Non-drug therapies for the management of menopausal symptoms in breast cancer survivors.

This article looked at different types of non-drug therapies for the management of menopausal symptoms (MS) such as night sweats and hot flushes in breast cancer (BC) survivors. The authors concluded that cognitive-behavioral therapy (CBT) and hypnosis may offer some benefit for these women.

BC is the most common cancer in women. Treatment usually involves surgery, hormone treatment, chemotherapy, and radiotherapy. While these treatments have improved survival, they have long-term physical consequences such as MS that impact patients' quality of life. MS include hot flushes and night sweats.

In BC survivors, non-hormonal treatment options are recommended. These include behavioral or drug therapies. Drug therapies can have unwanted side effects such as weight gain or sexual dysfunction. Other therapies include CBT (structured talk therapy with a therapist), hypnosis (use of mind-body therapy to help create a deeply relaxed state), lifestyle changes, yoga, and mindfulness therapy. It is important to review which of these non-hormonal therapies work best in improving MS in BC survivors.

This study reviewed clinical trials that evaluated the effectiveness of non-drug therapies for MS in BC survivors.

2 trials looked at the use of CBT, consisting in psychoeducation, controlled breathing and relaxation. Both trials showed a significant improvement in MS with CBT compared to usual care. A study evaluated an internet-based CBT method that increased adherence to CBT to 90.6% of 280 women and showed improvements in MS. 

2 trials looked at hypnosis in improving MS symptoms. One of the trials found that a 5-week course of 50 minutes of hypnosis decreased hot flash severity by 68% when compared to a no-treatment group. A second trial showed that hypnosis reduced hot-flush symptoms by 80% in a group of 27 BC survivors. This was compared to 33% reduction in symptoms with gabapentin (Neurontin; anti-seizure drug that also improves hot flashes).

One trial found that weekly yoga sessions may reduce the frequency and severity of hot flushes although this benefit was shown to be short-term. Acupuncture seemed to reduce MS and was better tolerated than gabapentin. Trials assessing the use of lifestyle changes such as diet and exercise and mindfulness were not large enough to be assessed properly. 

The authors found that there is evidence to support the use of CBT and hypnosis in the treatment of MS in BC survivors.