Bloodletting puncture and cupping as an adjuvant therapy for breast cancer-related lymphedema in female adults: A non-randomized controlled pragmatic trial

Abstract Objective To evaluate the effectiveness of bloodletting puncture and cupping in relieving breast cancer-related lymphedema. Methods We conducted a non-randomized controlled study at the Galactophore Department of the 3rd Affiliated Hospital of Beijing University of Chinese Medicine from March 2013 to December 2014. Seventy-five patients undergoing treatment for breast cancer-related lymphedema were divided into two groups in accordance with the patients’ treatment choices: the treatment group (n = 50) underwent bloodletting puncture and cupping every 5 days for 15 min/session (one session per day) combined with exercise training once a day for 30 minutes; the control group (n = 25) underwent the same exercise training alone. Evaluation indexes were measured before and after treatment; these included arm circumference (at the wrist crease, 10 cm distal to the wrist crease, the elbow crease, and 10 cm distal to the elbow crease) and visual analogue scale (VAS) score for pain. The safety of the treatment was also evaluated. Results The treatment period was 50 days for all 75 patients. At the end of the treatment period, the mean reduction in arm circumference was 1.21 (0.65) cm the treatment group, and 0.58 (0.78) cm in the control group. Compared with the control group, the treatment group had a significantly greater reduction in arm circumference ( P  = .03) and a significantly lower VAS score for pain ( P  = .01). No patient in either group experienced any adverse events. Conclusion Bloodletting puncture and cupping effectively reduces arm circumference and relieves upper limb pain in patients with breast cancer-related lymphedema. Our results provide sufficient basis for exploring cupping as long-term therapy for managing breast cancer-related lymphedema.