International Hypnosis Research Institute - Acupuncture

Brief Effect of Acupoint Stimulation Using Focused Ultrasound.

Sun, 03 Mar 2013 14:31:00 -0500

Abstract Background: Acupuncture is used worldwide in medical treatment. However, needle insertion damages the skin and patients sometimes feel pain. To avoid such drawbacks, an acupoint stimulation device using focused ultrasound has been developed. Ultrasound stimulation does not damage the skin like acupuncture does because ultrasound can deliver vibration energy to soft tissues noninvasively. Objectives: The aim of this study was to clarify the effect of acupoint stimulation using focused ultrasound. Subjects: Fifty (50) healthy volunteers (40 males and 10 females) were included in this experiment. Design: Subjects were randomly assigned to two groups. LR-3 was stimulated bilaterally for 36 seconds by focused ultrasound and conventional acupuncture. Brachial artery blood flow volume was monitored by an ultrasound with an echo-tracking system. The hemodynamic parameters were measured before, during, and 30, 60, 180 seconds after stimulation. Results: During stimulation, the blood flow volume of the acupuncture stimulation group decreased significantly (p<0.05) compared with resting value, but that of the focused ultrasound stimulation group did not decrease. Blood flow volume of both groups increased gradually and showed significant increase at 180 seconds after stimulation (p<0.05). Conclusions: Blood flow volume was increased significantly by both focused ultrasound stimulation and conventional acupuncture. Although a significant decrease of blood flow volume during acupuncture stimulation was observed, no such decrease was observed during ultrasound stimulation. Findings of the present study show that noninvasive stimulation of acupoints by focused ultrasound is as effective as conventional acupuncture in blood flow volume of the brachial artery. J Altern Complement Med. 2012 Dec 7. Tsuruoka N, Watanabe M, Takayama S, Seki T, Matsunaga T, Haga Y. 1 Graduate School of Biomedical Engineering, Tohoku University , Sendai, Japan .

Auricular acupuncture for chemically dependent pregnant women...

Sun, 17 Feb 2013 14:30:00 -0500

Full title: Auricular acupuncture for chemically dependent pregnant women: a randomized controlled trial of the NADA protocol. BACKGROUND: The prevalence of maternal drug use during pregnancy in North America has been estimated to be as high as 6-10%. The consequences for the newborn include increased risk for perinatal mortality and ongoing physical, neurobehavioral, and psychosocial problems. Methadone is frequently used to wean women off street drugs but is implicated as a cause of adverse fetal/neonatal outcomes itself. The purpose of our study was to test the ability of maternal acupuncture treatment among mothers who use illicit drugs to reduce the frequency and severity of withdrawal symptoms among their newborns. METHODS: We randomly assigned chemically dependent pregnant women at BC Women's Hospital in Vancouver, British Columbia to daily acupuncture treatments versus usual care. By necessity, neither our participants nor acupuncturists were blinded as to treatment allocation. Our primary outcome was days of neonatal morphine treatment for symptoms of neonatal withdrawal. Secondary neonatal outcomes included admission to a neonatal ICU and transfer to foster care. RESULTS: We randomized 50 women to acupuncture and 39 to standard care. When analyzed by randomized groups, we did not find benefit of acupuncture; the average length of treatment with morphine for newborns in the acupuncture group was 2.7 (6.3) compared to 2.8 (7.0) in the control group. Among newborns of women who were compliant with the acupuncture regime, we observed a reduction of 2.1 and 1.5 days in length of treatment for neonatal abstinence syndrome compared to the non-compliant and control groups, respectively. These differences were not statistically significant. CONCLUSIONS: Acupuncture may be a safe and feasible treatment to assist mothers to reduce their dosage of methadone. Our results should encourage ongoing studies to test the ability of acupuncture to mitigate the severity of neonatal abstinence syndrome among their newborns. Subst Abuse Treat Prev Policy. 2012 Dec 23;7(1):48. Janssen P, Demorest LC, Kelly A, Thiessen P, Abrahams R.

A foot in both worlds: education and the transformation of Chinese medicine in the United States.

