Using traditional acupuncture for breast cancer-related hot flashes and night sweats.

Supportive Oncology Research Team (SORT), Lynda Jackson Macmillan Centre (LJMC), Mount Vernon Hospital, Middlesex, United Kingdom.
Journal of alternative and complementary medicine (New York, N.Y.) (Impact Factor: 1.52). 10/2010; 16(10):1047-57. DOI: 10.1089/acm.2009.0472
Source: PubMed

ABSTRACT Women taking tamoxifen experience hot flashes and night sweats (HF&NS); acupuncture may offer a nonpharmaceutical method of management. This study explored whether traditional acupuncture (TA) could reduce HF&NS frequency, improve physical and emotional well-being, and improve perceptions of HF&NS. DESIGN/SETTINGS/LOCATION: This was a single-arm observational study using before and after measurements, located in a National Health Service cancer treatment center in southern England.
Fifty (50) participants with early breast cancer completed eight TA treatments. Eligible women were ≥ 35 years old, ≥ 6 months post active cancer treatment, taking tamoxifen ≥ 6 months, and self-reporting ≥ 4 HF&NS incidents/24 hours for ≥ 3 months.
Participants received weekly individualized TA treatment using a core standardized protocol for treating HF&NS in natural menopause.
Hot Flash Diaries recorded HF&NS frequency over 14-day periods; the Women's Health Questionnaire (WHQ) assessed physical and emotional well-being; the Hot Flashes and Night Sweats Questionnaire (HFNSQ) assessed HF&NS as a problem. Measurements taken at five points over 30 weeks included baseline, midtreatment, end of treatment (EOT), and 4 and 18 weeks after EOT. Results for the primary outcome: Mean frequency reduced by 49.8% (95% confidence interval 40.5-56.5, p < 0.0001, n = 48) at EOT over baseline. Trends indicated longer-term effects at 4 and 18 weeks after EOT. At EOT, seven WHQ domains showed significant statistical and clinical improvements, including Anxiety/Fears, Memory/Concentration, Menstrual Problems, Sexual Behavior, Sleep Problems, Somatic Symptoms, and Vasomotor Symptoms. Perceptions of HF&NS as a problem reduced by 2.2 points (standard deviation = 2.15, n = 48, t = 7.16, p < 0.0001).
These results compare favorably with other studies using acupuncture to manage HF&NS, as well as research on nonhormonal pharmaceutical treatments. In addition to reduced HF&NS frequency, women enjoyed improved physical and emotional well-being, and few side-effects were reported. Further research is warranted into this approach, which offers breast cancer survivors choice in managing a chronic condition.

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    ABSTRACT: Objective: Short term effects of acupuncture treatment for hot flashes (HF) in breast cancer patients has been demonstrated in several studies, including a randomized controlled trial, by the present authors. Results for the first 59 Tamoxifen medicated women receiving a 10 week course of acupuncture treatment have already been published. A significant reduction in the number of hot flashes was demonstrated both day and night, for up to three months following treatment in the women receiving traditional Chinese acupuncture. The control group receiving sham (minimal acupuncture) demonstrated a HF reduction only at night during treatment, however the effect did not remain not significant during the following 12 weeks. The study was continued in order to investigate longer term effects of acupuncture treatment, and patient’s quality of life two years after treatment. Methods and materials: Eighty patients, who had 2 years previously been randomized to either a course of 15 acupuncture treatments or sham acupuncture (control) over a period of 10 weeks, were asked to fill out a Kupperman index (KI) indicating health related quality of life. Results: Sixty one women returned KI questionnaires. A mixed models procedure with diagonal covariance matrix was used for statistical analyses. Baseline values between the sham-group and acupuncture group were not significantly different. However scores at the end of treatment and after 3 months showed a statistically significant difference between the groups, this difference lost its significance when scores were analyzed after 2 years. Conclusion: Acupuncture seems to have a positive effect on health related quality of life for up three months post-treatment, this study suggests that these effects may be longer-term, however there was no significant effect 2 years later. Key Words: Acupuncture, breast cancer, hot flashes, quality of life, long-term follow up.
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    ABSTRACT: Hot flashes are a distressing symptom frequently experienced by survivors of breast cancer or prostate cancer who are receiving estrogen or androgen-deprivation therapies. The frequency and intensity of hot flashes can lead to diminished quality of life and decreased adherence with prescribed antineoplastic therapies. This evidence-based review synthesizes and updates the findings of the highest quality evidence-based studies of interventions to manage hot flashes resulting from cancer therapies in patients with breast or prostate cancer since the initial Putting Evidence Into Practice review of hot flashes in 2011. Recent studies involving a variety of pharmacologic and nonpharmacologic interventions were evaluated and, as reported in 2011, the drugs gabapentin and venlafaxine were the only therapies rated as likely to be effective. In addition, a strong placebo effect was noted in several studies that included a placebo intervention and should be considered when reviewing interventions for hot flashes.
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