Abstract
Acupuncture has been used to treat the problem of hot flashes in healthy postmenopausal women. The object of this study was to investigate the efficacy of acupuncture in women with breast cancer suffering from hot flashes as a result of anti-oestrogen medication. In a prospective, controlled trial, 59 women suffering from hot flashes following breast cancer surgery and adjuvant oestrogen-antagonist treatment (Tamoxifen) were randomized to either 10 weeks of traditional Chinese acupuncture or sham acupuncture (SA). Mean number of hot flashes at day and night were recorded prior to treatment, during the treatment period as well as during the 12 weeks following treatment. A validated health score (Kupperman index) was conducted at baseline, at the end of the treatment period and at 12 weeks following treatment. During the treatment period mean number of hot flashes at day and night was significantly reduced by 50 and almost 60%, respectively from baseline in the acupuncture group, and was further reduced by 30% both at day and night during the next 12 weeks. In the sham acupuncture group a significant reduction of 25% in hot flashes at day was seen during treatment, but was reversed during the following 12 weeks. No reduction was seen in hot flashes at night. Kupperman index was reduced by 44% from baseline to the end of the treatment period in the acupuncture group, and largely maintained 12 weeks after treatment ended. No corresponding changes were seen in the sham acupuncture group. Acupuncture seems to provide effective relief from hot flashes both day and night in women operated for breast cancer, treated with Tamoxifen. This treatment effect seems to coincide with a general health improvement measured with the validated Kupperman index.
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Carpenter JS, Andriykowski MA, Cordova M, Cunningham L, Studts J, McGrath P, Kenady D, Sloan D, Munn R (1998) Hot flushes in postmenopausal women treated for breast carcinoma: prevalence, severity, correlates, management, and relation to quality of life. Cancer 82:1682. doi:10.1002/(SICI)1097-0142(19980501)82:9<1682::AID-CNCR14>3.0.CO;2-0
Kronenberg F (1994) Hot flashes phenomenology, quality of life, and search for treatment options. Exp Gerontol 29:319–336. doi:10.1016/0531-5565(94)90012-4
Cobleigh MA, Berris RF, Bush T, Davidson NE, Robert NJ, Sparano JA et al (1994) Oestrogen replacement in breast cancer survivors: a time for change. JAMA 272:540–545. doi:10.1001/jama.272.7.540
Loprinzi CL, Zahasky KM, Sloan JA, Novotny PJ, Quella SK (2000) Tamoxifen induced hot flushes. Clin Breast Cancer 1(1):52–56. doi:10.3816/CBC.2000.n.004
Vincent A, Barton Dl, Mandrekar JN, Cha SS, Zais T, Wahner-Roedler DL, Keppler MA, Kreitzer MJ, Loprinzi C (2007) Acupuncture for hot flashes: a randomised, sham controlled clinical study. Menopause 14(1):45–52. doi:10.1097/01.gme.0000227854.27603.7d
Zaborowska E, Brynhildsen J, Damberg S, Fredriksson M, Lindh-Astrand L, Wyon Y, Nedstrand E, Hammar M (2007) Effects of acupuncture, applied relaxation, estrogens and placebo on hot flushes in postmenopausal women: an analysis of two prospective, parallel, randomised studies. Climacteric 10(1):38–45. doi:10.1080/13697130601165059
Nir Y, Huang MI, Schnyer R, Chen B, Manber R (2007) Acupuncture for postmenopausal hot flashes. Maturitas 56(4):383–395
Wyon Y, Wijma K, Nedstrand E, Hammar M (2004) A comparison of acupuncture and oral estradiol treatment of vasomotor symptoms in postmenopausal women. Climacteric 7(2):153–164. doi:10.1080/13697130410001713814
