The small study reviewed here found that 12 weeks of acupuncture provided the same relief from hot flashes related to breast cancer treatment as Effexor (chemical name: venlafaxine), an antidepressant medicine.
Hormonal therapy often is used after surgery and other treatments to lower the risk of hormone-receptor-positive, early-stage breast cancer coming back (recurring) in post-menopausal women. Hormonal therapy works by lowering the amount of estrogen in the body or by blocking estrogen's effect on cancer cells. Reducing the amount of estrogen or blocking its effects can cause hot flashes during treatment. Besides hot flashes, hormonal therapy also may cause sleeping problems, moodiness, and an overall lower quality of life. Doctors sometimes call hot flashes and related side effects "vasomotor symptoms." Naturally-occurring menopause often is accompanied by these same troubling vasomotor symptoms.
Antidepressants such as Effexor are used sometimes to ease severe hot flashes.
In this study, 47 women diagnosed with early-stage, hormone-receptor-positive breast cancer were treated with either tamoxifen or an aromatase inhibitor. All the women were having hot flashes and other side effects related to the hormonal therapy. Some of the women got Effexor for 12 weeks to ease the hot flashes. The other women got acupuncture twice a week for 4 weeks and then once a week for the next 8 weeks. All the women kept a hot flash and quality of life diary during the 12 weeks of treatment.
The results:
While acupuncture appears to ease hot flashes, it's not clear how the treatment works.
If you're having hot flashes because of breast cancer treatment and are considering medical treatment or have taken an antidepressant that didn't help or caused side effects, you might want to talk to your doctor about this study. Acupuncture is one of several complementary and holistic medicine techniques that have been shown to help women deal with menopausal or treatment-related hot flashes. Other techniques include yoga, massage, and meditation.
You can read more about treatments to help ease hot flashes on the Breastcancer.org All About Hot Flashes page and you can learn more about acupuncture in the Complementary and Holistic Medicine section.
BOSTON, Sept. 22 (MedPage Today) -- For breast cancer patients with treatment-related vasomotor symptoms, acupuncture may offer an effective, durable alternative to drug therapy with fewer side effects, researchers found.
Acupuncture and venlafaxine (Effexor) proved equally effective for reducing hot flashes, night sweats, and other effects of antiestrogen therapy, Eleanor M. Walker, M.D., of Henry Ford Health System in Detroit, reported here at the American Society for Therapeutic Radiology and Oncology meeting.
However, patients randomized to acupuncture reported no adverse effects, whereas those treated with venlafaxine reported a number of side effects.
Moreover, the therapeutic effects of acupuncture persisted longer after treatment ended compared with patients on the antidepressant, the researchers said.
"Women who took the drug therapy started to have an increase in the number and intensity of hot flashes within two weeks of discontinuing the drug therapy, whereas women who had acupuncture didn't start to have an increase in the number or severity of hot flashes for 14 or 15 weeks after discontinuing therapy."
Vasomotor symptoms are a common consequence of antiestrogen therapy for breast cancer patients and can be debilitating in some cases. Hormonal therapy, a standard treatment for menopausal symptoms, are contraindicated for breast cancer patients, Dr. Walker noted.
Antidepressants, particularly the selective serotonin-reuptake inhibitors (SSRIs), effectively relieve adverse effects of antiestrogen therapy, but side effects, which can include sexual dysfunction, are a problem for some patients, and others do not want to take additional medication, Dr. Walker added.
Some evidence had suggested that acupuncture can reduce treatment-related vasomotor symptoms, so the researchers examined the issue in a trial involving 47 breast cancer patients reporting significant vasomotor symptoms during treatment with tamoxifen or an aromatase inhibitor.
At study entry, every patient reported a minimum of 14 hot flashes a week.
Patients randomized to acupuncture had two treatment sessions weekly for the first four weeks, followed by weekly sessions during the final eight weeks.
Patients treated with venlafaxine received standard daily doses used to manage vasomotor symptoms.
Beginning a week before randomized therapy, patients maintained a daily diary of the number and severity of hot flashes, which they continued during the study and then at specified intervals for a year after the study ended.
The primary endpoint was the change in frequency and severity of hot flashes during the 12 weeks of treatment.
Secondary outcomes included menopause-specific quality of life, general health status, change in score on the Beck Depression Inventory, and treatment-related adverse effects.
Patients in both groups reported significant improvement in menopausal symptoms, quality of life, and depressive symptoms, and the extent of improvement was similar with either treatment, Dr. Walker reported.
Patients in the venlafaxine group reported a variety of adverse effects that included nausea, dry mouth, headache, sleep disturbance, dizziness, vision disturbance, increased blood pressure, fatigue, and anxiety.
The acupuncture group not only reported no treatment-related side effects but said they had improvement in energy, clarity of thought, sexual desire, and overall sense of well-being.
Future studies will focus on elucidating the mechanisms of action by which acupuncture relieves vasomotor symptoms, the researchers said. Evaluations in patients with prostate cancer and peripheral neuropathy also are planned.
Dr. Walker and her co-investigators reported no conflicts of interest.
Primary source: International Journal of Radiation Oncology - Biology - Physics Source reference: Walker EM, et al "Acupuncture for the treatment of vasomotor symptoms in breast cancer patients receiving hormone suppression treatment" Int J Radiat Oncol Biol Phys 2008; 72(1 Suppl):S103. Abstract 228.
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