Sun, 20 Jan 2013 14:27:00 -0500

Although insufficiently studied, schools of complementary and alternative medicine (CAM) provide substantial insight into the transformation of medicine in the United States. Scholars have suggested that the increasing acceptance of CAM is due to its alignment with biomedical models of professionalization, education, research, and practice. At West Coast University, students of acupuncture and Oriental medicine learn to straddle both Western and Eastern medical worlds through an increasingly science-oriented curriculum and the inculcation of professional values associated with West Coast University's emphasis upon integration with Western medicine as a means of achieving professional status and legitimacy vis-à-vis the dominant biomedical paradigm. The implications of integration with biomedicine for the identity of Chinese medicine are discussed: from the perspective of critical medical anthropology, integration reproduces biomedical hegemony; paving the way toward co-optation of Chinese medicine, the subordination of its practitioners, and, ultimately, the constraint of medical pluralism in the United States. Med Anthropol. 2013 Jan;32(1):8-24. doi: 10.1080/01459740.2012.694930. Flesch H. a McMaster University , Hamilton , Ontario , Canada.

Neuromuscular electrostimulation techniques: historical aspects and current possibilities in treatme

Sun, 06 Jan 2013 14:24:00 -0500

Application of electricity for pain treatment dates back to thousands of years BC. The Ancient Egyptians and later the Greeks and Romans recognized that electrical fishes are capable of generating electric shocks for relief of pain. In the 18th and 19th centuries these natural producers of electricity were replaced by man-made electrical devices. This happened in following phases. The first was the application of static electrical currents (called Franklinism), which was produced by a friction generator. Christian Kratzenstein was the first to apply it medically, followed shortly by Benjamin Franklin. The second phase was Galvanism. This method applied a direct electrical current to the skin by chemical means, applied a direct and pulsed electrical current to the skin. In the third phase the electrical current was induced intermittently and in alternate directions (called Faradism). The fourth stage was the use of high frequency currents (called d'Arsonvalisation). The 19th century was the "golden age" of electrotherapy. It was used for countless dental, neurological, psychiatric and gynecological disturbances. However, at beginning of the 20th century electrotherapy fell from grace. It was dismissed as lacking a scientific basis and being used also by quacks and charlatans for unserious aims. Furthermore, the development of effective analgesic drugs decreased the interest in electricity. In the second half of the 20th century electrotherapy underwent a revival. Based on animal experiments and clinical investigations, its neurophysiological mechanisms were elucidated in more details. The pain relieving action of electricity was explained in particular by two main mechanisms: first, segmental inhibition of pain signals to the brain in the dorsal horn of the spinal cord and second, activation of the descending inhibitory pathway with enhanced release of endogenous opioids and other neurochemical compounds (serotonin, noradrenaline, gamma aminobutyric acid (GABA), acetylcholine and adenosine). The modern electrotherapy of neuromusculo- skeletal pain is based in particular on the following types: transcutaneous electrical nerve stimulation (TENS), percutaneous electrical nerve stimulation (PENS or electro-acupuncture) and spinal cord stimulation (SCS). In mild to moderate pain, TENS and PENS are effective methods, whereas SCS is very useful for therapy of refractory neuropathic or ischemic pain. In 2005, high tone external muscle stimulation (HTEMS) was introduced. In diabetic peripheral neuropathy, its analgesic action was more pronounced than TENS application. HTEMS appeared also to have value in the therapy of symptomatic peripheral neuropathy in end-stage renal disease (ESRD). Besides its pain-relieving effect, electrical stimulation is of major importance for prevention or treatment of muscle dysfunction and sarcopenia. In controlled clinical studies electrical myostimulation (EMS) has been shown to be effective against the sarcopenia of patients with chronic congestive heart disease, diabetes, chronic obstructive pulmonary disease and ESRD. Clin Nephrol. 2013 Sup;79(13):12-23. Heidland A, Fazeli G, Klassen A, Sebekova K, Hennemann H, Bahner U, Di Iorio B. Department of Internal Medicine, University of Würzburg, KfH-Kidney Center, Institute of Pharmacology and Toxicology, University of Würzburg, Würzburg, Germany, Institute of Molecular Biomedicine, Medical Faculty, Comenius University, Bratislava, Slovakia, KfH Kidney Center Coburg, Coburg, Germany, and Faculty of Medicine and Surgery, Seconda Universita di Napoli, Italy.

Correlation between facial nerve functional evaluation...

