Japanese Acupuncture and Moxibustion Eases Nerve Pain in Breast Cancer Survivors

For millions of breast cancer survivors, the end of chemotherapy does not mark the end of treatment. Long after the last infusion of a taxane drug such as paclitaxel or docetaxel, many women continue to live with chemotherapy-induced peripheral neuropathy, or CIPN, a painful and often disabling condition caused by damage to the peripheral nerves. Now, a team of Japanese researchers has reported promising preliminary evidence that a traditional, multimodal form of acupuncture and moxibustion may reduce this persistent nerve pain, offering a potential non-drug option for a condition that currently has no established treatment.

The study, led by Hiroto Ishiki of the Department of Palliative Medicine at the National Cancer Center Hospital in Tokyo and published in the journal Supportive Care in Cancer, examined a program the researchers call multimodal Japanese-style acupuncture and moxibustion, abbreviated MJAM. Unlike a single-technique acupuncture session, MJAM is a composite intervention that weaves together several distinct components: filiform needle acupuncture, in which fine needles are inserted into the skin; non-insertive needle therapy using a Teishin, a blunt instrument pressed against the skin without puncturing it; motion-style acupuncture, in which needling is combined with guided movement of the affected limb; indirect moxibustion, which applies the gentle heat of burning mugwort above the skin; hot pack application; and structured self-care instruction that patients continue at home.

The rationale for testing such a program rests on a substantial body of evidence suggesting that acupuncture can modulate chronic pain. Individual patient data meta-analyses have shown that acupuncture outperforms both sham procedures and usual care for chronic musculoskeletal pain, and systematic reviews have associated acupuncture and acupressure with improved cancer pain outcomes. Yet the picture for CIPN specifically has remained murky. Randomized trials of acupuncture for CIPN, including a large sham-controlled trial published in JAMA Network Open, have produced mixed results, and international guidelines from ASCO and ESMO currently offer few validated options for treating established CIPN, with duloxetine being one of the only pharmacological approaches supported by randomized evidence.

To explore whether the Japanese multimodal approach might help, the researchers conducted a single-center, single-arm study at the National Cancer Center Hospital. They enrolled women who had completed curative treatment for stage I to III breast cancer at least three months earlier and who were experiencing moderate to severe taxane-related CIPN pain, defined as a score of 4 or greater on item 5 of the Brief Pain Inventory, a validated instrument that asks patients to rate their average pain on a scale from 0 to 10. Between October 2022 and April 2024, 30 women with a median age of 58.0 years joined the study. On average, these patients were not fresh out of chemotherapy: the median time since completing treatment was 2.47 years, meaning their neuropathy had become a chronic, entrenched problem rather than a transient side effect.

Each participant received 12 weekly sessions of the standardized MJAM program, delivered over roughly three months. The researchers then tracked outcomes through week 16, four weeks after the final session, to see whether any benefit would persist beyond the treatment period itself. The primary endpoint was the change in the Brief Pain Inventory item 5 score, the patient’s rating of average pain, from baseline to week 16. At the start of the study, the mean baseline score was 5.3, with a standard deviation of 1.7, indicating that most participants were living with pain that was more than moderate on a daily basis.

The results showed a clear and statistically significant decline in pain over the course of the program. At week 4, after roughly a month of sessions, the mean change from baseline was only −0.1 points, a difference that could easily have arisen by chance, with a 95 percent confidence interval ranging from −0.6 to 0.3 and a p-value of 0.56. But by week 8, the mean reduction had grown to −0.7 points, a change that reached statistical significance. By week 12, the mean reduction was −1.1 points, and at the primary endpoint of week 16 it stood at −1.2 points, with a 90 percent confidence interval of −1.7 to −0.8 and a p-value below 0.0001. Notably, the benefit continued to accrue after the final session, suggesting that the effects of the program did not evaporate the moment treatment stopped.

The magnitude of the improvement matters as much as its statistical significance. In chronic pain research, the consensus recommendations from the IMMPACT initiative suggest that a reduction of roughly one point on a 0-to-10 pain scale can be clinically meaningful, and a drop of about 1.2 points on the Brief Pain Inventory average pain item approaches the thresholds often considered clinically important. For patients whose pain had persisted for more than two years after chemotherapy, a sustained reduction of this size, achieved without adding any new medication, represents a meaningful shift in daily comfort, even if it does not amount to a cure.

Safety and feasibility were equally central to the study’s conclusions. Twenty-eight of the 30 participants, or 93.3 percent, completed all 12 sessions, an adherence rate that speaks to the tolerability of the program and the practicality of weekly visits. Adverse events were uncommon and uniformly mild: nine participants, or 30.0 percent, experienced grade 1 events, the lowest severity category, with no serious harms reported. For a population of cancer survivors who are often wary of adding further interventions to their care, this safety profile is an important part of the story.

The researchers are careful to frame these findings as preliminary rather than definitive. Because the study was single-arm, with no control group, there is no way to rule out explanations such as the natural course of the condition, regression to the mean, or a strong placebo response, all of which are particularly relevant in pain research, where patient expectations can powerfully shape reported outcomes. The relatively small sample of 30 women and the single-center design further limit how far the results can be generalized. What the study does establish is that MJAM is safe, feasible, and associated with a reduction in pain severe enough to justify the confirmatory randomized clinical trial that the authors say is warranted.

Even so, the trial occupies an important position in a growing research landscape. Electroacupuncture trials for taxane-induced neuropathy are underway, pragmatic trials of acupuncture added to standard care have shown signals of benefit, and dose-response meta-analyses are beginning to explore how the timing and frequency of acupuncture sessions influence outcomes in CIPN. Integrative oncology guidelines from the Society for Integrative Oncology and ASCO already encourage the consideration of acupuncture for pain management in cancer care. If a rigorous randomized trial confirms what this exploratory study suggests, a centuries-old Japanese practice, refined with modern standardization and delivered alongside self-care education, could become a genuine option for the many breast cancer survivors whose nerve pain has, until now, had nowhere to go.

Subject of Research: Multimodal Japanese-style acupuncture and moxibustion as a treatment for taxane-related chemotherapy-induced peripheral neuropathy in breast cancer survivors

Article Title: Multimodal Japanese-style acupuncture and moxibustion for taxane-related chemotherapy-induced peripheral neuropathy in breast cancer survivors

Article References: Ishiki, H., Satomi, E., Matsuoka, H., Arakawa, S., Kawasaki, N., Horiguchi, Y., Takahashi, A., Takagi, T., Kobayashi, S., Oyamada, S., Ariyoshi, K., Kihara, K., Suto, A., Murata, T., & Takayama, S. (2026). Multimodal Japanese-style acupuncture and moxibustion for taxane-related chemotherapy-induced peripheral neuropathy in breast cancer survivors. Supportive Care in Cancer, 34(10), Article 997. https://doi.org/10.1007/s00520-026-11237-1

Image Credits: AI Generated

DOI: 10.1007/s00520-026-11237-1

Keywords: chemotherapy-induced peripheral neuropathy, breast cancer, acupuncture, moxibustion, taxanes, pain management, survivorship, integrative oncology, clinical trial, non-pharmacological therapy, Brief Pain Inventory, Japan