This is an in-depth assessment of the current evidence for acupuncture for cancer-related fatigue. Follow the links for other information regarding acupuncture for cancer:
General characteristics of included studies
Eight systematic reviews published between 2021 and Jan 2026 examining acupuncture and related therapies for cancer-related fatigue (CrF) in adults have been included. Please see the table for full details of the included studies.
Number of included studies: 8 systematic reviews (SRs) including 3 network meta-analyses (NMAs); Chou 2026; Tian 2023; Yao 2026; Choi 2022; He 2022; Voigtländer 2026; Hsieh 2021; Bae 2024). Published between 2021 and January 2026.
Number of RCTs per SR: from 9 to 34 RCTs.
Participants: Adults with cancer-related fatigue, across various cancer types (including 2 focusing solely on breast cancer), across treatment stages (during or post-treatment), sample size per SR from 744 to 2632 participants.
Interventions: Manual acupuncture, electroacupuncture; Acupressure (including relaxing, stimulating, oil acupressure; Moxibustion (including infrared laser, warm needle); Transcutaneous electrical acupoint stimulation (TEAS)
Comparators: Usual care / standard care; sham acupuncture/acupressure; wait-list / no treatment; other active interventions (e.g., herbal medicine, different acupoint techniques).
Outcome measures: Primary outcome: Fatigue measured using validated scales including FACIT-F, BFI, MFI, PFS/RPFS, CFS, VAS-F, MDASI; Adverse events
Methodological quality and limitations of the evidence
Quality of systematic reviews: According to assessment with AMSTAR2 moderate for 3 SRs (Chou 2026, Choi 2022, Hsieh 2021); low–moderate for 1 SR (Yao 2026) and low to critically low for 4 SRs (Tian 2023, He 2022, Voigtländer 2026, Bae 2024).
Risk of bias of included RCTs: assessed using Cochrane RoB / RoB2 tools. Many RCTs are at high or unclear risk of bias, very few RCTs were consistently at low risk. Common limitations across included studies included insufficient blinding (challenging in acupuncture trials; high heterogeneity (intervention protocols, populations, outcomes); small sample sizes and limited power; limited subgroup and sensitivity analyses; publication bias often not or inadequately addressed.
Results for effects of interventions
Improvement in fatigue was consistently reported across most SRs and NMAs. Benefits were observed for acupuncture, acupressure, TEAS and moxibustion (less consistent).
Compared with usual care: moderate to large effect sizes reported for acupuncture vs usual care; acupressure vs control; TEAS vs control.
Sham-controlled comparisons: effects were less consistent or non-significant for acupuncture and acupressure, significant mainly for TEAS.
Effect sizes: SMD ~0.5–1.0 suggest potential clinically relevant improvements, however the clinical relevance remains uncertain due to heterogeneity and risk of bias.
Certainty of the evidence: GRADE assessment in 4/8 SRs: overall certainty is low, limiting confidence in effect estimates. 2 SRs very low certainty, one reportedly high, but likely overestimated.
Adverse events: underreported / inconsistently reported across reviews, mostly mild (mild bruising with acupuncture), no serious AEs reported.
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