title: Acupoint stimulation, massage therapy and expressive writing for breast cancer: A systematic review and meta-analysis of randomized controlled trials.
abstract: Researches have accumulated using non-pharmacologic interventions including acupoint stimulation, massage therapy and expressive writing to manage breast cancer-related symptoms. Results from randomized controlled trials (RCTs) can get contradictory.
  
  
  OBJECTIVE
  A systematic review and meta-analysis were conducted to determine the effects on the quality of life, negative emotions and disease-related symptoms among women with breast cancer.
  
  
  METHODS
  Two independent researchers performed a structured search using data sources including MEDLINE, CINAHL, Cochrane Central Register of Controlled Trials, EMBASE, PubMed and PsychINFO from the beginning of time until the first week of January 2015. A total of 23 acupoint stimulation, massage therapy and expressive writing RCTs were included in the review.
  
  
  RESULTS
  The study showed that no single intervention could be put under the spotlight exhibiting an overall effective result on all measured outcomes; however, looking into each one in detail shows different results in specific outcomes. Among the three interventions, acupoint stimulation has a treatment effect for general pain (MD=-1.46, 95% CI=-2.38 to -0.53) and fatigue (MD=-2.22, 95% CI=-3.68 to -0.77), massage therapy has a treatment effect for anxiety (MD=-0.50, 95% CI=-0.77 to -0.24), and expressive writing has a treatment effect for quality of life (MD=7.18, 95% CI=0.38 to 13.98). The measurement other outcomes showed either ineffective or equivocal results.
  
  
  CONCLUSIONS
  Non-pharmacologic interventions including acupoint stimulation, massage therapy and expressive writing have an effect on a middle-age woman with breast cancer. However, because of limitations, the seemingly promising results should be interpreted with caution.
authors: School of Nursing, College of Nursing, National Taipei University of Nursing and Health Sciences, No. 365 Min-Te Road, Taipei 11219, Taiwan, ROC. Electronic address: phoebeelee@gmail.com.
authors: Phoebe Lyssandra Tan
authors: PL
authors: Lee
authors: Department of Surgery, School of Medicine, College of Medicine, Taipei Medical University, Taiwan, ROC; Division of General Surgery, Department of Surgery, Taipei Medical University-Shuang Ho Hospital, No. 250, Wu-Hsing Street., Wu-Hsing District, Taipei 11031, Taiwan, ROC. Electronic address: kelvintam@h.tmu.edu.tw.
authors: Ka-Wai
authors: KW
authors: Tam
authors: Graduate Institute of Integration of Traditional Chinese Medicine with Western Nursing, College of Nursing, National Taipei University of Nursing & Health Sciences, No. 365, Min-Te Road, Taipei 11219, Taiwan, ROC. Electronic address: meiling@ntunhs.edu.tw.
authors: Mei-Ling
authors: ML
authors: Yeh
authors: School of Nursing, College of Nursing, National Taipei University of Nursing and Health Sciences, No. 365 Min-Te Road, Taipei 11219, Taiwan, ROC. Electronic address: weiwen@ntunhs.edu.tw.
authors: Wei-Wen
authors: WW
authors: Wu
mesh_terms: D015669:Acupuncture Points; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000503:physiopathology* / Q000523:psychology*; D005260:Female; D006801:Humans; D008405:Massage / Q000523:psychology*; D008875:Middle Aged; D016032:Randomized Controlled Trials as Topic; D014956:Writing
keywords: Acupoint stimulation; Anxiety; Breast cancer; Expressive writing; Massage therapy; Meta-analysis; Pain; Quality of life; Systematic review