Acupuncture eases tamoxifen-related hot flashes

A new study provides more evidence that acupuncture can help ease hot flashes in women with breast cancer who are being treated with the “anti-estrogen” drug tamoxifen. Acupuncture, researchers found, is free of side effects and has a side benefit for some women: an increased sex drive.

“Acupuncture appears to be at least as effective as drug therapy,” Dr. Eleanor M. Walker of Henry Ford Hospital in Detroit and her colleagues report, “and it may provide additional and longer-term benefits without adverse effects.”

Breast cancer patients with estrogen-sensitive tumors are typically given estrogen-blocking drugs for years at a time. These drugs, which include tamoxifen, bring on menopausal symptoms like hot flashes and night sweats.

The antidepressant drug Effexor (venlafaxine) is the standard treatment for these symptoms, Walker and her team note in the Journal of Clinical Oncology, but it can have unpleasant side effects, including dry mouth, nausea, and constipation. Non-drug treatments with few or no side effects are “urgently needed,” they add.

To investigate whether acupuncture might be an option, Walker and her team randomly assigned 25 women to receive Effexor or acupuncture for 12 weeks, following them for up to year after the end of treatment.

Both treatments reduced hot flashes, night sweats, and symptoms of depression to a similar degree, and also significantly improved mental health, the researchers found. But within two weeks after treatment ended, women in the Effexor group saw their hot flashes increase; this didn’t happen in the acupuncture group.

Eighteen women in the Effexor group had side effects, such as dizziness and anxiety, while none of the women given acupuncture had such side effects. About a quarter of the women given acupuncture said their sex drive had increased. “Most women also reported an improvement in their energy, clarity of thought, and sense of well-being,” Walker and her team note.

The researchers also point out that Effexor could impair the effectiveness of tamoxifen in some patients, because it can block the body’s metabolism of the drug.

Acupuncture, they conclude, is a “safe, effective and durable treatment” for hot flashes and other menopausal symptoms stemming from anti-estrogen hormone therapy in women with breast cancer. They hope this study will “lead to a change in the pattern of practice” of treating these symptoms in patients with breast cancer.

In traditional Chinese medicine, acupuncture has been used for hot flashes. The current findings showing that acupuncture has the ability to cool breast cancer-related hot flashes build on findings reported by the same researchers in 2008. (See Reuters Health report, Sept. 22, 2008).

SOURCE: Journal of Clinical Oncology, online December 28, 2009.

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