Acupuncture may be an effective treatment for women suffering from hot flashes due to the estrogen-targeting therapies of breast cancer, according to researchers at the Perelman School of Medicine at the University of Pennsylvania.
Hot flashes are brief episodes of flushing, sweating, racing heartbeat, and sensations of heat. The exact cause of hot flashes is unknown, though they are closely linked to decreased estrogen levels.
For breast cancer survivors, hot flashes tend to occur quite frequently and with severe intensity, but current FDA-approved remedies for these unpleasant episodes, such as hormone replacement therapies are off-limits because they include estrogen.
“Though most people associate hot flashes with menopause, the episodes also affect many breast cancer survivors who have low estrogen levels and often undergo premature menopause, following treatment with chemotherapy or surgery,” said lead author Jun J. Mao, M.D., MSCE, associate professor of Family Medicine and Community Health.
“These latest results clearly show promise for managing hot flashes experienced by breast cancer survivors through the use of acupuncture, which in previous studies has also been proven to be an effective treatment for joint pain in this patient population.”
For the study, the researchers recruited 120 breast cancer survivors, all of whom reported experiencing multiple hot flashes per day. Participants were randomized into four different interventions in order to determine the efficacy of electroacupuncture, an acupuncture technique in which embedded needles deliver weak electrical currents.
The researchers wanted to know whether electroacupuncture could reduce incidents of hot flashes in comparison to the epilepsy drug gabapentin, which was previously shown to be effective in reducing hot flashes for these patients.
For an eight-week period, participants received one of the following treatments: gabapentin (900 mg) daily, gabapentin placebo daily, electroacupuncture (twice per week for two weeks, then once weekly), or “sham” electroacupuncture, which involves no actual needle penetration or electrical current.
The findings show that the participants in the electroacupuncture group showed the greatest improvement in a standard measure of hot flash frequency and severity, known as the hot flash composite score (HFCS).
They were followed by the group that had received the “sham acupuncture” treatment. The gabapentin pill group reported less improvement than the sham acupuncture group, and the placebo pill group placed last.
In addition to reporting the greatest reductions in hot flash frequency/severity, both acupuncture groups reported fewer side effects than either of the pill groups.
The Pennsylvania researchers surveyed the subjects sixteen weeks after treatment ended, and found that the electroacupuncture and sham electroacupuncture groups had enjoyed a sustained — and even slightly increased — abatement of hot flashes. The pill-placebo patients also reported a slight improvement in symptoms, whereas the gabapentin pill group reported a worsening.
“Acupuncture is an exotic therapy, elicits the patient’s active participation, and involves a greater patient-provider interaction, compared with taking a pill,” Mao said.
“Importantly, the results of this trial show that even sham acupuncture — which is effectively a placebo — is more effective than medications. The placebo effect is often dismissed as noise, but these results suggest we should be taking a closer look at how we can best harness it.”
The sham acupuncture also seemed to create a significantly lower experience of negative side effects, which were virtually absent in this group. Only one woman reported an episode of drowsiness from the sham acupuncture, whereas the placebo pill recipients reported eight adverse events such as headache, fatigue, dizziness, and constipation.
The findings are published in the Journal of Clinical Oncology.