Vasomotor symptoms (hot flashes, etc.) are common debilitating side effects of anti-estrogen treatment in conventional breast cancer care. Hormone replacement therapy, normally used in postmenopausal women to treat these symptoms, is contraindicated in breast cancer patients. The antidepressant, venlafaxine (Effexor), a serotonin reuptake inhibitor, is currently the pharmacological therapy of choice for these hot flashes. However, many women refuse this treatment approach because of potential side effects that include sexual dysfunction and nausea, or they simply do not want to take any more medication. This randomized clinical trial (RCT) tested the hypothesis that acupuncture reduces vasomotor symptoms in breast cancer patients receiving hormonal therapy and produces fewer side effects than venlafaxine.
Patients treated for breast cancer (Stages 0-III) receiving either Tamoxifen or Arimidex and having at least 14 hot flashes per week were randomized to receive a 12 week course of acupuncture or venlafaxine. 47 total patients completed the study (24 acupuncture, 23 venlafaxine). Patients logged daily the number and severity of hot flashes for one-week prior to treatment (baseline), during the course of treatment, and at regular intervals throughout 1 year following treatment. Other outcome measures assessed before, during, and after treatment included menopause-specific quality of life, general health status (SF-12), Beck Depression Inventory, and side effects.
Both acupuncture and venlafaxine groups exhibited significant decreases in hot flashes and other menopausal, quality of life symptoms, as well as decreases in depressive symptoms. These changes were similar in the 2 groups, indicating that acupuncture is at least as effective as venlafaxine in reducing vasomotor and other symptoms associated with anti-estrogen hormonal treatment of breast cancer. Additionally, numerous patients treated with venlafaxine reported negative side effects including nausea, dry mouth, headache, difficulty sleeping, dizziness, double vision, increased blood pressure, constipation, fatigue, anxiety, feeling “spaced out,” and body jerking during the night. Patients treated with acupuncture experienced no negative side effects. They reported increased energy, clarity of thought, sexual desire, and overall sense of well-being (compared to pretreatment).
The results of this study suggest that adding acupuncture to breast cancer treatment regimens may establish an integrative approach that is more effective in managing symptoms due to treatment with fewer side effects than conventional pharmacotherapy treatment.
Funded by the Susan G. Komen Foundation.
Author Disclosure: E.M. Walker, None; A.I. Rodriguez, None; B. Kohn, None; J. Pegg, None; R.M. Bell, None; R.A. Levine, None.
© 2008 Elsevier Inc. Published by Elsevier Inc. All rights reserved.