Behavioral therapy reduces hot flashes after breast cancer treatment

Behavioral Therapy Safe and Effective for Hot Flashes
Behavioral Therapy Safe and Effective for Hot Flashes

HealthDay News -- Women who develop problematic hot flashes after breast cancer treatment, a contraindication for hormone replacement therapy, experienced significant improvement in quality of life after receiving behavioral therapy, study data indicate.

Cognitive behavioral therapy consisting of one 90-minute session per week for six weeks, significantly reduced hot flashes and night sweats 46% after nine weeks of treatment and 52% after 26 weeks, Eleanor Mann, DPhil, from King's College London, and colleagues reported in Lancet Oncology.

"Our findings suggest that this cognitive behavioral treatment, designed to be delivered by trained health professionals such as breast-care nurses, has the potential to improve long-term health outcomes for patients with breast cancer, and could be incorporated into breast cancer survivorship programs," the researchers wrote.

They randomly assigned 96 women who experienced at least 10 episodes of hot flashes and night sweats after receiving breast cancer treatment to either usual care (N=49),  or usual care plus group cognitive behavioral therapy (N=47).

Usual care consisted of access to clinical specialists and cancer support services during routine follow-up appointments or as part of a breast cancer survivorship program. The counseling sessions educated patients about hot flashes, night sweats and offered behavioral interventions, such as paced breathing and psycho-education, to help manage the problem.

Participants recorded episodes of hot flashes and night sweats in a weekly diary. The researchers conducted questionnaires  at nine and 26 weeks after treatment started to assess the extent to which symptoms were bothersome and interfered with life using a hot flash rating scale (1-7).

Adjusted mean hot flash and night sweat problem ratings fell an average of 1.67 points (95% CI: –2.43 to –0.91; P<0.0001) at nine weeks. Reduction in problem ratings  were maintained at 26 weeks (mean difference –1.76; 95% CI:–2.54 to –0.99; P<0.0001).

"Cognitive behavioral therapy showed statistically significant and lasting reductions in problem rating and improvements in quality of life," the researchers wrote. "Cognitive behavioral therapy could, therefore, be an important alternative or additional treatment option for patients with breast cancer."

Study limitations included high variability in measures of symptom frequency; the retrospective nature of the hot flush rating scale questionnaires; lack of controlling for potential confounding factors, including use of drugs to manage hot flashes and night sweats; and inability to distinguish whether participants' symptoms were the result of menopause or breast cancer treatment.

Mann E et al. Lancet Onc. 2012; doi:10.1016/S1470-2045(11)70364-3.


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