Wed, 26 Dec 2012 17:19:00 -0500

Full title: Correlation between facial nerve functional evaluation and efficacy evaluation of acupuncture treatment for Bell's palsy. To assess and grade facial nerve dysfunction according to the extent of facial paralysis in the clinical course of acupuncture treatment for Bell's palsy, and to observe the interrelationship between the grade, the efficacy and the period of treatment, as well as the effect on prognosis. The authors employed the House-Brackmann scale, a commonly used evaluation scale for facial paralysis motor function, and set standards for eye fissure and lips. According to the improved scale, the authors assessed and graded the degree of facial paralysis in terms of facial nerve dysfunction both before and after treatment. The grade was divided into five levels: mild, moderate, moderately severe, severe dysfunction and complete paralysis. The authors gave acupuncture treatment according to the state of the disease without artificially setting the treatment period. The observation was focused on the efficacy and the efficacy was evaluated throughout the entire treatment process. Fifty-three cases out of 68 patients with Bell's palsy were cured and the overall rate of efficacy was 97%. Statistically significant differences (P<0.01) were perceived among the efficacy of five levels of facial nerve dysfunction. Efficacy was correlated with the damage level of the disease (correlation coefficient r=0.423, P<0.01). The course of treatment also extended with the severity of facial nerve dysfunction (P<0.01). Differences exist in patients with Bell's palsy in terms of severity of facial nerve dysfunction. Efficacy is reduced in correlation with an increase in facial nerve dysfunction, and the period of treatment varies in need of different levels of facial nerve dysfunction. It is highly necessary to assess and grade patients before observation and treatment in clinical study, and choose corresponding treatment according to severity of damage of the disease. Zhong Xi Yi Jie He Xue Bao. 2012 Sep;10(9):997-1002. Zhou ZL, Li CX, Jiang YB, Zuo C, Cai Y, Wang R. Department of Acupuncture and Moxibustion, General Hospital of the People's Liberation Army, Beijing 100853, China; E-mail: zhouzhangling@sina.com.

Complementary and alternative medicine treatments among stroke patients in India.

Wed, 19 Dec 2012 17:18:00 -0500

Complementary and alternative medicine (CAM) is commonly used by persons with stroke throughout the world, particularly in Asia. Objective: The objectives of this study were to determine the frequency of CAM use and the factors that predict the use of CAM in stroke patients. Methods: This study was carried out in the stroke units of Christian Medical College, Ludhiana, and Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, India, from June 2010 to December 2010. Participants were interviewed using a structured questionnaire (=6 months post stroke). Outcomes were assessed using a modifi ed Rankin Scale (mRS). Results: Three hundred fourteen stroke patients were interviewed; mean age was 57.4 ± 12.9 years, and 230 (73.2%) patients were men. Of 314 patients, 114 (36.3%) had used the following CAM treatments: ayurvedic massage, 67 (59.3%); intravenous fl uids, 22 (19.5%); herbal medicines, 17 (15%); homeopathy, 15 (13.3%); witchcraft, 3 (2.7%); acupuncture, 3 (2.7%); opium intake, 10 (8.8%); and other nonconventional treatments, 10 (8.8%). Patients with severe stroke (P < .0001), limb weakness (P < .0001), dysphagia (P = .02), dyslipidemia (P = .007), hypertension (P = .03), or hemorrhagic stroke (P<.0001) and patients with poor outcome (mRS >2;P < .0001) often used CAM treatments. Conclusion: More than one-third of the patients in this study opted for CAM. Presence of limb weakness, dysphagia, dyslipidemia, hypertension, hemorrhagic stroke, severe stroke, and poor outcome predicted the use of CAM. Top Stroke Rehabil. 2012 Sep-Oct;19(5):384-94. Pandian JD, Toor G, Arora R, Kaur P, Dheeraj KV, Bhullar RS, Sylaja PN. Stroke Unit, Department of Neurology, Christian Medical College, Ludhiana, Punjab, India.

Efficacy of acupuncture for chronic knee pain...

