fatigue in breast cancer survivors. In an interview with i3 Health, Dr. Zick spoke about these findings and discussed ways to integrate acupressure treatment into cancer supportive care.

Can you talk about the scope of the problem of anxiety, depressive symptoms, and pain in breast cancer survivors?

Suzanna Zick, ND, MPH: For all of those symptoms, there is a higher incidence in breast cancer survivors than you would find in age- and gender-matched individuals in the general population. If you compare those who do not have breast cancer to those who do have breast cancer, women with breast cancer have higher rates of chronic pain, anxiety, and depression. To give you an idea of how much higher the rates are, you're talking anywhere from two to four times higher.

Why do you think acupressure is more effective than standard care in reducing these symptoms?

Dr. Zick: We're not entirely sure, but we have done studies looking at the brains of women who are fatigued who have used our different types of acupressure. We do a procedure called functional magnetic resonance spectroscopy (fMRS) that uses magnetic resonance imaging (MRI) to study brain metabolism. This method allows you to measure the levels of neurochemicals in the brain. In our study, we looked at neurochemicals in the brains of participants before they had done any type of acupressure, and then we looked at them six weeks later after they've finished acupressure. We found that levels of the most common excitatory neurotransmitter in your brain, glutamate, decreases. Changes in levels of glutamate impact how your brain connects, and these connections within your brain are what's really important to symptoms like pain, fatigue, anxiety, and depression. We know that the acupressure is associated with changes in brain connectivity, and these changes in connectivity are associated with decreasing symptoms such as fatigue.

Could acupressure also serve as a preventative treatment for these symptoms?

Dr. Zick: It might, but we don't know yet. We have a pilot study that we are going to be starting that actually looks at that question.

What are the most challenging aspects of incorporating acupressure into patients' lives?

Dr. Zick: I would say the most challenging thing is having the time to do the acupressure treatments. It takes right around half an hour a day. You have to carve out that half an hour for the six weeks. Some women's lives are very busy, so they can find that difficult.

What questions about acupressure do you commonly encounter from patients and caregivers?

Dr. Zick: I think most of the questions we get are: where are the points? How long should I stimulate the points? When will I begin to notice an improvement of symptoms if it's working? We also do get questions about what's the best way to apply the pressure to the points—is it with fingers or thumbs?

What steps are needed to begin incorporating acupressure into treatment in more cancer care centers around the country?

One thing that we have done is develop an app for breast cancer survivors called MeTime Acupressure that can actually teach a patient how to do the acupressure intervention. It's available on the Apple Store and Google Play. If patients were seeing their oncologist or even their primary care provider or the nurse practitioner in the oncologist's office, health care providers could easily give that to them as a prescription, or they could download it and use it themselves.

About Dr. Zick

Suzanna M. Zick, ND, MPH, is a Research Associate Professor in the University of Michigan Department of Family Medicine and Nutritional Sciences. Dr. Zick is currently the Co-Director of the Integrative Family Medicine Program at the University of Michigan. Her research interests include evaluation of complementary and integrative medicine for the prevention, treatment, and control of symptoms of cancer treatment and cancer survivorship.

For More Information

Zick SM, Sen A, Hassett AL, et al (2019). Impact of self-acupressure on co-occurring symptoms in cancer survivors. JNCI Cancer Spectrum, 4(2). DOI:10.1093/jncics/pky064

Image courtesy of Chronic Pain & Fatigue Research Center at University of Michigan

Transcript edited for clarity. 

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