Acupuncture Shows Promise for Treating Cognitive Impairment in Breast Cancer Survivors
Key Insights
A phase II clinical trial found that real acupuncture (search) significantly improved both perceived and objective cognitive function in breast cancer (search) survivors experiencing "brain fog (search)" or "chemo brain (search)."
The study enrolled 260 women with stage 0-III breast cancer (search) and compared real acupuncture (search), sham acupuncture, and usual care over 10 weeks of treatment.
While both real and sham acupuncture (search) improved patients' perceived cognitive abilities, only real acupuncture demonstrated measurable improvements on standardized cognitive tests.
A rigorous phase II clinical trial has demonstrated that acupuncture (search) can improve both perceived and objective cognitive function in breast cancer (search) survivors experiencing cancer-related cognitive impairment (search), commonly known as "brain fog (search)" or "chemo brain (search)." The ENHANCE trial results, presented at the 2025 San Antonio Breast Cancer Symposium, offer new hope for addressing a condition that affects approximately 40% of breast cancer survivors.
Study Design and Methodology
The randomized controlled trial enrolled 260 women with a mean age of 56.6 years who had completed treatment for stage 0 to III breast cancer (search). All participants reported moderate or greater cognitive difficulties and insomnia (search). The study employed a three-arm design comparing real acupuncture (search) (n=129), sham acupuncture (n=70), and usual care (n=61).
"Acupuncture (search) should be seen as a complex intervention that involves both the needling and the care being delivered," explained lead investigator Jun J. Mao, MD, MSCE, Chief of the Integrative Medicine and Wellness Service at Memorial Sloan Kettering Cancer Center. "By comparing real acupuncture to sham acupuncture, and not just to usual care, we were able to better understand whether the benefits were due to the acupuncture technique itself or to the overall experience."
Participants received weekly treatments for 10 weeks, with cognitive function assessed at baseline, 10 weeks, and 26 weeks using both patient-reported outcomes and standardized neurocognitive assessments.
Significant Improvements in Cognitive Function
The trial revealed distinct patterns of improvement between real and sham acupuncture (search). Perceived cognitive impairment (search), measured by the Functional Assessment of Cancer Therapy–Cognitive Function, improved by 10.3 points in the real acupuncture group and 10.5 points in the sham group, compared with only a 4.8-point improvement with usual care. These improvements were sustained at the 26-week follow-up for both acupuncture groups.
However, objective cognitive function showed more selective benefits. Using the Hopkins Verbal Learning Test–Revised, real acupuncture (search) produced a statistically significant improvement at week 10, surpassing sham acupuncture by four points. Notably, sham acupuncture did not improve objective cognitive scores despite patients' perceived improvements.
Among participants with documented baseline objective impairment, real acupuncture (search) showed a promising trend toward better memory outcomes compared with both sham acupuncture and usual care.
Safety Profile and Clinical Implications
The treatment demonstrated an excellent safety profile, with adverse events occurring only in the real acupuncture (search) arm. Mild bruising was reported in just 3.1% of participants receiving real acupuncture. The study also confirmed a strong correlation between sleep quality and cognitive performance, with insomnia (search) and sleep fragmentation associated with poorer objective cognitive measures.
"Cognitive difficulties for women with breast cancer (search) are complex and involve finding ways to address both the distress associated with perceived cognitive abilities as well as objective function," Dr. Mao noted. "While this trial showed that acupuncture (search)'s ability to improve a patient's perceived cognitive difficulty is likely due to the process of receiving acupuncture care rather than specific needling techniques, it is still reasonable for women with breast cancer to try a course of acupuncture to see if it can help improve their sense of cognitive difficulty."
Addressing an Unmet Medical Need
The findings address a significant unmet need in breast cancer (search) survivorship care. Cancer-related cognitive impairment (search) can severely impact quality of life, making it difficult for survivors to focus, work, and perform daily tasks. Previous studies using brain scans suggest that acupuncture (search) may stimulate brain areas involved in memory, attention, and learning.
Dr. Mao emphasized the importance of evidence-based integrative therapies: "At a time when there's a lot of speculation and misinformation about wellness therapies for cancer patients, we are conducting research to offer evidence-based therapies that may help them."
The research team plans to continue investigating acupuncture (search)'s benefits in breast cancer (search) survivors and explore its potential for improving cognitive abilities in older cancer patients, who face additional age-related cognitive challenges. Future studies will also examine other integrative interventions including exercise and mindfulness approaches.