Wed, 12 Dec 2012 17:16:00 -0500

Full Title: Efficacy of acupuncture for chronic knee pain: protocol for a randomised controlled trial using a Zelen-design randomised controlled trial. Chronic knee pain is a common and disabling condition in people over 50 years of age, with knee joint osteoarthritis being a major cause. Acupuncture is a popular form of complementary and alternative medicine for treating pain and dysfunction associated with musculoskeletal conditions. This pragmatic Zelen-design randomised controlled trial is investigating the efficacy and cost-effectiveness of needle and laser acupuncture, administered by medical practitioners, in people with chronic knee pain. Two hundred and eighty two people aged over 50 years with chronic knee pain have been recruited from metropolitan Melbourne and regional Victoria, Australia. Participants originally consented to participate in a longitudinal natural history study but were then covertly randomised into one of four treatment groups. One group continued as originally consented (ie natural history group) and received no acupuncture treatment. The other three were treatment groups: i) laser acupuncture, ii) sham laser or, iii) needle acupuncture. Acupuncture treatments used a combined Western and Traditional Chinese Medicine style, were delivered by general practitioners and comprised 8--12 visits over 12 weeks. Follow-up is currently ongoing. The primary outcomes are pain measured by an 11-point numeric rating scale (NRS) and self-reported physical function measured by the Western Ontario and McMaster (WOMAC) Universities Osteoarthritis Index subscale at the completion of treatment at 12 weeks. Secondary outcomes include quality of life, global rating of change scores and additional measures of pain (other NRS and WOMAC subscale) and physical function (NRS). Additional parameters include a range of psychosocial measures in order to evaluate potential relationships with acupuncture treatment outcomes. Relative cost-effectiveness will be determined from health service usage and outcome data. Follow-up assessments will also occur at 12 months. The findings from this study will help determine whether laser and/or needle acupuncture is efficacious, and cost-effective, in the management of chronic knee pain in older people. BMC Complement Altern Med. 2012 Sep 19;12(1):161. Hinman RS, McCrory P, Pirotta M, Relf I, Crossley KM, Reddy P, Forbes A, Harris A, Metcalf BR, Kyriakides M, Novy K, Bennell KL.

Rehabilitation and treatment of a recreational golfer with hip osteoarthritis: a case report.

Mon, 03 Dec 2012 17:16:00 -0500

This case study reviews the conservative chiropractic treatment of hip osteoarthritis (OA) and the prescription of a rehabilitation program for a recreational golfer. A 49-year-old registered nurse/ college instructor presented with a five year history of left hip OA and pain, recent right hip pain and occasional low back stiffness. Once her symptoms improved, a golf-specific functional rehabilitation program was prescribed in preparation for the upcoming golf season. The initial treatment included ultrasound, soft tissue and myofascial therapy, mobilizations, acupuncture and home advice. Rehabilitative exercises included core and scapular stability exercises, general conditioning, golf specific stretches, functional swinging, proprioceptive and strengthening exercises, and referral to a swing coach. The positive outcomes included increased ranges of motion, decreased pain, as well as improvements in golf driving distance and endurance. Conservative management and golf-specific rehabilitation prescription appears to be beneficial for hip OA and recreational golf performance in this case. J Can Chiropr Assoc. 2012 Sep;56(3):201-8. Howell ER. Ashbridge's Health Centre, 1522 Queen St. East, Toronto, ON M4L 1E3. E-mail: dremilyhowell@hotmail.com

Effects of auricular acupressure on body weight parameters in patients with chronic schizophrenia.

Wed, 28 Nov 2012 17:15:00 -0500

Auricular acupressure is widely used in complementary and alternative medicine to reduce body weight, but little is known about the effects of auricular acupressure on body weight parameters in patients with chronic schizophrenia. The purpose of this study was to evaluate the effects of auricular acupressure on body weight parameters in patients with chronic schizophrenia. Eighty-six inpatients with schizophrenia were recruited from chronic wards in a psychiatric center. The participants were randomly divided into experimental (acupressure at 4 acupuncture sites: hunger, stomach, shenmen and endocrine) and control groups, and body weight parameters were determined weekly for 8 weeks. There was no significant difference between the experimental and control groups in mean body weight, waist circumference, or body fat percentage at the pretest or during the entire 8-week study period. Therefore, auricular acupressure did not cause body weight reduction in patients with chronic schizophrenia. Evid Based Complement Alternat Med. 2012;2012:151737. Epub 2012 Sep 10. Ching HY, Wu SL, Chen WC, Hsieh CL. Graduate Institute of Integrated Medicine, College of Chinese Medicine, China Medical University, Taichung 40402, Taiwan ; Department of Psychiatry, Tsao-Tun Psychiatric Center, Department of Health, Executive Yuan, Nan-Tou 54249, Taiwan.

Complementary medicine, exercise, meditation, diet, and lifestyle modification...

