(1) Background: This pilot study evaluates the feasibility and preliminary effects of acupuncture for cancer-related cognitive dysfunction (CRCD) in cancer survivors. (2) Methods: A randomized trial comparing real acupuncture (RA) to sham acupuncture (SA) and waitlist control (WLC) among cancer survivors reporting cognitive difficulties. Interventions were delivered weekly over 10 weeks. Feasibility was evaluated by recruitment, treatment adherence, and assessment completion. Subjective CRCD was assessed by the Functional Assessment of Cancer Therapy-Cognitive Function—Perceived Cognitive Impairment subscale (FACT-Cog PCI) and objective CRCD was assessed by the Hopkins Verbal Learning Test—Revised (HVLT-R). (3) Results: 32 participants (57.1% of eligible patients) were enrolled. All participants in acupuncture groups completed ≥8 of 10 treatments. Assessment completion rate was 100% for all participants. From baseline to week 10, the RA group (n = 19) reported a clinically meaningful 17.3-point increase in FACT-Cog PCI (95% confidence interval [CI] 12.5 to 22.1), compared to 9.7 points (95% CI 2.8 to 16.7) in the SA group (n = 9), and 6.8 points (95% CI −3.7 to 17.2) in the WLC group (n = 4). In the subgroup analysis among patients with a below-average baseline HVLT-R (T-score < 50), the RA group (n = 8) increased FACT-Cog PCI scores by 20.4 (95% CI 13.6 to 27.3), compared to 11.1 points (95% CI 0.6 to 21.5) in the SA group (n = 5). The improvements from RA persisted through week 16 in both the total sample and the sub-group. Eleven mild adverse events were reported, with pain and bleeding at the needling sites being the most common. (4) Conclusions: The findings support the feasibility and safety of conducting a randomized, placebo-controlled trial to evaluate acupuncture for cognitive dysfunction in cancer survivors.

Chronic pain significantly impairs functional performance in patients with cancer. Although acupuncture is effective for cancer-related pain, its impact on pain-related functional interference remains unclear. This secondary analysis of the PEACE randomized clinical trial included patients with prior cancer diagnoses and musculoskeletal pain for ≥3 months. Participants were randomized to groups undergoing 10 weeks of electro-acupuncture, auricular acupuncture, or a waitlist control. Functional performance was assessed using the Quick-Disability Arm/Shoulder/Hand (Q-DASH) for upper limbs and the Western Ontario and McMaster Universities Osteoarthritis (WOMAC) subscale for lower limbs (higher scores = worse function). Linear mixed models compared changes over time between groups, with week 12 as the primary endpoint. Functional changes were also compared between pain responders and non-responders in the acupuncture arms. Among 360 patients (mean [SD] age, 62.1 [12.7] years; 69.7% women), mean baseline Q-DASH and WOMAC scores were 33.2 (19.8) and 33.3 (20.3). At week 12, both electro-acupuncture and auricular acupuncture significantly improved function versus waitlist: Q-DASH by −7.18 and −9.64 points, respectively, and WOMAC by −6.89 and −7.61 points (all p < 0.001). No differences were found between the two acupuncture groups. Treatment effects on Q-DASH diminished during follow-up, while improvements on WOMAC persisted. Within the acupuncture groups, pain responders achieved greater functional gains than non-responders (Q-DASH, −6.74; WOMAC, −6.16; both p < 0.001). Electro-acupuncture and auricular acupuncture improved upper and lower extremity function in cancer patients with chronic pain. These findings support acupuncture as a potential adjunct in functional rehabilitation for cancer survivors.