Women who have hit the “change of life” often experience hot flashes triggered by plummeting estrogen levels. But it’s not only women going through normal menopause who suffer from these annoying episodes marked by sudden feelings of intense heat, sweating, a racing heartbeat, and flushing. Breast cancer survivors can experience premature menopause after chemotherapy or surgery to treat their malignancy, resulting in severe and frequent hot flashes, according to Jun J. Mao, MD, associate professor of family medicine and community health at the University of Pennsylvania.
Breast cancer patients also frequently are prescribed estrogen-blocking medications to help treat their disease or to prevent a recurrence of estrogen-driven tumors, and these therapies cause hot flashes, too. FDA-approved drugs to relieve uncomfortable and sometimes sleep-disrupting hot flashes are mostly hormone replacement therapies containing estrogen, which are off-limits for breast cancer patients. However, a study by Mao and his University of Pennsylvania colleagues found a modern version of the ancient therapy known as acupuncture can be an effective non-drug way to treat breast cancer patients’ hot flashes.
The research team randomly assigned 120 breast cancer survivors, all suffering from many hot flashes daily, into four different groups. The volunteers were randomly assigned to various therapies for eight weeks. One group received electroacupuncture (acupuncture with embedded needles that deliver weak electrical currents) twice a week while another group received sham acupuncture, involving no real penetration with needles or actual electric current, two times weekly. Another group was given daily doses of the epilepsy drug gabapentin (shown in previous research to help reduce hot flashes), while other research subjects took a placebo pill containing no active ingredients.
At the end of the study period, the research participants in the electroacupuncture group had the greatest improvement, reporting far fewer and less severe hot flashes. Curiously, the sham acupuncture was the next most successful treatment in reducing hot flashes.
Compared to the fake acupuncture, electroacupuncture produced a 25 percent greater reduction in hot flash symptoms. That suggests the real acupuncture was producing effects that went beyond those of a placebo. However, the study was not large enough to make a definite conclusion, the researchers noted.
The sham acupuncture procedure worked far better than placebo pills at relieving hot flash severity and frequency, possibly because the research subjects had a stronger expectation they were receiving a treatment that could help, leading to a stronger placebo impact.
The study participants who were given gabapentin reported less improvement than those who were given the real or fake acupuncture therapy. Those who took the inert placebo pill had the least change in their hot flash symptoms.
“These latest results clearly show promise for managing hot flashes experienced by breast cancer survivors through the use of acupuncture, which in previous studies has also been proven to be an effective treatment for joint pain in this patient population,” Mao said. “Importantly, the results of this trial show that even sham acupuncture — which is effectively a placebo — is more effective than medications. The placebo effect is often dismissed as noise, but these results suggest we should be taking a closer look at how we can best harness it.”
Acupuncture, which involves the stimulation of points on the body using thin, solid, metallic needles manipulated by hands or electrical stimulation, is used by millions of Americans each year, according to the National Center for Complimentary and Integrative Health (NCCIH). In addition to relieving hot flashes, there’s also evidence acupuncture can soothe cancer patients’ nausea and vomiting from chemotherapy. Exactly how the therapy produces these and other possible health benefits remains unknown, although research is underway to find out.
If you are considering treatment with an acupuncturist for cancer-treatment side effects or any other health problem, the NCCIH points out it’s important to talk to your healthcare provider to see if acupuncture is appropriate for you. And never use acupuncture to postpone seeing your doctor about a medical concern.
January 04, 2016
Christopher Nystuen, MD, MBA