Acupuncture May Reduce Hot Flashes in Breast Cancer Patients

A recent study suggests that acupuncture may reduce hot flashes in women with breast cancer undergoing anti-estrogen therapy.

In breast cancer, some cells begin growing abnormally. The cells divide more rapidly than healthy cells and may spread through the breast tissue to the lymph nodes or other parts of the body (metastasize). The most common type of breast cancer begins in the milk-producing ducts, but cancer may also occur in the lobules or in other breast tissue. Estrogen and progesterone receptor tests are usually performed on the malignant cells. These tests help determine whether female hormones affect the way the cancer grows. If the cancer cells have receptors for estrogen, progesterone or both, the doctor may recommend treatment with a drug tamoxifen.

Tamoxifen is an anti-estrogen and works by competing with the hormone estrogen by binding to estrogen receptors in breast cancer cells. By blocking estrogen in the breast, tamoxifen helps slow the growth and reproduction of breast cancer cells. Tamoxifen is taken orally, and possible side effects include hot flashes. Acupuncture has been suggested as a possible treatment for tamoxifen-related hot flashes.

In a new study, researchers investigated the effect of acupuncture on breast cancer patients with anti-estrogen therapy-related hot flashes. Ten women who were receiving tamoxifen or anastrozole, another anti-estrogen drug, were assigned to receive acupuncture treatments three times weekly for four weeks. Participants rated their hot flash severity by the visual analogue scale and a hot flash score.

The researchers found that in all participants, hot flash severity was significantly reduced on both the visual analogue scale and the hot flash score when compared to before treatment. Furthermore, the alleviation of hot flash symptoms remained four weeks after the final acupuncture session.

While promising, further well-designed clinical trials evaluating larger patient populations are needed before a conclusion can be made.

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Comments

[NBF]

Hot flashes are very common in post-menopausal women and can be a very uncomfortable experience that really effects an individuals quality of life. It is great to see a study such as this for the use of acupuncture to treat hot flashes. Hormone Replacement Therapy is the gold standard for treating hot flashes but in women that can't take estrogen or are being treated with an anti-extrogen medications an alternative treatment is very much needed. This study has its limitations but the results sound very promising. I would like to see larger studies done that compare the results to people taking anti-deppressants or gabapentin to control their hot flashes.

[bp]

This is one of those treatments that if a patient of mine asked about it, I think I would tell them, "why not?" There seems to be some positive evidence out there for a variety of complaints, and there really doesn't seem to be any negative data. It shouldn't interfere with any medications they are on, and since disposable needles are often used now, risk of disease transmission shouldn't be a concern. Since it is supposed to be painless (I haven't tried it myself, and I have heard a few rare reports of the acupuncturist hitting a nerve), if it makes the patient feel better, why not give it a try?

[ML]

This is very interesting. Acupuncture is beneficial for many disease states. I know the theory behind acupuncture is based on stimulating the acupuncture points correcting the imbalance of qi flow. I have visited a place that practices acupuncture and it was amazing how patients will go to the acupuncturist before their PCP with problems. I have tried getting a needle placed and it actually doesn’t hurt at all. In the near future, I would like to try a session.

[deb]

While there is a significant reduction on both the visual analogue scale and the hot flash score when compared to baseline, I hope to see a larger study group with a controlled or placebo group plus double-blinding method. I was just reading about how to implement placebo in acupuncture clinical trial. There are definitely different placebo acupuncture methods to provide better data. My favored one is electrical shock but no penetration of skin.

[SB]

Anything that helps the poor women suffering from breast cancer is wonderful. It would be interesting to see if this would also work in menopause, as their are still women who insist on HRT despite the known risks associated with it.

[Zach]

My sister is an acupuncturist, and I have never heard her talk about treating hot flashes. We have talked about the benefit of acupuncture for chemotherapy related side effects though, so maybe there is some merit here. I wonder how much of it is the placebo effect, but it hardly matters; if the patients feel better, then the patients feel better.

