Depression in people with cancer

This page reports what reviews, trials and guidelines say about acupuncture and acupressure for depressive symptoms in people with cancer or after cancer treatment, which the trials measured on rating scales. The Hospital Anxiety and Depression Scale (HADS) is a 14-item questionnaire with seven items on depression, scored 0 to 21 for that part, as the 2014 Pennsylvania trial below describes it; the Hamilton Depression Rating Scale (HAMD) is scored by a clinician and the Self-Rating Depression Scale (SDS) by the patient. No Cochrane review covers acupuncture for depression in people with cancer. The Cochrane review closest to it, a 2025 review of acupuncture for insomnia in people with cancer, took sleep outcomes and adverse events as its outcomes and not depression. The evidence here comes from reviews in other journals, a few trials that measured depression alongside another symptom, and two guidelines from the Society for Integrative Oncology (SIO). Depression in general is covered in Depression.

Reviews

Reviews that pool trials using different questionnaires report a standardised mean difference (SMD), the gap between groups in units of the spread of scores; those pooling one questionnaire report a mean difference in its own points. Sham acupuncture is a control procedure made to look like acupuncture, such as needles that retract into the handle, and Sham acupuncture covers the kinds in use. Acupressure is pressure on acupuncture points with a finger or a device instead of a needle.

Li and colleagues, at Chengdu University of Traditional Chinese Medicine, found that every trial they included was conducted in China and that the usual care in the trials was mainly antidepressant drugs. Most trials added acupuncture to usual care and compared the combination with usual care alone. In the three trials that compared acupuncture alone with usual care, the differences on HAMD and SDS were not significant, and the authors described acupuncture on those scales as a complementary therapy rather than an alternative. They also reported fewer adverse effects in the acupuncture groups (risk ratio 0.43) and wrote that most trials had no sham control, that several were small, and that self-rated depression scales could magnify a placebo effect. The trials most often needled GV20 (Baihui), LV03 (Taichong), LI04 (Hegu), PC06 (Neiguan) and HT07 (Shenmen), twice a week to once a day for 4 to 12 weeks.

Wang and colleagues, at Charles Darwin University in Australia, found no high-quality evidence among their trials. They rated the evidence for anxiety as moderate and for depression as low, and called for larger trials with placebo controls. Zhang and colleagues, at Shandong University of Traditional Chinese Medicine, and Yang and colleagues, at Jiangxi University of Traditional Chinese Medicine, each concluded that the methodological quality of the trials limited what their pooled results could show. Chien and colleagues in Taiwan pooled trials of fatigue, sleep and depression in breast cancer, three symptoms that often occur together, and called for further high-quality trials; their fatigue results are in Cancer-related fatigue.

Trials

A 2014 trial in Cancer by Mao and colleagues at the University of Pennsylvania randomised 67 postmenopausal women with breast cancer who had joint pain from aromatase inhibitors, hormone drugs that lower oestrogen. They received 10 sessions of electroacupuncture over 8 weeks, sham acupuncture with non-penetrating needles at non-acupuncture points, or a waiting list. Against the waiting list, electroacupuncture was associated with lower HADS depression scores (p=0.015), and so was sham acupuncture (p=0.0088). Depression was a secondary outcome of a trial designed around pain.

A 2010 trial in the Journal of Clinical Oncology by Walker and colleagues at Henry Ford Hospital in Detroit randomised 50 women with hormone receptor-positive breast cancer and hot flushes to 12 weeks of acupuncture or the antidepressant venlafaxine. Both groups reported fewer depressive symptoms after treatment, and the changes were similar between groups. The venlafaxine group reported 18 adverse effects and the acupuncture group none. The trial had no sham or untreated group, and its main results on hot flushes are in Hot flushes.

A 2026 phase III trial in Supportive Care in Cancer by Mengyuan Li and colleagues randomised 108 breast cancer survivors at two hospitals affiliated with Zunyi Medical University in China to true self-acupressure, sham self-acupressure or usual care, 36 in each group; 93 completed the study. Women in the acupressure groups were trained to press the points themselves daily for 7 weeks and did not know whether their points were true or sham. The true self-acupressure group had lower HADS depression scores than both the sham and usual care groups at 7 and 19 weeks (all p<0.05), and no adverse events were reported. The authors noted that all outcomes were self-reported.

What guidelines say

The SIO 2017 guideline on integrative therapies during and after breast cancer treatment, led by Greenlee and based on trials published from 1990 to 2015, recommended meditation, relaxation, yoga, massage and music therapy for depression and mood disorders. It did not include acupuncture among them, and recommended acupuncture and acupressure for nausea and vomiting from chemotherapy.

The 2023 SIO and American Society of Clinical Oncology (ASCO) guideline on anxiety and depression in adults with cancer, led by Linda Carlson, drew on 110 studies published from 1990 to 2023: 30 systematic reviews and 80 randomised trials. It recommended acupuncture for anxiety after cancer treatment. Its recommendations for depression named mindfulness-based interventions, yoga, music therapy, relaxation and reflexology during treatment, and mindfulness-based interventions, yoga, and tai chi or qigong after treatment, without acupuncture. A 2026 review by Carlson and colleagues describes the acupuncture recommendation as weak and as applying particularly to women with breast cancer, and says the evidence on acupuncture and acupressure for depression remains limited in quality and consistency. No update to the guideline had been published by November 2026; the 2026 review cites the 2023 version. Clinical guidelines compares other bodies’ positions on acupuncture.

What the reviews could not settle

The largest pooled differences come from comparisons with usual care, waiting lists or routine nursing, where people knew whether they were treated and rated their own mood. Where sham was the comparison, Wang’s review found no significant difference between true and sham points, and in the 2014 Pennsylvania trial sham acupuncture lowered depression scores against the waiting list as well. The 2026 Zunyi trial is the one sham-controlled trial here that found true points ahead of sham on depression, in 93 completers at two hospitals. In Li’s review acupuncture was mostly added to antidepressants, and the three trials of acupuncture alone did not differ from usual care, so the review does not show what acupuncture contributes on its own. Li’s trials were all in China, and most trials outside it enrolled women with breast cancer and measured depression as one of several symptoms, which leaves open how the results apply to other cancers and other countries.

AcuiQ’s cancer-related depression page lists the protocols individual studies prescribed, each with its citation.