Hot flushes cause daily problems for postmenopausal breast cancer survivors
Hot flushes are a continuing problem for women long after completing breast cancer treatment, causing distress, disrupted sleep and interference in their daily lives, reports a UK team of researchers.
Many treatments for breast cancer suppress levels of the hormone oestrogen, resulting in menopausal problems, in particular hot flushes. But hot flush treatments, which raise oestrogen levels, are contraindicated in women who have had breast cancer.
Thus, not only are hot flushes more likely among postmenopausal women who have had breast cancer than those without breast cancer, the problem is exacerbated by a lack of well tolerated and effective treatment options, explain Dr D Fenlon (University of Southampton) and co-authors of the study.
“Faced with this problem, women need to have an understanding of the course and causes of hot flushes in order to make informed choices about treatment options,” they say.
Their study included 150 women who were experiencing hot flushes after receiving treatment for breast cancer, including some women who had treatment-induced menopause.
The researchers assessed the participants’ experiences of hot flushes by asking them to complete a diary of their symptoms as well as using standard questionnaires – the Hot Flushes and Night Sweats Questionnaire, the Functional Assessment of Cancer Therapy with Endocrine Subscale and the Spielberger State/Trait Anxiety Index.
The findings, published in the European Journal of Cancer Care, showed that 51 (34%) women were experiencing hot flushes more than 5 years after diagnosis and 75 (50%) more than 5 years after menopause.
No differences were seen in the number or severity of flushes according to whether women were using the cancer treatment tamoxifen or had received chemotherapy. However, women taking tamoxifen appeared to have a peak incidence of hot flushes around 10 am, whereas no such pattern was seen in women not receiving tamoxifen.
The severity, but not the frequency, of women’s flushes correlated with their levels of anxiety.
Furthermore, 90 (72%) of the women who completed diaries experienced disturbed sleep, ranging from a few minutes to 6 hours and affecting half the nights recorded. Indeed, night sweats appeared to have a greater impact than hot flushes on everyday life.
“After breast cancer, the duration of hot flushes, potential distress and disruption to women’s lives should not be underestimated and appropriate interventions should be offered,” conclude Dr Fenlon and team.