To mark World Cancer Day we are proud to highlight the incredible journey of our graduate, Sarah, as she brings the power of acupuncture to cancer care. In Autumn 2023, Sarah joined The Fountain Centre Cancer Unit as a volunteer acupuncturist, providing supportive treatments for oncology outpatients. One year into her role, she reflects on her transformative experience, the unique challenges of working in this specialized field, and the deep connections formed with patients. Here’s her inspiring story and the lessons she’s learned along the way.
A Year Treating Oncology Patients with Acupuncture
by Sarah San
Introduction
In Autumn 2023, I joined The Fountain Centre Cancer Unit, working as a volunteer acupuncturist treating oncology outpatients. Here’s a summary of my experience a year on.
The Fountain Centre Cancer Unit
The Fountain Centre is an independent charity supporting cancer patients and their loved ones. It is located in the Royal Surrey County Hospital, which houses the fourth biggest cancer centre in the UK. My main role is to treat cancer outpatients. On a side note, HRH The Princess of Wales did a tour of the maternity unit at the Royal Surrey County Hospital back in 2022, who now is diagnosed with cancer herself.
The Fountain Centre Cancer Unit being located inside an NHS hospital means that I have to meet NHS recruitment guidelines. Being a member of the British Acupuncture Council (BAcC) made the process so much easier, as this membership is recognised as a mark of high standards. The Centre does ask that you to commit to the position on a regular basis, as patients tend to be assigned to the same practitioner as much as possible to monitor progress.
Other complementary services are also available at The Fountain Centre such as aromatherapy, massage, reflexology, and hypnotherapy. However, acupuncture is the only complementary therapy that can address many issues/symptoms. As such, acupuncture is in high demand. Because of this, oncology outpatients are only allowed up to eight acupuncture sessions per person, while they can have as many sessions with other therapies as they like (except counselling, which is a maximum of 12 sessions per patient).
Common oncology symptoms I am treating
The most common symptoms I am treating cancer outpatients for are anxiety, hot flushes, night sweats, peripheral neuropathy, and joint pain. Most patients have already had hospital treatments such as surgery, chemotherapy or radiotherapy. Breast cancer patients are also likely to be taking hormone suppressing medication to keep the breast cancer at bay. As such, I see many breast cancer patients with medically induced menopause – the key side effects being hot flushes and night sweats.
Patients who I see for peripheral neuropathy are those who have had either radiotherapy or chemotherapy. Joint pain can sometimes be from medication, and once a patient changes the brand of medication, the joint pain may disappear.
What red flags to look for before treating a cancer patient?
When treating a cancer patient, the key things to look for are:
White blood cells – always check the white blood cells count. Do not provide any treatment if neutrophils are under 1%, as this means that the patient’s autoimmune system is severely compromised.
Anticoagulants – if patients are taking anticoagulants, then cupping or Gua Sha is not recommended.
Botox/ fillers – and although highly unlikely, some patients I have treated have had cosmetic facial tattoos or facial piercings. As such, always check with them if you are going to be needling on the face. According to the BAcC, no needling onto the affected area for at least 6 weeks after the injection.
Peripheral neuropathy – I have had patients with no sensation on the feet at all and some with very dry cracked feet from radiotherapy. Do not needle on the feet or parts of the feet with no sensation.
Where you can and can't needle patients with cancer?
Treating on the local site of the cancer is forbidden – full-stop.
For breast cancer patients, treating the arm on the side of the mastectomy or site of the cancer is not recommended. In small cases, it has been identified that this can affect the lymph nodes. You’ll find that in many hospitals, they do not take blood pressure reading or take bloods from the same side arm as the breast cancer.
Oh – and always disinfect with a swab before needling the acupoints.
Why questioning & observation are more useful than tongue & pulse for diagnosis.
For my cancer outpatients, I’ve found questioning and observations to be a more useful diagnostic tool than tongue and pulse. Given the treatments, medication and the stress oncology patients are going through, the tongue and pulse can be information overload. In many patients, their tongues are almost always showing signs of heat – either peeled, yellow or even black. Their pulse will mostly show liver qi stagnation, as most are highly stressed.
I have found questioning so more useful when treating cancer outpatients. For example, if movement helps with reducing the pain, this tells me there’s qi stagnation, especially when there’s pain in the mornings. The nature of the pain also gives me a lot of information – one patient told me she had ‘burning pain on my right shin’ which told me she had Liver Fire. The location of the pain tells me which meridian to explore and any action which brings on the pain – one patient told me that it was when she tried to open a jar lid, the pain would come on, but lifting a cup up and down was fine, which indicated there was stagnation in the Shao Yang meridian.
Some fun facts about working in a specialist cancer unit
Working in a cancer specialist unit in a hospital environment is fascinating. The first thing you are aware of, is that you first work in a hospital environment. Parking is always the conversation of talk, as space is limited. We often get emails to not park in patient-dedicated parking spaces!
Then, as you walk through the hospital to enter the Fountain Centre, you pass many sick patients along the way – some in wheelchairs, some in a bed being pushed along, many carers accompanying their loved ones for their hospital appointments. Along the corridor are consultants, nurses and lots of hospital support staff – some on their break. I pass the maternity unit, the maxillofacial unit, and the pastoral care service before reaching the cancer unit where the Fountain Centre is located.
On my shift is another acupuncturist, a massage and aromatherapist and a counsellor. During the time of COVID, many volunteers stopped working at the centre and have not returned. As such, there is a big recruitment drive to recruit volunteers back to the centre.
Having another acupuncturist working the same shift as me has been great from a learning perspective. Although I have to rely on my TCM training for diagnosis, in terms of treating cancer patients, I have learnt a lot about red flags and contraindications with the support from my fellow acupuncturist. Being in a hospital setting, there is a lot of emphasis on health and safety. Moreover, as some patients can be treated by more than one acupuncturist, I love reading the treatment notes from other acupuncturists as I get to learn this way too.
The centre does try to make you feel as part of a team through regular email updates, training courses, tours of the hospital etc. But there is something to be said about the little coffee breaks and Christmas get-togethers. Most therapists come in, do their job, and then finish for the day. So, the only real time for a chat is during those coffee-breaks and Christmas get-together moments. This is the time to learn more about your fellow volunteers and other staff members. As an acupuncturist running your practice, it’s good to have networks and support systems in place so you don’t feel isolated. Coming to the Fountain Centre every week is one of my support and networking system.
A final reflection
Giving back is such a rewarding experience. I find that despite the challenges these patients are going through, deep down, they have a fighting spirit inside of them, which I find very inspirational. Medically, I’ve really got to learn more about the world of oncology and how to treat such a niche area. Technically, my questioning diagnostic skill has really been refined. And given that I only have eight sessions with each patient, I value the importance of Yang Shen advice to help patients with ongoing self-management of their symptoms.
If you are interested in finding out more about treating oncology outpatients, Sarah can be contacted at www.SarahSanAcupuncture.co.uk. Sarah San Acupuncture is located in two private practices in Esher and Cobham, Surrey. As well as volunteering at the Fountain Centre Cancer Unit, Sarah also assists in teaching anatomy and acupuncture points at the City College of Acupuncture.