Self-Acupressure App Reduces Fatigue in Ovarian Cancer Patients

Self-Acupressure Shows Promise in Alleviating Fatigue for Ovarian Cancer Patients

A new study published this month indicates that self-acupressure, learned through a dedicated mobile application, can significantly reduce cancer-related fatigue in women battling ovarian cancer. The research, appearing in JAMA Network Open, found that nearly 60% of women utilizing the self-acupressure technique reported no longer experiencing clinically significant fatigue. This non-pharmacological approach also demonstrated improvements in overall quality of life for participants, offering a potentially accessible and cost-effective way to manage a debilitating symptom of both the disease and its treatment.

Cancer-related fatigue is a pervasive issue affecting a substantial proportion of those undergoing cancer treatment. Approximately 250,000 women in the U.S. Are living with ovarian cancer, and prior research suggests that around 77% experience acute fatigue, with over 32% developing chronic fatigue. This symptom isn’t simply tiredness; it’s a persistent, overwhelming exhaustion that doesn’t improve with rest and can significantly impact daily functioning and well-being. It can persist even when other symptoms, like pain or sleep disturbances, are well-managed.

How Self-Acupressure Works

Self-acupressure is rooted in the principles of traditional Chinese medicine, similar to acupuncture but without the use of needles. “Acupuncture is just taking needles to key points called acupoints that are defined in Chinese medicine to be significant for improving illnesses or symptoms when stimulated,” explains Suzanna M. Zick, ND, MPH, professor in the department of family medicine at Michigan Medicine and Nutritional Sciences in the School of Public Health. “But you can stimulate acupoints with all different sorts of things… Acupressure just means you use your thumb, your finger, your elbow, or other parts of the body or a device to stimulate the exact same points by pressing on them and going in small circles.”

The study utilized the MeTime Acupressure app, which provides guided instruction on how to perform acupressure on five specific acupoints. Researchers didn’t directly teach the participants; the app served as the primary educational tool. This approach aims to empower patients to take an active role in managing their symptoms.

Study Design and Findings

The randomized trial involved 171 women with ovarian cancer who reported moderate to severe fatigue (a score of four or more on the Brief Fatigue Inventory). Participants were divided into three groups: true self-acupressure (n=58), sham self-acupressure (n=58), and usual care (n=55). The true acupressure group received a tablet with the MeTime app and a device to aid in stimulating the acupoints. The sham group used the app and device but performed acupressure on non-therapeutic points. All groups were instructed to perform acupressure for approximately 27 minutes daily over six weeks, with follow-up monitoring continuing for an additional 18 weeks.

The primary endpoint was changes in cancer-related fatigue. At week 6, women in the true acupressure group experienced a significant reduction in fatigue compared to those receiving usual care (signify difference BFI = –1.23; 95% CI, –2.17 to –0.29). This improvement was sustained at week 24 (mean difference BFI = –1.38; 95% CI, –2.36 to –0.41). Interestingly, the sham acupressure group also showed a significant reduction in fatigue compared to usual care at week 24 (mean difference = –0.97; 95% CI, –1.93 to –0.02), although the difference between the true and sham acupressure groups wasn’t statistically significant at either time point.

“I wasn’t surprised that it didn’t perform a whole lot differently from the sham,” Zick said. “We’ve seen that repeatedly in acupuncture and acupressure studies. You’ll get a bit of a boost from having remarkably specific points vs. Nonspecific points, but we know that anytime you stimulate points on the body, it changes how the brain is organized.”

Beyond fatigue reduction, the true acupressure group also reported significantly improved quality of life compared to the usual care group at both week 6 (57.5% vs. 30%; OR = 2.85; 95% CI, 1.2-6.8) and week 24 (56.8% vs. 33.3%; OR = 2.63; 95% CI, 1.07-6.45). A substantial proportion – 58.5% at week 6, and 56.8% at week 24 – in the true acupressure arm were no longer experiencing clinically significant fatigue.

Understanding the Results: Placebo and Beyond

The finding that both true and sham acupressure showed benefits compared to usual care highlights the potential role of placebo effects and the body’s inherent capacity for self-regulation. The act of self-care, focused attention, and the belief in a treatment can all contribute to symptom improvement. However, the greater magnitude of benefit observed in the true acupressure group suggests that there may be specific physiological effects associated with stimulating the correct acupoints. Further research is needed to elucidate the underlying mechanisms.

Researchers acknowledge limitations of the study, including a lack of diversity in the participant cohort (86% white) and a higher dropout rate in the acupressure arms (29% in true acupressure, 22% in sham, 7% in usual care). These factors could limit the generalizability of the findings.

Implications for Patient Care and Future Research

This study adds to a growing body of evidence supporting the use of complementary therapies, such as acupuncture and massage, music therapy, and personalized light exposure, to manage cancer-related fatigue. The accessibility and low cost of self-acupressure make it a particularly appealing option for patients.

Zick emphasizes the need for further research to understand the mechanisms of action and to explore the effectiveness of self-acupressure in other cancer populations. She also highlights the importance of improving implementation strategies, including educating healthcare professionals and finding ways to integrate evidence-based mobile apps into routine clinical practice. “When you place an app out there, unless you have an award-winning game, people just don’t know about it,” Zick noted. “Different ways of getting evidence-based mobile apps that have positive impacts on patients need to happen.”

Suzanna M. Zick, ND, MPH, can be reached at [email protected].

Looking ahead, the focus will be on refining these interventions and ensuring they are readily available to those who could benefit most. The integration of digital health tools, like the MeTime app, represents a promising step towards empowering patients to actively manage their symptoms and improve their quality of life during and after cancer treatment.