Non-drug treatments help alleviate symptoms of treatment-induced menopause in breast cancer patients

March 22, 2012

Researchers from The Netherlands have found that the menopausal symptoms caused by giving chemotherapy or hormonal therapy to younger women with breast cancer can be ameliorated considerably through the use of cognitive behavioural therapy (CBT) and physical exercise (PE). These interventions can be effective in dealing with such distressing symptoms as hot flushes, night sweats, vaginal dryness, weight gain, urinary incontinence and sexual problems, a researcher will tell the 8th European Breast Cancer Conference (EBCC-8) today.

The researchers studied 422 with an average age of 48 years recruited from 14 hospitals from the Amsterdam and Rotterdam regions of the Netherlands. They were randomly assigned to four groups – CBT alone, PE alone, CBT and PE combined – and a control group. Compared with the control group, all those patients who received one or both interventions showed an overall decrease in the levels of menopausal symptoms, in addition to reporting an increase in sexuality and an improvement in physical functioning. These positive effects were still apparent after six months.

"To our knowledge, this is the first study to investigate the efficacy of these two interventions specifically in women who have experienced acute, treatment-induced menopause," Dr. Marc van Beurden from The Netherlands Cancer Institute, Amsterdam, The Netherlands, will say. "This is a very important issue for the quality of life of younger patients. Unlike healthy women starting the menopause, they are unable to take hormone replacement therapy to alleviate their symptoms. There are other drugs available, but they are only moderately effective and have troublesome side-effects."

The CBT programme consisted of six weekly group sessions of 90 minutes each, including relaxation exercises. The primary focus of the CBT was on hot flushes and night sweats, but other symptoms were also addressed. The PE programme was a 12-week, individually tailored, home-based and self-directed exercise programme of two and a half to three hours per week. Initial training and follow-up was provided by physiotherapists. The goal was to exercise at an intensity level that achieved a target heart rate.

The researchers believe that the CBT reduces stress levels and helps women cope effectively with the symptoms they are experiencing. is intended to reduce hot flushes through an effect on the thermoregulatory system. "There was already evidence that both interventions were effective in women undergoing the natural menopause," says Dr. van Beurden's colleague, Dr. Hester van Oldenburg. "We are pleased to have established that they also work in women with induced menopause, which is significantly more difficult for patients to deal with both because it is caused by cancer treatment, which is distressing in itself, and because the symptoms often come on so quickly that there is little or no time to get used to them."

Patients said that participation in the CBT programme made them more aware of their symptoms and how to deal with them. "Before, I more or less accepted them unconsciously. Now I'm more alert about my symptoms, their effect, and possible ways to cope with them. By sharing my experiences with others, I've learned to put my symptoms in perspective and to cope with them," said one participant.

While the evidence that the interventions worked was convincing, compliance with them was poor, the researchers say. In the case of CBT, it was difficult to schedule the group sessions at a time that was convenient for women who often had both work and parenting responsibilities. The frequency and intensity of the PE programme was also a challenge for many women.

"We think that we have made an important step forward in improving the quality of life of these patients," Dr. van Beurden will say. "Based on input from patients, we are now developing an internet-based version of the programme. We hope that this will further increase the accessibility and convenience of the interventions and lead to more women benefiting from their results."

Professor David Cameron, from the University of Edinburgh (Edinburgh, UK), and chair of EBCC-8 said: " can often be an added burden of side effects for undergoing treatment for breast cancer. This study is important as it offers evidence that there is a way to intervene to make this less of a problem for women, thus allowing them to get on with their lives after curative therapy for breast cancer."

Explore further: Cognitive behavioral therapy is safe, effective for women having hot flushes, night sweats following breast cancer treat

Related Stories

Cognitive behavioral therapy is safe, effective for women having hot flushes, night sweats following breast cancer treat

February 14, 2012
Hot flushes and night sweats (HFNS) affect 65-85% of women after breast cancer treatment; they are distressing, causing sleep problems and decreased quality of life. Hormone replacement therapy is often either undesirable ...

Younger breast cancer patients have more adverse quality-of-life issues

January 20, 2012
Younger women with breast cancer experience a decrease in their health-related quality of life (QOL), associated with increased psychological distress, weight gain, a decline in their physical activity, infertility and early ...

Older women still suffer from hot flushes and night sweats years after the menopause, finds study

October 19, 2011
Women still have hot flushes and night sweats years after the menopause finds a new study published today in BJOG: An International Journal of Obstetrics and Gynaecology.

Recommended for you

Outdoor light at night linked with increased breast cancer risk in women

August 17, 2017
Women who live in areas with higher levels of outdoor light at night may be at higher risk for breast cancer than those living in areas with lower levels, according to a large long-term study from Harvard T.H. Chan School ...

Scientists develop novel immunotherapy technology for prostate cancer

August 17, 2017
A study led by scientists at The Wistar Institute describes a novel immunotherapeutic strategy for the treatment of cancer based on the use of synthetic DNA to directly encode protective antibodies against a cancer specific ...

Toxic formaldehyde is produced inside our own cells, scientists discover

August 16, 2017
New research has revealed that some of the toxin formaldehyde in our bodies does not come from our environment - it is a by-product of an essential reaction inside our own cells. This could provide new targets for developing ...

Cell cycle-blocking drugs can shrink tumors by enlisting immune system in attack on cancer

August 16, 2017
In the brief time that drugs known as CDK4/6 inhibitors have been approved for the treatment of metastatic breast cancer, doctors have made a startling observation: in certain patients, the drugs—designed to halt cancer ...

Researchers find 'switch' that turns on immune cells' tumor-killing ability

August 16, 2017
Molecular biologists led by Leonid Pobezinsky and his wife and research collaborator Elena Pobezinskaya at the University of Massachusetts Amherst have published results that for the first time show how a microRNA molecule ...

Popular immunotherapy target turns out to have a surprising buddy

August 16, 2017
The majority of current cancer immunotherapies focus on PD-L1. This well studied protein turns out to be controlled by a partner, CMTM6, a previously unexplored molecule that is now suddenly also a potential therapeutic target. ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.