New Treatment Could Cool Hot Flashes for Breast Cancer Patients

Breast cancer patients often have a second battle to wage, this time against hot flashes, a common occurrence in menopause and during breast cancer treatment.

A study at Baylor College of Medicine is looking at whether very low doses of an anti-depressant can reduce the number and severity of hot flashes for breast cancer patients.

The usual remedy, hormone replacement therapy, is not recommended for breast cancer patients because estrogens may promote or facilitate the disease.

"It’s a considerable problem," said Dr. Lois Friedman, associate professor of psychiatry and behavioral sciences at Baylor. "Patients often want to stop some of their treatment for breast cancer because of hot flashes."

Hot flashes range from mild to very severe. Women suffering from the most severe form can experience a change in heart rhythm and difficulty breathing and functioning. The physical and emotional symptoms may last up to 45 minutes.

Preliminary data also suggests that low dosages of an anti-depressant might improve attention, concentration and memory.

"The dosages being used in the study are low and are not being used to have an anti-depressant effect," said Dr. Friedman, also director of psychosocial oncology at the Breast Care Center at Baylor College of Medicine and the Methodist Hospital. "Side effects are minimal, if present at all."

The study will enroll 128 women who will receive either the antidepressant or a placebo. Selection is random and neither the patient nor the doctor will know which treatment has been given until the six-week treatment phase is concluded. Participants will be asked to keep a daily diary of hot flashes and will be required to meet with investigators four times during the six-week period.

"Hot flashes are a common problem and very little other than hormone replacement therapy is available to treat hot flashes effectively," Dr. Friedman said. "If this new type of therapy proves effective, it will offer relief to many women who have struggled with symptoms that affect their quality of life."

For more information, contact Dr. Friedman at (713) 798-1972.

Hot Flashes – From Mild to Very Severe

MILD: May last less than 5 minutes. Woman feels warm, uncomfortable, face may redden. No emotional symptoms.

MODERATE: May last up to 15 minutes. Head, neck and ears or whole body feels warm. Tension, tight muscles, clammy skin and a change in heart rhythm are possible, along with sweating and dry mouth. Feelings of irritation, agitation, restlessness and energy loss are common, as well as embarrassment if the hot flash occurs in front of others.

SEVERE: May last up to 20 minutes. Feeling of "burning up," with a change in heart rhythm, headache, severe sweating, weakness and chest heaviness. Embarrassment and anxiety may occur, as well as the feeling of having a panic attack.

VERY SEVERE: May last up to 45 minutes. Boiling heat, rolling sweat, difficulty breathing, faintness, dizziness, leg cramping, stomach uneasiness and change in heart rhythm are experienced. Emotional symptoms are described as feeling distressed, with an urge to escape and difficulty functioning normally.

– Source: Loprinzi, C., 2000; personal communication

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©2006 Texas Medical Center

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