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Supportive Care in Cancer

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01-03-2021 | Acupuncture | Review Article

Nonpharmacological therapies for the management of menopausal vasomotor symptoms in breast cancer survivors

Authors: Stephanie Tran, Martha Hickey, Christobel Saunders, Lesley Ramage, Paul A. Cohen

Published in: Supportive Care in Cancer | Issue 3/2021

Abstract

Purpose

Breast cancer affects millions of women worldwide, and for many, therapy results in treatment-induced menopause. Menopausal symptoms in breast cancer survivors are often more severe, frequent, and of greater duration compared with natural menopause. Hot flushes and night sweats pose a significant burden for many women, with limited therapeutic options as menopausal hormone therapy is contraindicated. Guidelines recommend non-hormonal pharmacological agents including clonidine, gabapentin, and some antidepressants. However, some women may be reluctant to use medications due to concerns about side effects. The aim of this narrative review was to appraise recent evidence for nonpharmacological treatments for vasomotor symptoms in breast cancer survivors including cognitive behavioural therapy, hypnosis, yoga, mindfulness, acupuncture, and lifestyle changes.

Methods

A literature search was conducted. Studies were included if they were randomised and involved breast cancer survivors and nonpharmacological treatments for menopausal vasomotor symptoms.

Results

Twelve studies met the criteria, and three studies of exercise in healthy menopausal women were included. Cognitive behavioural therapy reduces menopausal symptoms and perceived impact of hot flushes and night sweats in breast cancer survivors and is cost effective. The efficacy of hypnosis as a treatment for menopausal vasomotor symptoms in women with breast cancer is supported by two randomised controlled trials. Yoga and acupuncture may reduce vasomotor symptom frequency and/or burden. Studies of exercise as an intervention for vasomotor symptoms in healthy menopausal women have not shown benefit.

Conclusion

Evidence for nonpharmacological interventions supports cognitive behavioural therapy and hypnosis in the management of vasomotor symptoms in breast cancer survivors.

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Title: Nonpharmacological therapies for the management of menopausal vasomotor symptoms in breast cancer survivors
Authors: Stephanie Tran
Martha Hickey
Christobel Saunders
Lesley Ramage
Paul A. Cohen
Publication date: 01-03-2021
Publisher: Springer Berlin Heidelberg
Keywords: Acupuncture
Behavioural Therapy
Breast Cancer
Breast Cancer
Hypnosis in Dentistry
Flush
Gabapentin
Published in: Supportive Care in Cancer / Issue 3/2021
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI: https://doi.org/10.1007/s00520-020-05754-w

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