Acupuncture provides effective relief from hot flushes for women taking tamoxifen after surgery for breast cancer

Acupuncture provides effective relief from hot flushes in women who are being treated with the anti-oestrogen tamoxifen following surgery for breast cancer, according to new research presented today (Friday) at the 6th European Breast Cancer Conference (EBCC-6) in Berlin.

Mrs Jill Hervik, a physiotherapist and acupuncturist at the Vestfold Central Hospital (Tønsberg, Norway), told a news briefing that breast cancer patients who received traditional Chinese acupuncture had a 50% reduction in hot flushes, both during the day and the night, and that this effect continued after the acupuncture ceased.

“Acupuncture is increasingly used in western countries to treat the problem of hot flushes in healthy post-menopausal women, so we wanted to see whether it was effective in women with breast cancer suffering from hot flushes as a result of their anti-oestrogen medication,” she said.

Tamoxifen can cause many of the symptoms that occur during the menopause, including hot flushes. For healthy women, hormone replacement therapy has traditionally been used to alleviate symptoms, but it is associated with an increased risk of relapse in women with oestrogen sensitive breast cancers.

In a prospective, single-blind, controlled trial, Mrs Hervik and her supervisor, Dr Odd Mjåland, randomised 59 breast cancer patients to receive either ten weeks of traditional Chinese acupuncture or sham (minimal) acupuncture between March 2003 and December 2006. All were taking tamoxifen following surgery and were postmenopausal. She delivered both the real and the sham acupuncture to the patients, and maintained a neutral treatment atmosphere (e.g. no soft music, and minimal time spent talking to the patients) in order to reduce the placebo effect of the treatments.

The patients recorded the number of hot flushes they experienced for four weeks before the treatment, during the treatment and during a 12-week follow-up period. Other menopausal symptoms were also measured over the same periods using a quality of life index – the Kupperman Index – that incorporates symptoms such as hot flushes, sweating, sleep problems, depression, dizziness, palpitations, joint pain, headache, vaginal dryness etc.

Both the acupuncture and the sham acupuncture were given twice a week for the first five weeks and then once a week for the next five weeks. The real acupuncture was given using needles inserted at varying depths to a maximum of 3cms at several well-known acupuncture points. For the sham acupuncture, the needles were not inserted so deep (a maximum of 3mm) and in places well way from acupuncture points.

Mrs Hervik said: “During the treatment, hot flushes were reduced by 50%, both day and night, in the acupuncture group. Three months after the last treatment a further reduction was seen. No significant changes were seen in the sham group during the day. At night there was a slight reduction during the treatment period but, once treatment had ceased, the number of hot flushes increased again.

“This effect was paralleled in the scores from the Kupperman Index for the real acupuncture group, with a slight reduction also in the sham group. However, once treatment ceased the scores remained lowered for the treatment group, but increased for the sham group.”

She concluded: “Acupuncture seems to provide effective relief from hot flushes, both day and night, for women taking tamoxifen after surgery for breast cancer. This treatment effect seems to coincide with a general improvement in well-being. Acupuncture has two advantages over other treatments for hot flushes: it is cheap and does not cause adverse side-effects. Our results suggest that acupuncture could be used more widely for treating breast cancer patients suffering from symptoms related to their anti-oestrogen medication.”