Sat, 24 Nov 2012 18:03:00 -0500

Full title: Complementary medicine, exercise, meditation, diet, and lifestyle modification for anxiety disorders: a review of current evidence. Use of complementary medicines and therapies (CAM) and modification of lifestyle factors such as physical activity, exercise, and diet are being increasingly considered as potential therapeutic options for anxiety disorders. The objective of this metareview was to examine evidence across a broad range of CAM and lifestyle interventions in the treatment of anxiety disorders. In early 2012 we conducted a literature search of PubMed, Scopus, CINAHL, Web of Science, PsycInfo, and the Cochrane Library, for key studies, systematic reviews, and metaanalyses in the area. Our paper found that in respect to treatment of generalized anxiety or specific disorders, CAM evidence revealed current support for the herbal medicine Kava. One isolated study shows benefit for naturopathic medicine, whereas acupuncture, yoga, and Tai chi have tentative supportive evidence, which is hampered by overall poor methodology. The breadth of evidence does not support homeopathy for treating anxiety. Strong support exists for lifestyle modifications including adoption of moderate exercise and mindfulness meditation, whereas dietary improvement, avoidance of caffeine, alcohol, and nicotine offer encouraging preliminary data. In conclusion, certain lifestyle modifications and some CAMs may provide a beneficial role in the treatment of anxiety disorders. Evid Based Complement Alternat Med. 2012;2012:809653. Epub 2012 Aug 27. Sarris J, Moylan S, Camfield DA, Pase MP, Mischoulon D, Berk M, Jacka FN, Schweitzer I. Department of Psychiatry, The University of Melbourne, Melbourne, VIC 3000, Australia.

Efficacy observation on osteoarthritis of the knee...

Wed, 21 Nov 2012 17:14:00 -0500

Full title: Efficacy observation on osteoarthritis of the knee treated with the ultrastructural acupotomy therapy at the counter-Ashi points. To compare the difference in the efficacy on osteoarthritis of the knee between the ultrastructural acupotomy therapy at the counter-Ashi points and the conventional acupuncture-moxibustion therapy. Sixty cases were randomly devided into an ultrastructural acupotomy therapy group (group A) and a conventional acupuncture-moxibustion group (group B), 30 cases in each one. In the group A, the ultrastructural acupotomy therapy was applied to the counter-Ashi points in which pain was alleviated or disappeared on pressure. The treatment was given once a week, lasting for 1 month. In the group B, the acupuncture-moxibustion therapy was applied to Dubi (ST 35), Neixiyan (EX-LE 4), Zusanli (ST 36), Yanglingquan (GB 34), etc. The treatment was given once daily, lasting for 1 month. Before and after treatment, the Visual Analogue Scale (VAS), Lysholm knee joint scale and the affected knee joint flexion angle were observed in the two groups. The clinical efficacy was compared between the two groups. After treatment, the scores of VAS, Lysholm knee joint scale and the affected knee joint flexion angle were improved obviously as compared with those before treatment in either group (P < 0.01, P < 0.05). The results of them in the group A were superior apparently to those in the group B (all P < 0.05). The total effective rate in the group A was superior to that in the group B [80.0% (24/30) vs 60.0% (18/30), P < 0.05]. The ultrastructural acupotomy therapy at the counter-Ashi points achieves the superior clinical efficacy on osteoarthritis of the knee as compared with the conventional acupuncture therapy. It relieves pain and improves the motion range of knee joint effectively. It is simple in operation and less in treatment frequency. Zhongguo Zhen Jiu. 2012 Jul;32(7):621-4. Liu MR, Li L, He ZW. Department of Acupuncture-Moxibustion and Tuina, The First Affiliated Hospital of Hunan University of CM, Changsha 410007, China.

Survey of studies on drug abstinence with acupuncture in recent 10 years.

Wed, 21 Nov 2012 17:13:00 -0500

The effect of acupuncture on substance withdrawl syndromes and craving relapse prevention of the recent 10 years were reviewed as well as its mechanism. The therapeutic effect and the possible mechanism were analyzed on the basis. From the three aspects of anti protracted abstinence symptoms, craving relapse prevention and mechanism of acupuncture, the development tendency and the prospect of application on drug withdrawl with acupuncture were expected. And it is proposed that clinical observation of acupuncture intervention on craving should be developed, the mechanism of acupuncture impact on cognitive behavior, blocking study and memory processing related to drug addiction should be explored, so as to further give play to the advantages of acupuncture on anti-drug addiction. Zhongguo Zhen Jiu. 2012 Jul;32(7):669-72. Song XG, Lü H, Cai XH, Zhang RJ. Institute of Acupuncture and Meridian, Anhui University of CM, Hefei 230038, China. zsongxg0128@163.com

Fear-driven cesarean section on request.

