Acupuncture and Exercise for EV-Pembro-Induced Peripheral Neuropathy

Inclusion Criteria: * Age ≥ 18 years old * Diagnosed with pathologically proven advanced or metastatic urothelial cancer (mUC) * Planning to receive treatment with EV-Pembro or have received up to two cycles of EV-Pembro treatment with enrollment occurring prior to the start of the third cycle * Self-reported ability to walk for 6 minutes and/or 2 blocks * Deemed acceptable for exercise by their treating provider * Sedentary, currently engaging in less than or equal to 60 minutes of moderate or vigorous structured exercise/week, as assessed by the Godin Leisure-Time Exercise Questionnaire * Willing to adhere to all study-related procedures, including randomization to one of the two possible acupuncture treatments * Eligible per verbally administered Physical Activity Readiness Questionnaire (PAR-Q+) * Referrals to physical therapy are allowed during the study if necessary; and * Participants taking any of medications listed below must be on a stable regimen, with no changes in the past three months. Use of these medications may continue while on study. * Duloxetine, amitriptyline, nortriptyline, gabapentin, and pregabalin Exclusion Criteria: * History of peripheral neuropathy prior to EV-Pembro initiation * Patients with a pacemaker or other electronically charged medical device; or * Participate in more than 60 minutes of moderate or vigorous structured exercise/week Investigators will not include the following special populations: * Adults unable to consent * Individua…