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Acupuncture produced significantly greater reductions in nocturia episodes and IPSS scores in survivors of prostate cancer relevant to usual care.

Acupuncture produced significantly greater reductions in nocturia episodes and overall International Prostate Symptom Score (IPSS) scores in survivors of prostate cancer relevant to usual care, according to a research letter detailing the study findings published online in JAMA Oncology.

Study author Kevin Liou, MD, of Memorial Sloan Kettering Cancer Center, and colleagues stated that nocturia affects more than half of survivors of prostate cancer, but evidence for nocturia treatments is ranked as weak.

“Randomized placebo-controlled trials demonstrated acupuncture improves urinary function in Chinese populations without cancer, but no studies investigated acupuncture for nocturia in survivors of prostate cancer, to our knowledge,” the authors wrote.

Memorial Sloan Kettering Cancer Center Clinical Trial

The researchers conducted a pilot randomized clinical trial at Memorial Sloan Kettering Cancer Center involving adult men enrolled from September 2022 to March 2024 with treated prostate cancer and no evidence of disease who reported two or more nocturia episodes per night for the past month. The 60 participants (mean age 72.4) were randomly assigned 2:1 to acupuncture or waitlist control (usual care).

The acupuncture intervention comprised ten weekly sessions targeting 11 nocturia‑specific acupoints plus adjunct points for comorbid symptoms, with bilateral electrical stimulation (2–10 Hz, 20–30 min). Nocturia frequency (IPSS item 7) served as the primary endpoint. Outcomes were assessed at baseline, week 10 (end of treatment), and week 14.

Significant Nocturia Reductions & Mild Adverse Events

According to the authors, linear mixed‑effects modeling showed significantly greater nocturia reduction with acupuncture at week 10 (–1.08 vs 0.05 episodes; between‑group difference = –1.13; 95 % CI, –1.56 to –0.71; P < .001) and week 14 (–0.80 vs 0.05; difference = –0.85; 95 % CI, –1.27 to –0.42; P < .001). Corresponding declines in IPSS total scores favored acupuncture at week 10 (–3.64 vs 0.12; difference = –3.76; 95 % CI, –6.07 to –1.44; P = .002) and week 14 (–3.11 vs 0.29; difference = –3.39; 95 % CI, –5.70 to –1.09; P = .004).

The most common treatment-related adverse events reported were dizziness (mild, 2 [5%]) and insomnia (mild 2 [5%]).

“Acupuncture produced greater reductions in nocturia relative to usual care,” the authors wrote. “The nocturia reduction was comparable to other treatments such as desmopressin, α-blockers, and antimuscarinic medications; however, acupuncture was associated with fewer adverse events. The between-group difference in the IPSS total score change exceeded the MCID (minimum clinically important difference), suggesting acupuncture produced clinically meaningful improvements in urinary function compared with usual care.”

The team added, “In preclinical research, acupuncture modulated bladder activity and brainstem structures involved in micturition, supporting the biological plausibility of these findings.”

Addressing a Substantial Unmet Need

The authors acknowledged study limitations, including a small sample, modest imbalances in cancer staging/treatment, the 1-month post-treatment follow-up, lack of placebo controls and masking, and the single-site design.

Nonetheless, the authors concluded, “The promising effects of acupuncture on nocturia warrant further investigation in larger trials to address a substantial unmet need among survivors of prostate cancer.”