Relaxation may cool chemo-related hot flashes

For women undergoing treatment for breast cancer, relaxation training may bring at least some relief from hot flashes, a new study suggests.

Some drugs used to treat breast cancer can cause women to develop symptoms of menopause, including severe hot flashes. Treatment options are limited, however; hormone replacement therapy is no longer the preferred treatment for hot flashes in general, and it was never considered safe for women with a history of breast cancer.

Menopausal hot flashes are thought to involve a change in the brain’s regulation of body temperature, such that women become more sensitive to small variations in their core temperature. In theory, relaxation training could help by affecting nervous system activity and the release of the stress hormone norepinephrine. Furthermore, a few small studies have suggested that relaxation helps cool hot flashes in women without breast cancer.

In the new study, published in the Journal of Pain and Symptom Management, British researchers recruited 150 women who had been treated for breast cancer and were suffering bothersome hot flashes.

They randomly assigned the women to either undergo relaxation training or to discuss general hot flash management with a nurse, but receive no specific therapy.

Women in the relaxation group met once, one-on-one, with a therapist who gave them a session in deep breathing, muscle release and guided imagery. They then took home audiotapes so they could repeat the session on their own.

Over the next three months, women in both groups kept track of their hot flash symptoms in a diary.

After the first month, the researchers found, women in the relaxation group were reporting fewer and less severe hot flash episodes. The difference was not dramatic; the women typically reported four episode per day rather than five in the comparison group.

However, the improvement did appear meaningful, as women in the relaxation group also reported lower distress levels.

“Personally, I believe that it is a real change which has the potential to help women, as it reduced not only the incidence but also the severity and the degree to which women reported that it had an impact on their lives,” lead researcher Dr. Deborah R. Fenlon, of the University of Southampton, told Reuters Health.

At the three-month mark, there was no longer a clear difference between the two groups of patients. This finding may stem from the fact that the women could decide for themselves whether to continue the relaxation sessions after the first month, according to Fenlon.

Overall, she said, there is a “good level of evidence” that relaxation training may help ease hot flashes. Fenlon also suspects that the findings are “transferable to all women, with or without breast cancer,” though additional study would clarify that.

Fenlon pointed out that women in her study practiced relaxation for an average of 20 to 30 minutes, twice a week. “So that should be enough,” she said, “and possible, even for busy people, to fit in.”

SOURCE: Journal of Pain and Symptom Management, April 2008.

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