How much does acupuncture actually reduce nausea and vomiting?
The evidence shows that acupuncture provides a modest but real benefit when added to standard antiemetic drugs. A 2023 systematic review of 38 randomized trials with 2,503 patients found that adding acupuncture to usual care increased the complete control of acute vomiting (no vomiting and only mild nausea or less) by 13% (risk ratio 1.13) and delayed vomiting by 47% (risk ratio 1.47) compared to usual care alone [1]. This means that for every 100 patients receiving usual care, about 13 more would achieve complete control of acute vomiting if acupuncture were added. However, the certainty of this evidence was rated as low or very low due to study limitations.
A 2024 multicenter trial of 115 patients tested acupuncture at the P6 point (on the inner forearm, a classic anti-nausea point) and auriculotherapy (ear acupuncture) against usual care alone. All patients were already on optimal antiemetic drugs. At 24 hours after chemotherapy, acupuncture reduced nausea intensity by about 1.5 points on a 0–10 scale compared to usual care (p=0.008) [4]. The combination of acupuncture and auriculotherapy also reduced delayed nausea (p=0.023). Neither treatment reduced vomiting episodes significantly, but they did lower the severity of nausea that did occur.
Which type of acupuncture works best for chemotherapy nausea?
Both traditional body acupuncture and auricular (ear) acupuncture appear effective, and combining them may offer extra benefit. A 2024 complex network analysis of 489 studies found that the most common and effective acupoints for chemotherapy-induced nausea and vomiting are ST36 (on the lower leg) and PC6 (on the inner forearm) [6]. For manual acupuncture, adding CV12 (on the abdomen) also improved results. For electro-acupuncture, PC6 and ST36 were the key points. The study noted that manual acupuncture seemed better for nausea, while electro-acupuncture was more effective for vomiting.
A 2024 clinical validation study of an auricular acupuncture protocol (using points on the ear) showed that it reduced the incidence, frequency, severity, and length of nausea and vomiting after chemotherapy, as well as anticipatory nausea [3]. The protocol was developed with expert consensus (85.7–100% agreement) and tested in patients, but the authors note it still needs larger randomized trials. The 2024 multicenter trial found that auriculotherapy alone reduced acute nausea intensity as effectively as body acupuncture, and the combination of both was even better for delayed nausea [4].
Is acupuncture safe for chemotherapy patients, and who should consider it?
Acupuncture is very safe for cancer patients, with only minor side effects reported. In the 2024 multicenter trial, no serious adverse events were attributed to acupuncture or auriculotherapy [4]. A 2023 trial of acupuncture for pain in advanced cancer patients (298 participants) reported only mild bruising in 6.5% of acupuncture patients and transient soreness in 15.1% of massage patients [2]. The same study showed that both acupuncture and massage improved fatigue, insomnia, and quality of life over 26 weeks, suggesting broader benefits beyond nausea.
Acupuncture is worth considering for patients who still experience nausea despite taking standard antiemetic drugs. The evidence is strongest for acute nausea (within 24 hours of chemotherapy) and delayed vomiting (days 2–5). A 2026 meta-analysis of 58 trials on highly emetogenic chemotherapy found that acupuncture improved the complete control rate of nausea and vomiting overall by 54% (risk ratio 1.54) [5]. However, the authors caution that most studies had a high risk of bias and the evidence is not yet conclusive. Patients should discuss acupuncture with their oncologist to ensure it fits with their treatment plan and to find a qualified practitioner experienced with cancer patients.
Sources used in this answer
Acupuncture for the prevention of chemotherapy‐induced nausea and vomiting in cancer patients: A systematic review and meta‐analysis
Acupuncture plus usual care increased complete control of acute vomiting by 13% (RR 1.13) and delayed vomiting by 47% (RR 1.47) in a meta-analysis of 38 RCTs with 2,503 patients, though evidence certainty was low.
Acupuncture vs Massage for Pain in Patients Living With Advanced Cancer
In 298 advanced cancer patients, both acupuncture and massage reduced worst pain by about 2.5–3 points on a 0–10 scale over 26 weeks, with no significant difference between them; side effects were mild (bruising 6.5%, soreness 15.1%).
Development and Validation of an Auricular Acupuncture Protocol for the Management of Chemotherapy-Induced Nausea and Vomiting in Cancer Patients
An auricular acupuncture protocol developed with expert consensus (85.7–100% agreement) reduced the incidence, frequency, severity, and length of chemotherapy-induced nausea and vomiting in clinical validation.
Auriculotherapy and acupuncture treatments for chemotherapy-induced nausea and vomiting: a multicenter clinical trial
In 115 patients on optimal antiemetics, acupuncture and auriculotherapy each reduced acute nausea intensity by about 1.5 points on a 0–10 scale at 24 hours (p=0.008 and p=0.007), and their combination also reduced delayed nausea (p=0.023).
Acupuncture for nausea and vomiting induced by highly emetogenic chemotherapy: a systematic review and meta-analysis.
A meta-analysis of 58 RCTs found acupuncture improved the complete control rate of nausea and vomiting from highly emetogenic chemotherapy by 54% (RR 1.54), but most studies had high risk of bias and evidence was insufficient to be conclusive.
Discovering different acupoint combinations of manual or electro-acupuncture to treat chemotherapy-induced nausea and vomiting based on the complex networks analysis
A complex network analysis of 489 studies identified ST36 and PC6 as the most common and effective acupoints for chemotherapy-induced nausea and vomiting, with manual acupuncture better for nausea and electro-acupuncture better for vomiting.