The very first session of the symposium on ‘cancer and acupuncture’ was held at the 53^rd Annual Conference of the Japan Society of Acupuncture and Moxibustion (JSAM). It suggested the efficacy and potential of acupuncture and moxibustion not only for cancer but also for cancer patients. This is the second session for further discussion. In recent years, acupuncture and moxibustion treatment for cancer patients has come to the world's attention, and many reports about its expediency and beneficial effect have been conducted in Japan and in the world. However, the adaptation range of acupuncture and moxibustion treatment for cancer is still limited because there is not enough evidence, so compilations of more sufficient case reports or research for presentation and effects in preventing relapse of cancer are required to prove its reliability. Acupuncture and moxibustion are used as one of the medical treatments directed at relieving symptoms and life-sustaining treatment in hospitals today. Earlier, frequent acupuncture treatment led to significant efficacy for cancer patients, and it is also reported that the number of lymphocytes increases in sequential acupuncture treatment but the number tends to return in a short time after cessation of treatment. Sequential autonomic immune therapy over a long term revealed several significant effects as follows; lymphocyte activation while the lymphocyte count remained, increase of cytokine (IL 12, IFNγ, TNFα, etc.) production and Th 1, Th 1/Th 2, immunostimulatory activity effect, reduction of tumor markers down to or close to normal, reduction or resolve of malignant neoplasm and recurrence prevention for unoperated cancer patients, QOL improvement with symptoms relief and life prolongation. In this seminar, it suggested that acupuncture and moxibustion are potential and appropriate treatments for cancer and further research in this field is required.

This is the third symposium on 'cancer and acupuncture and moxibustion'. Many physicians and intellectuals are skeptical of the use of Western medicine for cancer patients, which often lead to serious adverse events. Acupuncture and moxibustion, which is capable of improving quality of life (QOL) and activating immunity with minimal side effects is also expected to have beneficial effects on various stages of cancer patients, such as prevention of development or recurrence of cancer and palliative care. In fact, evidence has recently accumulated in the field. Dr. Fukuda, Associate Professor of Meiji University of Integrative Medicine, who reported the usefulness of acupuncture and moxibustion in palliative care in the first symposium and bibliographical information in the second has reported this time on the topic of safety and effectiveness of acupuncture on chemotherapy-induced peripheral neuropathy. Dr. Kurokawa from the National Defense Medical College reported the effectiveness of acupuncture on physical and psychological symptoms, QOL, prevention of adverse events, and pre-and post-operative disorders in cancer patients. Dr. Kouchi from Saitama Medical School reported on the usefulness of acupuncture in the university hospital and factors which influence the effect. Dr. Nakamura from Morinomiya University presented a case with chemotherapy-related symptoms who had been cared for with a long-term application of moxibustion. In contrast to these reports on the efficacy of the acupuncture for chemotherapy-and radiotherapy-induced side effects, Dr. Magara from Somon Hachipuji Clinic, who had consistently reported a preventive effect of autonomic immune therapy that involves acupuncture without Western clinical treatment from the first symposium, this time presented topics regarding improvement in the immunity by increasing various cytokines, the possibility of reduction of a tumor even in a case of advanced cancer that cannot be treated with a surgical approach, reduction of the recurrence rate among cases who were treated with his approach as compared with those under conventional approaches. He insisted we should concentrate our efforts on research on preventing the recurrence of cancer with approaches that activates the natural healing process of human beings.
We concluded that clinical trials with a larger sample are needed to clearly identify the usefulness of acupuncture and moxibustion for cancer patients.

In recent years, we have been told that the western medicine has developed the techniques of treatments on cancer, but the truth is that very few practical accomplishments has been made, while death rate from cancer has been steadily increasing. Although acupuncture has been thought to be ineffective in the treatments of cancer, nowadays we find some reports concerning its effectiveness in palliative cares, improvements of quality of life (QOL) and cancer regressions. Thus, this symposium was planned to investigate this theme. There were reports from appointed speakers on the acupuncturists' feelings of swung back and forth between joy and despair when treating patients with cancer, the experiences in treating her parents who died of lung cancer, and the patients who failed or rejected to be treated in western medicine but successfully treated using acupuncture eventually.
A panelist who practices acupuncture treatments in a hospital reported the effectiveness and indications on combined application of acupuncture and standard treatments for the patients in the terminal stage of cancer. He also reported that no correlation had been found between effective rates and duration (frequency) of treatments neither between stages (duration) of disorders and efficacy. Furthermore, if the environment of acupuncture treatment is well organized, he mentioned that acupuncture can produce a good deal of effect even in patients with terminal stage. He also reported that acupuncture will be able to influence on the physiology in autonomic nervous system, leading to the hyperactivity of parasympathetic nerve.
A panelist who practices his acupuncture treatments based on the theory of Professor Abo reported the effectiveness of acupuncture in improving QOL and in prolonging one's life. He showed an actual situation of the patient with scirrhous carcinoma who had prolonged his life for a long period using acupuncture treatment. He also demonstrated that radiotherapy, one of the three major medical treatments for cancer, will deprive the resistance of the patients.
A panelist who advocates salutogenesis demonstrated the possibility of the direct effectiveness of acupuncture treatment on cancer because acupuncture has significant effects in alleviating pains and enhancing the power of restoring human energy in patients with cancer. He mentioned the limitation of the treatments using “a theory of pathogenesis (modern medicine)” and the importance of the treatments using “a theory of salutogenesis (traditional medicine)”, and emphasized the necessity of acupuncture treatments as well as supplemental agents, and the importance of psychological approaches toward the mind of patients.
In this symposium, the efficacy of acupuncture treatments as palliative cares was indicated. Although there are few convincing evidences, the efficacy of acupuncture treatments as one of treatment methods for cancer may be demonstrated. Further integrative researches on the efficacy of acupuncture in patients with cancer are needed.

Background/Aims: A subgroup analysis was conducted in Japanese patients with moderate to severe ulcerative colitis (UC) enrolled in the phase 3 VISIBLE 1 study, which evaluated the safety and efficacy of a new vedolizumab subcutaneous (SC) formulation. Methods: Eligible patients received open-label infusions of vedolizumab 300 mg intravenous (IV) at weeks 0 and 2 in the induction phase. Patients with clinical response by complete Mayo score at week 6 entered the double-blind maintenance phase and were randomized to vedolizumab 108 mg SC every 2 weeks, placebo, or vedolizumab 300 mg IV every 8 weeks. The primary endpoint was clinical remission (complete Mayo score ≤ 2 points; no individual subscore > 1 point) at week 52. Results: Of 49 patients who entered the induction phase, 22 out of 49 patients (45%) had clinical response at week 6 and were randomized to vedolizumab 108 mg SC (n = 10), placebo (n = 10), or vedolizumab 300 mg IV (n = 2). At week 52, 4 out of 10 patients (40%) who received vedolizumab SC had clinical remission versus 2 out of 10 patients (20%) who received placebo (difference: 20% [95% confidence interval, –27.9 to 61.8]). Two patients (2/10, 20%) who received vedolizumab SC experienced an injection-site reaction versus none who received placebo. Conclusions Our results indicate that the efficacy of vedolizumab SC in a subgroup of Japanese patients with UC are similar with those in the overall VISIBLE 1 study population, and with those established with vedolizumab IV. The safety and tolerability of vedolizumab SC were generally similar to that established for vedolizumab IV. (ClinicalTrials.gov ID NCT02611830; EudraCT 2015-000480-14)