[bp]

I've heard of acupuncture being used for so many things, including several "women's complaints." When I looked it up, I noticed one of the subtypes is acupuncture with use of electrical stimulation. I've heard of several "treatments" for things like fibromyalgia recently that say they are realigning the magnetic or electrical fields in the body to relieve pain. Is there any possibility that the flow through the meridians in acupuncture is actually a similar concept?

[KJ]

Acupuncture has been used in the treatment of hot flashes in healthy postmenopausal women. Another study (PMID: 18839306) investigated the use of acupuncture in women with breast cancer also suffering from hot flashes due to anti-estrogen therapy. This was a prospective, controlled trial with 59 women also taking tamoxifen. During the treatment period, mean number of hot flashes was significantly reduced by 50% from baseline in the acupuncture group, and was further reduced by 30% during the next 12 weeks. As a pharmacist, I would definitely recommend acupuncture to women suffering from vasomotor side effects of anti-estrogen therapy.

[MS]

Even though the study was done on a small population of individuals and there was no control group, this is a good start in establishing the use of acupuncture in relieving hot flashes. If the impact acupuncture has on tamoxifen related hot flashes is similar to possibly relieving post menopausal hot flashes this would be a very exciting finding. This would substantially increase the popularity of acupuncture. The exact etiology and pathogenesis of hot flashes is not fully known. Estrogen relieves hot flashes but the mechanism is not fully understood since other than lack of estrogen there are other factors that influence hot flashes. It would be interesting in future research involving acupuncture different biomarkers in the body are measured to possibly find the physiology behind hot flashes.

[SB]

I think accupuncture is a fascinating procedure with endless possibilities. I would have to find incredible relief from it, to make time for it three times per week however.

[bz]

Acupuncture is such an interesting procedure, I'm glad to see its popularity increasing. I have a patient who has severe migraines who was on many different medications to treat them. Adding acupuncture to her treatment regimen allowed her to stop taking two of the four medications she was on, greatly improving her qualiy of life. I hope the popularity of this procedure allows more patients to benefit from acupuncture like this patient!

[a]

A recent study in the Annal of Internal Medicine showed that Acupuncture improved symptoms of allergic seasonal rhinitis. I thought it was interesting that they used "fake acupuncture" treatments as their control. The limitation of this study is that results were only a modest benefit and that they didn't last very long after treatment ended (up to 2 months).

http://annals.org/article.aspx?articleid=1583575

[a]

Since there is no control in this study, I would think that these results may be exaggerated due to the placebo effect. Although if these patients are receiving relief, I'm not sure it matters too much whether it's just a placebo effect. I also noticed that these women received acupuncture three times per week. I wonder if the same results would be seen in once weekly treatment - I can imagine that most women don't have time to visit the acupuncturist three times weekly!

[AR]

Larger studies are certainly needed to determine if acupuncture can truly relieve hot flashes in anti-estrogen treated breast cancer patients. It would also be interesting if studies could include menopausal women with hot flash symptoms as well as compare other treatment options like acupressure to acupuncture. It would be nice to have a treatment option like this to recommend to patients who have hot flashes.

[bc]

This is a very interesting study in such a specific group of people. I'm curious to know how the results will show in a larger patient population. If it has consistent promising data, then this is great news.

[bz]

I am glad to see more research is being done on the effectiveness of acupuncture. The findings of this study make sense as they correlate with the results of a previous study I read evaluating the effectiveness of acupuncture for the treatment of hot flashes in menopausal women. I hope more research continues to find more effective uses for acupuncture to dispel the myths that it does not work!

[kl]

Hot flashes are common in post-menopausal women worldwide. It would be exciting to see if the improvement of hot flash symptoms secondary to acupuncture therapy, seen here in breast cancer women, carries over to all those who experience hot flashes, especially since the symptom relief extended four weeks after the acupuncture treatment. Current alternative therapies with good scientific evidence for hot flashes include calcium, phytoestrogens, rose hip, and vitamin B6. More research is necessary to elucidate the true benefit of acupuncture on symptoms of hot flashes.