A Swedish pilot study has tested a modified single subject experimental design for evaluating the use of acupuncture for emesis during radiotherapy. Ten cancer patients were randomised to verum penetrating acupuncture or non-penetrating sham needles for 30 minutes, two to three times per week during radiotherapy. They answered test-retested emesis questions covering nausea, vomiting, use of antiemetics, wellbeing and activities of daily living. Overall, the patients completed 98% of the 345 emesis-questionnaire days. Ten patients experienced antiemetic effects, seven relaxation, five pain-reduction and five experienced sleep improvement. Nausea was experienced by one out of five verum acupuncture-treated patients and four out of five sham acupuncture treated patients. (Pilot testing of methods for evaluation of acupuncture for emesis during radiotherapy: a randomised single subject experimental design. Acupunct Med. 2011 Apr 3). A study published by some of the same Swedish authors has found no difference between verum and sham acupuncture for treating nausea in cancer patients undergoing radiotherapy. Two hundred and seventy-seven cancer patients were randomised to receive verum (penetrating) acupuncture at Neiguan P-6 or sham acupuncture (performed with a telescopic non-penetrating needle at a sham point) two to three times per week during radiotherapy. The acupuncture cohort was compared to a reference cohort receiving standard care. Nausea and vomiting during the preceding week was reported by 8% of the verum acupuncture group, 7% of the sham acupuncture group and 15% of the standard care group respectively. Nausea intensity was lower in the acupuncture cohort compared to the standard care cohort and 95% of the acupuncture cohort expected antiemetic effects from their treatment. Patients who expected nausea had increased risk for nausea compared to those who expected low risk for nausea. The authors conclude that patients treated with verum or sham acupuncture experienced less nausea and vomiting compared to patients receiving standard care, possibly through a general care effect or due to a high level of patient expectancy. (Getting the grip on nonspecific treatment effects: emesis in patients randomized to acupuncture or sham compared to patients receiving standard care. PLoS One. 2011 Mar 23;6(3):e14766).