Acupuncture Can Relieve Hot Flushes Caused by Tamoxifen

April 22, 2008

Acupuncture reduced by half the hot flushes caused by tamoxifen in a small clinical trial involving 59 breast cancer patients after surgery. Relief was experienced both day and night, and the reduction in hot flushes was seen 3 months after the last acupuncture treatment.

These results were presented today at the European Breast Cancer Conference (EBCC) in Berlin, Germany, by Jill Hervik, a physiotherapist and acupuncturist at the Vestfold Central Hospital, Tønsberg, Norway. She was working with Odd Mjåland, MD, PhD, from Sørlandet Hospital in Kristiansand, Norway.

Acupuncture is being used increasingly in Western countries to treat hot flushes associated with the menopause, Ms. Hervik commented, and this study shows that it “seems to provide effective relief from hot flushes, both day and night, for women taking tamoxifen after surgery for breast cancer.”

The treatment effect seems to coincide with a general improvement in well-being, as measured by the Kupperman Index, which assesses quality of life, she told a press briefing. Acupuncture is inexpensive and does not cause adverse side effects, she pointed out. “Our results suggest that acupuncture could be used more widely for treating breast cancer patients suffering from symptoms related to their anti-estrogen medication.”

“If I could be sure that I could get exactly the same acupuncture that was performed in this study, then I would be happy to send my patients on tamoxifen with hot flushes, but the problem here is reproducibility,” commented Dr. Emiel Rutgers, MD, PhD, from the Netherlands Cancer Institute and Antoni van Leeuwenhoek Hospital, in Amsterdam. Dr. Rutgers chaired the EBCC meeting and moderated the press briefings.

“This was a very nice study, very clean, and I do believe that the patients in this study derived benefits from the acupuncture that was performed,” he commented in an interview with Medscape Oncology. “The problem is that I cannot be sure about acupuncture that is performed elsewhere. It is not like taking a paracetamol pill, it is so subjective, so I would be reluctant to send a patient for acupuncture to a practitioner that I do not know.”

The study involved a 10-week course of treatment (with sessions twice a week for 5 weeks, and then once a week for 5 weeks). A control group received sham acupuncture, with needles inserted shallowly (to a depth of 3 mm; in real acupuncture, needles are inserted to a depth of 3 cm), and in places far away from known acupuncture points. Ms. Hervik said that in both cases she aimed for a neutral atmosphere, with no soft music and minimal time spent talking to the patient, to reduce the placebo effect of the treatment.

Women treated with real acupuncture reported a 50% reduction in hot flushes, both day and night, and reported a further reduction in hot flushes when assessed 3 months after the last acupuncture treatment. The women in the sham group reported no changes in hot flushes during the day, and a slight reduction in hot flushes at night while the treatment was ongoing, but they increased once the treatment stopped.

European Breast Cancer Conference (EBCC): Abstract 491. Presented April 18, 2008.

Reviewed By Ramaz Mitaishvili, MD and Gina Gagua, LAc, PhD

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