Acupuncture for hot flashes in breast cancer patients
Medication for breast cancer patients causes severe hot flashes, leading to discomfort and disrupting sleep. The hot flashes can be so severe that some patients stop taking the medication. But acupuncture may be able to help with the problem.
Each year, more than 4,000 Danish women are diagnosed with breast cancer. In most cases, treatment consists of surgery, chemotherapy, and anti-estrogen hormone therapy for at least five years to prevent recurrence of the disease. In younger women, treatment can cause unpleasant side effects in the form of artificial menopause and can worsen hot flashes in older women who have already reached menopause.
"Especially sweating and interrupted sleep are a problem. Some women change nightwear several times during the night, and some even have a made-up bed next to them that they switch to because the bedding is soaked through. The interrupted sleep leads to unalertness, fatigue, and reduced quality of life for many women," says Susanne Bokmand, chief physician at the Mammacenter, a department for breast cancer patients at Vejle Hospital.
Acupuncture may alleviate hot flashes
For some, hot flashes are so unbearable that they stop taking anti-estrogens for a shorter or longer period, explains Jill Hervik, an acupuncturist and physiotherapist at the pain relief department at Sykehuset in Vestfold in Norway. Jill Hervik has therefore, in collaboration with chief physician Odd Mjåland, investigated whether acupuncture can relieve hot flashes in breast cancer patients.
In the study, half of the patients received traditional Chinese acupuncture, while the other half received 'sham acupuncture,' where needles identical to acupuncture needles were only inserted a few millimeters into the skin.
Among the women who received real acupuncture, five out of six experienced a halving of the number of hot flashes. Only a little more than one out of six who received sham acupuncture experienced the same effect. Furthermore, the effect persisted in the group that received real acupuncture. 12 weeks after the treatment stopped, the number of hot flashes was still 30 percent lower than before treatment. Conventional treatment for hot flashes is prohibited.
Healthy women who experience hot flashes due to menopause often receive female sex hormones. But this treatment is prohibited for breast cancer patients because it would increase the risk of the cancer returning.
Instead, some breast cancer patients receive a blood pressure-lowering substance that reduces sweating, explains Susanne Bokmand. But for the substance to have the proper effect, such a high dose is required that women experience other side effects such as drowsiness and dizziness.
Doctor positive about acupuncture
Susanne Bokmand believes it is important to investigate whether acupuncture can be a side-effect-free solution for breast cancer patients. At the Mammacenter, she recently completed a study on the effect of acupuncture on hot flashes and night sleep in breast cancer patients. The study compared three groups of women who received correct acupuncture, 'sham acupuncture' (placebo), and no acupuncture, respectively.
"In my project, acupuncture has shown a significant effect with an improvement in hot flashes and night sleep, and the effect lasted for at least 12 weeks," she says.
Based on the study and her own experience, Susanne Bokmand is not afraid to recommend acupuncture and assesses that acupuncture can be given at any time during the treatment course.
More research needed
Jill Hervik, who is behind the Norwegian study, hopes that acupuncture will make it easier for breast cancer patients to live with anti-estrogen treatment. However, she explains that a larger American study from 2007 could not demonstrate a decisive effect of real acupuncture over sham acupuncture. Therefore, she emphasizes the importance of more research.
This news was published: 20.08.2010
Sources
Deng, G. et. al.: Randomized, Controlled Trial of Acupuncture for the Treatment of Hot Flashes in Breast Cancer Patients, Journal of Clinical Oncology, 2007
Hervik, Jill et. al.: Acupuncture for the treatment of hot flashes in breast cancer patients, a randomized controlled trail, Breast Cancer Research and Treatment, 2009
