What MSK just published about acupuncture and prostate cancer survivors
Two in three prostate cancer survivors wake up more than once a night to urinate.
Not occasionally. Most nights. For the rest of their lives.
It is called nocturia, and it is not a small thing. It fragments sleep. It corrodes quality of life. And it is independently linked to higher mortality in this population. The American Cancer Society's prostate cancer survivorship guidelines rate the evidence supporting current nocturia treatments at zero. The lowest rating possible. Desmopressin, alpha blockers, anti-muscarinics, surgical interventions. Zero. That is what these men are being offered.
Sit with that for a second.
In April, JAMA Oncology published a pilot randomized controlled trial out of Memorial Sloan Kettering's Integrative Medicine Service (major props to MSK for their work with cancer AND ACUPUNCTURE). The NOCTURNAL trial. Sixty prostate cancer survivors, mean age seventy two, randomized two to one to either ten weekly acupuncture treatments or a usual care waitlist control. Every participant came in with at least two nocturia episodes per night for the past month. Outcomes were measured with the International Prostate Symptom Score, the validated instrument for this work.
Here is what they found.
At the end of ten weeks, the acupuncture group had 1.13 fewer nocturia episodes per night than usual care (95% CI -1.56 to -0.71, P < .0001). One month after treatment ended, the effect was still there. 0.85 fewer episodes per night (95% CI -1.27 to -0.42, P = .0001). IPSS total scores dropped by 3.76 points at end of treatment and 3.39 points at one month follow up. Both clinically meaningful. Both holding.
Adverse events in the acupuncture group were few and mild.
The authors note that the effects of acupuncture on nocturia in this trial were comparable or superior to desmopressin, alpha blockers, and anti-muscarinic medications. The medications these men are being prescribed right now, with their dry mouth and their dizziness and their hyponatremia risk in an aging population already sitting on a stack of other prescriptions. Acupuncture matched or beat them. With a side effect profile that does not.
I want to name what this study is, and what it is not.
It is a pilot. Sixty men. The authors are clear that larger trials are coming and need to come. This is not the final word. It is a simply a start.
It is a strong signal. In a population the field has functionally given up on. In a symptom the establishment has rated zero.
The biological plausibility has been there for a while. Electrical stimulation of lumbosacral acupoints modulates the pelvic, pudendal and hypogastric nerves that innervate the bladder and lower urinary tract. We have animal models showing acupuncture of the sacral vertebrae suppresses bladder activity and bladder activity related neurons in the brainstem micturition center. We have RCTs in stress urinary incontinence, overactive bladder, BPH and chronic prostatitis. The mechanism is not mysterious. The pathway is not new.
What is new is that someone finally ran the trial in this exact population. And the trial worked.
Here is the part I want my colleagues to hear.
We have been treating these clients for years. Quietly. In our treatment rooms. With needles in BL 23, BL 28, BL 32, BL 33, with sacral electrostim, with the deeper work in the bao mai and the kidney jing and the slow tending of a pelvic floor that has been irradiated or surgically altered. We have watched men in their seventies sleep through the night for the first time since their diagnosis. We have watched their wives cry in the front office because their husband finally came back to the bed.
We have known.
What we have not had, until now, is the language of a JAMA Oncology citation to put next to the work. We do now.
Liou KT, Carlsson S, Ajay D, et al. Acupuncture for nocturia in survivors of prostate cancer: The NOCTURNAL randomized clinical trial. JAMA Oncol 11:791-794, 2025.
Save it. Print it. Put it in the folder you keep for the urologist who has not referred to you yet.
This is closing the gap.
This is the medicine showing up in the journals where the oncologists are reading. This is integrative medicine researchers at one of the most respected cancer centers in the world publishing a positive pilot in the exact population that the survivorship guidelines have been failing for a decade.
Two in three. Zero evidence rating. Until now.