Wed, 14 Nov 2012 17:12:00 -0500

Traditionally, women gave birth surrounded by other, experienced women. Modern women not only require continuous support during labor, but they also want to have a part in decision-taking. That is why some of them, regardless of how much or how little medical knowledge they have, want to decide about the way of birth on their own. The aim of this study was to find the underlying cause of the growing percentage of cesarean sections and cesarean sections on request and to find an answer to the question of what can be done to reduce that number. A survey was conducted among 100 nulliparas between 38 and 40 week of pregnancy who were determined to give birth in a natural way, and among 50 nulliparas, in the same gestational age, who requested cesarean section. The analysis of our survey shows that request for cesarean section in 12% of cases resulted from fear of labor pain, more than before were declared 2%. After they were informed about methods of reducing labor pain and guaranteed that those methods would be available, as many as 52% of pregnant women who had previously requested cesarean section changed their mind and wanted to give birth in a natural way (this could reduce cesarean section rate about 52%, p<0.05), and 42% (of the total) wanted to have epidural anesthesia. Better access of pregnant women to information about pharmacological and non-pharmacological methods of reducing labor pain, coupled with the availability of those methods, can reduce the number of cesarean sections on request even by half. In the group of pregnant women determined to have cesarean section, one in four would give it up if they had access to epidural anesthesia, and one in ten if they had access to non-pharmacological methods of reducing labor pain (mainly acupuncture). Pol Merkur Lekarski. 2012 Aug;33(194):86-9. Pawelec M, Pietras J, Karmowski A, Palczynski B, Karmowski M, Nowak T. First Chair and Department of Gynecology and Obstetrics, Medical University of Wroclaw, Poland. mproust@wp.pl

DoD-NCCAM/NIH Workshop on Acupuncture for Treatment of Acute Pain.

Wed, 07 Nov 2012 17:11:00 -0500

The Department of Defense (DoD) and the National Center for Complementary and Alternative Medicine (NCCAM) at the National Institutes of Health (NIH) cosponsored a workshop that explored the possible benefits of acupuncture treatment for acute pain. One goal of the workshop was to establish a roadmap to building an evidence base on that would indicate whether acupuncture is helpful for treating active-duty military personnel experiencing acute pain. The workshop highlighted brief presentations on the most current research on acupuncture and acute pain mechanisms. The impact of various modifiers (stress, genetics, population, phenotypes, etc.) on acute pain pathways and response to acupuncture treatment was discussed. Additional presentations focused on common neural mechanisms, an overview of real-world experience with using acupuncture to treat traumatic acute pain, and best tools and methods specific for acupuncture studies. Three breakout groups addressed the gaps, opportunities, and barriers to acupuncture use for acute pain in military and trauma settings. Different models of effectiveness research and optimal research designs for conducting trials in acute traumatic pain were also discussed. J Altern Complement Med. 2012 Sep 28. Edwards E, Louis Belard J, Glowa J, Khalsa P, Weber W, Huntley K. 1 Division of Extramural Research, National Center for Complementary and Alternative Medicine , Bethesda, MD.

The importance of supportive care in optimizing treatment outcomes...

Wed, 31 Oct 2012 17:11:00 -0500

Full Title: The importance of supportive care in optimizing treatment outcomes of patients with advanced prostate cancer. Optimal oncologic care of older men with prostate cancer, including effective prevention and management of the disease and treatment side effects (so-called best supportive care measures) can prolong survival, improve quality of life, and reduce depressive symptoms. In addition, the proportion of treatment discontinuations can be reduced through early reporting and management of side effects. Pharmacologic care may be offered to manage the side effects of androgen-deprivation therapy and chemotherapy, which may include hot flashes, febrile neutropenia, fatigue, and diarrhea. Nonpharmacologic care (e.g., physical exercise, acupuncture, relaxation) has also been shown to benefit patients. At the Georges Pompidou European Hospital, the Program of Optimization of Chemotherapy Administration has demonstrated that improved outpatient follow-up by supportive care measures can reduce the occurrence of chemotherapy-related side effects, reduce cancellations and modifications of treatment, reduce chemotherapy wastage, and reduce the length of stay in the outpatient unit. The importance of supportive care measures to optimize management and outcomes of older men with advanced prostate cancer should not be overlooked. Oncologist. 2012;17 Suppl 1:23-30. Scotté F. Oncologie Médicale et Unité Fonctionnelle de Soins de Support, Hôpital Européen Georges Pompidou, 20 Rue Leblanc, 75015 Paris, France. florian.scotte@egp.aphp.fr.