Filshie J, Bolton T, Browne D, Ashley S (2006) Acupuncture and self acupuncture for long- term treatment of vasomotor symptoms in cancer patients-audit and treatment algorithm. Acupunct Med 23(4):171–180
Nedstrand E, Wijma K, Wyon Y, Hammar M (2005) Vasomotor symptoms decrease in women with breast cancer randomised to treatment with applied relaxation or electro-acupuncture: a preliminary study. Climacteric 8(3):243–250. doi:10.1080/13697130500118050
Tukmachi E (2000) Treatment of hot flushes in breast cancer patients with acupuncture. Acupunct Med 18(1):22
Porzio G, Trapasso CT, Martelli S, Sallusti E, Piccone C, Mattei AD, Sanislao C, Ficorella C, Marchetti P (2002) Acupuncture in the treatment of vasomotor symptoms in postmenopausal women taking Tamoxifen. Tumori 88(2):128–130
Towlerton G, Filshie J, O Brien M, Duncan A (1999) Acupuncture in the control of vasomotor symptoms caused by Tamoxifen. Palliat Med 13(5):445. doi:10.1177/026921639901300516
Deng G, Vickers A, Yeung S, Cassileth B (2007) Randomised, controlled trial of acupuncture for the treatment of hot flashes in breast cancer patients. J Clin Oncol 35(25):5584–5590. doi:10.1200/JCO.2007.12.0774
Xinnong C (1990) Chinese acupuncture and moxibustion, vol 2. Foreign Languages Press, Beijing
Macioca G (1994) The practice of Chinese medicine, vol 1. Churchill Livingstone, New York
Heinemann K, Ruebig A, Potthoff P, Strelow H, Heinemann L, Thai DM (2004) The menopause rating scale (MRS). Health Qual Life Outcomes 2:45. doi:10.1186/1477-7525-2-45
Mattsson LA, Skouby S, Rees M, Heikkinen J, Kudela M (2007) 321 Study group. Efficacy and tolerability of continuous hormone replacement therapy in early post menopausal women. Menopause Int 13(3):124–131. doi:10.1258/175404507781605596
Lucerno MA, McCloskey WW (1997) Alternatives to oestrogen for the treatment of hot flashes. Ann Pharmacother 31:915–917
Goldberg RM, Loprinzi CL, O’Fallon JR, Veeder MH, Miser AW, Maillard JA et al (1994) Transdermal clonidine for ameliorating Tamoxifen-induced hot flashes. J Clin Oncol 12:155–158
Love RR, Cameron L, Connell BL, Levanthal H (1991) Symptoms associated with Tamoxifen treatment in postmenopausal women. Arch Intern Med 151:1842–1847. doi:10.1001/archinte.151.9.1842
Boekhout AH, Beijnen JH, Schellens JH (2006) Symptoms and treatment in cancer therapy-induced early menopause. Oncologist 11(6):641–654. doi:10.1634/theoncologist.11-6-641
Han JS (1997) Physiology of acupuncture: a review of thirty years research. J Altern Complement Med 3(suppl 1):S101–S108
Ilnyckyj A, Shanahan F, Anton PA, Cheang M, Bernstein CN (1997) Quantification of the placebo response in ulcerative colitis. Gastroenterology 112:1854–1858. doi:10.1053/gast.1997.v112.pm9178676
Anton PA, Shanahan F (1998) Neuroimmunomodulation in inflammatory bowel disease. How far from bench to bedside? Ann NY Acad Sci 840:723–734. doi:10.1111/j.1749-6632.1998.tb09611.x
Acknowledgements
Many thanks to Professor Stephen Seiler (University i Agder) for help with statistical analysis. To Jacob Myhre (administrative advisor, Vestfold Hospital) for technical help, and to Mette Amundsen (oncology nurse, breast cancer centre, Vestfold Hospital). Financial support from The Norwegian Acupuncture Association (NAFO), University of Tromsø (NAFKAM), and Vestfold Central Hospital, Norway.
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Hervik, J., Mjåland, O. Acupuncture for the treatment of hot flashes in breast cancer patients, a randomized, controlled trial. Breast Cancer Res Treat 116, 311–316 (2009). https://doi.org/10.1007/s10549-008-0210-3
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DOI: https://doi.org/10.1007/s10549-008-0210-3