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Study Finds Safe, Effective Alternative to Hormone Replacement Tx for Hot Flashes & Night Sweats

07 May

Researchers from the Institute of Psychiatry at King's College in London, UK, looked at the efficacy of treating hot flashes and night sweats (HFNS) with Cognitive Behavioral Therapy in post cancer breast cancer patients, where hormone replacement therapy is often seen as undesirable or contraindicated.
In this randomized controlled trial, 96 women were recruited from breast clinics in London who had problematic HFNS (a minimum of ten problematic episodes a week) after breast-cancer treatment.

Participants were randomly assigned to receive either usual care (n = 49) or usual care plus group CBT (n = 47).  Randomization was done in blocks of 12-20 participants, stratifying by age (younger than 50 years, 50 years or older), and was done with a computer-generated sequence. The trial statistician and researchers collecting outcome measures were masked to group allocation.

Group CBT comprised one 90 min session per week for 6 weeks, and included psycho-education, paced breathing, and cognitive and behavioral strategies to manage HFNS.

Assessments were done at baseline, 9 weeks, and 26 weeks after randomization. The primary outcome was the adjusted mean difference in HFNS problem rating (1-10) between CBT and usual care groups at 9 weeks after randomization. Analysis of the primary endpoint was done by modified intention to treat.

The study found that Group CBT significantly reduced HFNS problem ratings at 9 weeks after randomization, as compared to treatment as usual (mean difference -1·67, 95% CI -2·43 to -0·91; p<0·0001) and improvements were maintained at 26 weeks (mean difference -1·76, -2·54 to -0·99; p<0·0001). There were no adverse events or responses.
The study concludes that group CBT appears to be a safe and effective treatment for women who have problematic HFNS after breast cancer treatment, offering additional benefits to mood, sleep, and quality of life. The treatment could be incorporated into breast cancer survivorship programs and delivered by trained breast cancer nurses.

Citation: Mann E, Smith MJ, Hellier J, Balabanovic JA, Hamed H, Grunfeld EA, Hunter MS. Cognitive behavioural treatment for women who have menopausal symptoms after breast cancer treatment (MENOS 1): a randomised controlled trial. The Lancet Oncology. 2012 Mar; 13 (3): pages 309-18.

Belleruth Naparstek

Psychotherapist, author and guided imagery pioneer Belleruth Naparstek is the creator of the popular Health Journeys guided imagery audio series. Her latest book on imagery and posttraumatic stress, Invisible Heroes: Survivors of Trauma and How They Heal (Bantam Dell), won the Spirituality & Health Top 50 Books Award