Getting a Grip on Hormones While Fighting Cancer

Cancer patients who have cognitive behavior therapy better control early menopause

/ Author:  / Reviewed by: Joseph V. Madia, MD

(RxWiki News) It happens at some point to every woman: the hot flashes and night sweats signaling a major change in life. For cancer patients, these symptoms can be side effects of the treatment regimen.

Researchers found exercises and cognitive behavior therapy can help with the early menopause endured by certain female cancer patients.

"Talk to your oncologist about exercise."

With endocrine therapy and chemotherapy, breast cancer patients often start menopause early on compared to cancer-free patients of the same age.

The study, led by Saskia Duijts, PhD, a senior researcher of occupational health, lifestyle and cancer epidemiology at VU, included 422 patients who had menopausal symptoms because of their breast cancer treatment.

Patients averaged a little older than 48 years old. Almost half had a breast removed to treat their cancer, more than 90 percent had chemotherapy and about 86 percent had hormonal therapy.

More than 80 percent of those patients who had chemotherapy were done with their treatment at least a year before the study began.

As the study began, 85 percent of those having hormonal therapy were still being treated.

The participants were recruited through hospital registries and by their doctors, and each had to have at least two menopausal symptoms, including night sweats, hot flashes or dryness in the vagina.

Researchers also surveyed participants on their quality of life, body image, urinary symptoms, psychological distress and sexual functioning.

The questionnaires were given at the start of the study and at 12 weeks and six months after participants completed their programs.

Participants were randomly divided into one of four groups, each with a different treatment, and were given a questionnaire on their lifestyle and demographics.

The first group contained 109 participants who had cognitive behavior therapy for their treatment. The group had six 90-minute weekly meetings that taught relaxation exercises.

The therapy, led by a clinical psychologist and a few social workers experienced in counseling breast cancer patients, focused on hot flashes and night sweats but other problems were also addressed.

The second group of 104 participants was assigned to exercise for 12 weeks. Each had a self-directed program made especially for them.

Programs consisted of running, cycling or swimming two and a half to three hours each week that the participants could do at home.

Every four weeks, the participants had a phone interview to keep them accountable and monitor how it was going.

The third group combined the two activities together and did the programs at the same time.

The fourth group was put on a waiting list to better show how the therapy and exercise worked on those groups of breast cancer patients.

They found that the three groups given therapy, exercise and a combination of the two had significantly lower urinary symptoms in the short term.

Only the therapy group was able to keep the improvements during the long-term follow up.

The first three groups also had improved physical functions compared to the group without any treatment over the short-term.

The physical activity group was able to keep up the effects through the 12-week mark.

Hot flashes and night sweats significantly decreased among groups that had the therapy.

At the same time, sexual activity significantly increased for the combined group compared to the last group.

In the short term, troubles with hormones and other endocrine functions significantly decreased for each of the three groups compared to the last group.

The authors said that the two different treatment methods may "address different aspects of the symptom experience, namely their frequency and their perceived burden."

"Cognitive behavior therapy seems to affect both the frequency and perceived burden of symptoms, whereas the impact of physical exercise is primarily on frequency of symptoms," the authors wrote in their report.

"This suggests that women may benefit most from…therapy alone or in combination with physical exercise."

The study was published online October 8 in the Journal of Clinical Oncology. The authors report no conflicts of interest.

Reviewed by: 
Review Date: 
October 21, 2012
Last Updated:
October 23, 2012