After surgery, women diagnosed with hormone-receptor-positive breast cancer usually take hormonal therapy medicine to reduce the risk of the cancer coming back (recurrence). Hormonal therapy medicines work in two ways:
- by lowering the amount of estrogen in the body
- by blocking the action of estrogen on breast cancer cells
There are several types of hormonal therapy medicines. Tamoxifen, a selective estrogen receptor modulator (SERM), is one of the most well-known. Tamoxifen can be used to treat both premenopausal and postmenopausal women. In the early 2000s, the aromatase inhibitors:
- Arimidex (chemical name: anastrozole)
- Aromasin (chemical name: exemestane)
- Femara (chemical name: letrozole)
were shown to be more effective at reducing recurrence risk in postmenopausal women and are now used more often than tamoxifen to treat women who’ve gone through menopause. Aromatase inhibitors aren’t used to reduce recurrence risk in premenopausal women.
Both tamoxifen and aromatase inhibitors can cause side effects. Tamoxifen may cause hot flashes and increase the risk of blood clots and stroke. Aromatase inhibitors may cause muscle and joint aches and pains, as well as hot flashes. Less common but more severe side effects of aromatase inhibitors are heart problems, osteoporosis, and broken bones. Research has shown that about 25% of women who are prescribed hormonal therapy to reduce the risk of recurrence after surgery either don’t start taking the medicine or stop taking it early.
If there were a way to ease hot flashes -- one of the most aggravating side effects of hormonal therapy for many women -- more women might stick to their hormonal therapy treatment plans.
The results of a small study support earlier research showing that acupuncture can help ease hot flashes and improve quality of life in women who’ve been diagnosed with breast cancer.
The study was published online on March 28, 2016 by the Journal of Clinical Oncology. Read the abstract of “Acupuncture As an Integrative Approach for the Treatment of Hot Flashes in Women With Breast Cancer: A Prospective Multicenter Randomized Controlled Trial (AcCliMaT).”
To do the study, the researchers randomly assigned 190 women who had been diagnosed with and treated for breast cancer who were postmenopausal (either because of treatment or naturally) who were having six or more hot flashes per day to one of two groups:
- enhanced self-care (105 women): all these women were given a detailed information booklet on how to manage hot flashes, including recommendations on diet, exercise, and psychological support; the women were asked to follow the recommendations for at least 12 weeks
- enhanced self-care plus acupuncture (85 women): in addition to the enhanced self-care booklet and recommendations, these women also were offered ten 20-minute traditional Chinese medicine acupuncture sessions; the sessions were given once per week; women diagnosed with lymphedema didn’t receive acupuncture in the affected arm
The researchers wanted to know if the mean hot flash score would decrease more in one group than the other at three assessment points. The mean hot flash score was calculated by multiplying the mean number of daily hot flashes per week by a number that indicated how severe the hot flashes were:
- 1 = mild
- 2 = moderate
- 3 = severe
The women recorded the hot flash information in a study diary.
The researchers assessed the hot flash scores four times:
- just before the study started
- at the end of the 12 weeks of enhanced self-care or enhanced self-care plus acupuncture
- 3 months later
- 6 months later
The women also filled out questionnaires about their quality of life, including questions about their physical, psychosocial, and sexual health.
The women in the two groups were similar in terms of:
- age (about 50)
- weight (143 pounds)
- about 30% to 35% of the women in each group had at least one other medical condition
- more than 89% of the women in each group were being treated with hormonal therapy to reduce the risk of recurrence
None of the women were taking medicines to control hot flashes, including hormone replacement therapy or antidepressants.
At the beginning of the study, the two groups also had similar mean hot flash scores and quality of life assessments.
At the 12-week, 3-month, and 6-month assessments, the acupuncture group had a bigger decrease in hot flash scores compared to the enhanced self-care group. These differences were statistically significant, which means that it was likely due to the acupuncture and not just because of chance.
The women in the acupuncture group also had better physical and psychosocial health scores. These differences also were statistically significant.
There were no differences in the sexual health scores between the two groups.
No serious side effects were reported during the study.
If you're having hot flashes or other hormonal therapy 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 Menopause Symptoms: Hot Flashes pages, and you can learn more about acupuncture in the Complementary & Holistic Medicine section.
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