One of the biggest complaints of patients being treated for
breast cancer is treatment-related hot flashes. For women without cancer, hot
flashes are often treated with estrogen products; however, for breast cancer
patients, these products are contraindicated because of their potential to
increase the risk of cancer's return. Megestrol acetate (Megace®) is also
commonly used, but this drug causes weight gain, which is an understandably
unpopular side effect for many women. The drug most commonly used for hot
flashes is Effexor, a selective serotonin reuptake inhibitor/antidepressant, but this too
has associated side effects—namely sexual dysfunction and nausea— that require
taking yet more pills. But new research finds that some side effects of breast
cancer-related treatments may be handled by acupuncture treatment that is effective,
much less debilitating, with fewer side effects and more durable compared to
drug therapy.
Clinical Trial Effexor vs Acupuncture
In this randomized clinical trial, Dr Walker, director of breast radiation
oncology in the Henry Ford Health System, and colleagues examined the effect of
acupuncture or Effexor on hot flashess in breast cancer patients (Stages 0-III) who
had been receiving either tamoxifen or Arimidex and who had been having at
least 14 hot flashes per week.
Patients in both the acupuncture group and the Effexor group had significant
decreases in hot flashes, other menopausal symptoms, and depressive symptoms.
Thus, acupuncture was found to be at least as effective as venlafaxine in
reducing vasomotor and other symptoms associated with anti-estrogen hormonal
treatment of breast cancer.
Acupuncature treatment has less side effects
There was, however, a big difference between the 2 modalities with regard to
side effects: Many patients treated with Effexor reported experiencing
nausea, dry mouth, headache, difficulty sleeping, dizziness, double vision,
increased blood pressure, constipation, fatigue, anxiety, feeling “spaced out,”
and body jerking during the night. Patients treated with acupuncture
experienced no negative side effects. Instead they reported having more energy,
increased sexual desire, being able to think more clearly, and feeling better
overall than before treatment.
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 Effexor 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.
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.
