Behavioral Therapy Eases Side-Effects from Breast Cancer Treatment
Article date: March 20, 2012
By Stacy Simon
After breast cancer treatment, 65% to 85% of women experience hot flashes and night sweats – many of them severe enough to affect sleep, mood, and quality of life. These symptoms are challenging to treat because the most effective therapy, hormone treatment with estrogen and progesterone, can increase chances of the cancer returning and is therefore not often an option for breast cancer survivors. A new study by British researchers found that cognitive behavioral therapy (CBT) can help women safely manage their hot flashes and night sweats.
The study, which was published in The Lancet Oncology, involved 96 women who were treated at breast cancer clinics in London and were experiencing at least 10 episodes per week of hot flashes and night sweats. About half the women received usual care, which included 6-month follow-up appointments, telephone support services, information about managing symptoms through paced breathing and relaxation, and continued use of any medication they were already taking for their symptoms. The other half received usual care plus CBT. During one 90-minute session a week for 6 weeks, CBT participants practiced paced breathing and relaxation. They used class discussions and homework to identify triggers, manage social situations, and create strategies to improve sleep.
The women answered questionnaires about the frequency and severity of their hot flashes and night sweats and rated them on a 10-point scale. After 9 weeks, the CBT group reported a 46% reduction in the severity of symptoms compared to a 19% reduction reported by the usual care group. After 26 weeks, the CBT group reported a 52% reduction compared to a 25% reduction in the usual care group. There was no difference between the two groups in frequency of hot flashes and night sweats. However, the CBT group also reported improvements in mood, sleep and quality of life.
The researchers conclude that CBT has long-term health benefits, and suggest it be incorporated into breast survivorship programs. In an accompanying editorial, Holly Prigerson, Center for Psycho-Oncology and Palliative Care Research, Dana-Farber Cancer Institute in Boston, writes, there are concerns about restricted access to clinics where patients can enroll in CBT programs.
Prigerson writes, “The adaptation of the examined face-to-face, group CBT intervention to an online, CBT-based self-management intervention might be more cost-effective, offer greater flexibility in the timing and location of participation, enhance access, and potentially prove more sustainable.”
Reviewed by: Members of the ACS Medical Content Staff
Citation: Cognitive behavioural treatment for women who have menopausal symptoms after breast cancer treatment (MENOS 1): a randomised controlled trial. Published online Feb. 15, 2012 in The Lancet Oncology. First author: Eleanor Mann, DPhil, King’s College, London.
Thank you for your feedback.