Moxibustion for the Treatment of Cancer and its Complications: Efficacies and Mechanisms

This comprehensive review analyzes 39 studies on the application of moxibustion in the treatment of cancer and its complications, revealing promising evidence about its clinical benefits and mechanisms of action. Moxibustion, a traditional external therapy of Traditional Chinese Medicine that uses heat generated by the combustion of mugwort at specific acupuncture points, demonstrated significant efficacy in managing various complications related to cancer and oncological treatment. The clinical studies reviewed show that moxibustion can substantially improve the side effects of chemotherapy and radiotherapy. Regarding gastrointestinal symptoms, multiple studies demonstrated that moxibustion effectively reduces chemotherapy-induced nausea and vomiting, with efficacy rate increasing from 77% to 90% when combined with conventional antiemetics.

The Zusanli point (ST-36) was the most frequently used in clinical protocols, followed by points such as Zhongwan (CV-12) and Shenque (CV-8). For chemotherapy-induced myelosuppression, moxibustion showed the ability to increase leukocyte and platelet counts, offering an alternative or complement to granulocyte colony-stimulating factor. Cancer-related fatigue, a debilitating symptom that significantly affects patients' quality of life, responded positively to moxibustion intervention, with reduction in Brief Fatigue Inventory scores in several studies. Particularly interesting was the use of infrared laser moxibustion, which maintains therapeutic benefits while avoiding disadvantages such as smoke and difficulties in dosage control.

In the treatment of cancer pain, moxibustion demonstrated significant reduction in total Brief Pain Inventory scores, including both pain intensity and pain interference with daily life. For breast cancer-related lymphedema, a serious complication with a cumulative incidence of 41% at 10 years, electronic moxibustion at points such as Binao (SI-14) showed improvements in arm symptoms and quality of life. Animal model studies revealed fascinating mechanisms by which moxibustion exerts antitumor effects. The therapy demonstrated the ability to improve the tumor immune microenvironment, increasing infiltration of cytotoxic CD8+ T cells, helper CD4+ T cells, and natural killer cells, while reducing immunosuppressive regulatory T cells.

In addition, moxibustion promotes tumor vascular normalization, reducing vascular endothelial growth factor (VEGF) expression and improving tumor oxygenation. The mechanism of action involves both thermal effects and infrared radiation produced during combustion. The local heat (42-46°C) activates Langerhans cells at the acupuncture points, initiating immunological cascades that propagate systemically. Thermal stimulation also activates TRPV1 receptors, transmitting signals through neural pathways to the hypothalamus and modulating the hypothalamic-pituitary-adrenal axis.

Clinically, this translates into significant improvement in patients' quality of life, measured through validated instruments such as EORTC QLQ-C30 and Karnofsky performance scales. Patients reported reduction in symptoms such as fatigue, nausea, vomiting, anorexia, and diarrhea. However, this review also identifies important limitations in the current literature. Many studies have relatively small samples, and there is a need for more high-quality randomized clinical trials with standardized methodologies.

The selection of acupuncture points, intervention time, and treatment duration vary considerably between studies, making protocol standardization difficult. Despite these limitations, the compiled evidence provides a solid scientific basis for the clinical application of moxibustion in integrative oncology. The therapy offers a safe, non-invasive, and well-tolerated approach that can be easily integrated into conventional oncological treatment protocols, providing significant symptomatic relief and potentially improving clinical outcomes through its immunomodulatory and antitumor effects.