Psychotherapy May Ease Hot Flashes After Breast Cancer

TUESDAY, Feb. 14 (HealthDay News) — After breast cancer
treatment, many women suffer from hot flashes and night sweats, but a type
of “talk therapy” might relieve these symptoms for some women, British
researchers suggest.

In a new study, women who received this form of psychotherapy, known as
cognitive behavioral therapy, had reduced their symptoms by half within
six months.

“Hot flashes and night sweats are distressing symptoms, which cause
social embarrassment and sleep problems, and they are challenging to
treat, especially for women who have had breast cancer” because hormone
replacement therapy is generally not recommended for these women,
explained lead researcher Myra Hunter.

According to background information in the study, which is published in
the Feb. 15 online edition of The Lancet Oncology, 65 percent to 85
percent of women have hot flashes after breast cancer treatment.

Group cognitive behavioral therapy is a safe and effective treatment
for women who have hot flashes and night sweats following breast cancer
treatment, Hunter said, with additional benefits to mood, sleep and
quality of life.

“The women in this trial reported frequent and problematic symptoms and
relatively low quality of life,” said Hunter, a professor of clinical
health psychology at King’s College London’s Institute of Psychiatry.

Hunter’s team randomly assigned 96 women who had been treated for
breast cancer and suffered from night sweats and hot flashes to either
“talk therapy” or usual care.

The 47 women who received the therapy attended weekly 90-minute
sessions for six weeks. For the others, usual care consisted of access to
nurses and oncologists, telephone support and cancer support services, the
researchers noted.

The therapy sessions included psycho-education, paced breathing, and
behavioral strategies to manage hot flashes and night sweats, as well as
interactive PowerPoint presentations, group discussion, handouts and
weekly homework, Hunter said.

In addition, participants learned how to handle the stress associated
with hot flashes and night sweats, and found new ways to decrease anxiety,
she explained.

The women were also taught to manage hot flashes in social situations
and to understand night sweats and improve sleep habits using mental and
behavioral strategies.

The investigators found that the women who had received the cognitive
behavioral therapy significantly reduced the number of hot flashes and
night sweats they experienced in the nine weeks after the start of the
study.

This reduction in symptoms lasted for 26 weeks. At nine weeks there was
a 46 percent reduction in symptoms and a 52 percent reduction at 26 weeks,
Hunter’s team found.

However, among women receiving usual care, hot flashes and night sweats
decreased by 19 percent after nine weeks and 25 percent after 26
weeks.

“These reductions were sustained and associated with significant
improvements in mood, sleep and quality of life,” Hunter said. “This is a
safe, acceptable and effective treatment option, which can be incorporated
into breast cancer survivorship programs and delivered by trained breast
cancer nurses.”

Holly Prigerson, director of the Center for Psycho-Oncology and
Palliative Care Research at the Dana-Farber Cancer Institute in Boston,
wrote an accompanying journal editorial.

“Hot flashes and night sweats are very common, distressing and
persistent — women reported being troubled by them for an average of two
years after breast cancer treatment,” Prigerson said.

She noted that the new study provides sound evidence upon which to
recommend cognitive behavioral therapy for breast cancer patients
suffering from these symptoms.

“Adaptations to an online, self-management version of the intervention
would allow for more flexible scheduling and greater access at potentially
lower cost of delivery,” Prigerson said. “Combining the intervention with
medications that effectively treat hot flashes and night sweats might
produce the most dramatic effects with reductions in symptoms as well as
the distress caused by them.”

Prigerson said this type of therapy might also be used to treat
postmenopausal women suffering from these symptoms.

“Of course, scientifically, we can’t generalize beyond the sample of
women who experience menopausal symptoms as a result of treatment for
breast cancer,” she said. “But given that they found that [this type of
therapy] worked on the distress associated with hot flashes and night
sweats, then it would seem likely to generalize to menopausal symptoms
experienced outside of this context.”

More information

For more about psychotherapy, visit the U.S. National Institute of Mental Health.

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