Cognitive behaviour therapy for menopausal symptoms following breast cancer treatment


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Myra Hunter

King's College London, London, UK

Abstract

Background
Menopausal symptoms - hot flushes and night sweats - are problematic for women who have undergone breast cancer treatments. They adversely affect sleep and quality of life, and since hormonal therapies are often contraindicated, there is a need for effective non-hormonal treatments. We have adapted a form of cognitive behavioural treatment for menopausal symptoms and evaluated this in a sample of breast cancer patients.

Method
A single group design was used with pre, and post treatment assessment and a three month follow up. 24 women who had completed active breast cancer treatment were included. Following a two week daily diary assessment they were offered six (90 min) weekly sessions of CBT in groups. The CBT included information, discussion, paced breathing and CBT to reduce stress and to manage hot flushes, night sweats and sleep. The primary outcome measure was the Hot Flush Rating Scale (frequency and Problem Rating) and secondary outcomes were Womens Health Questionnaire, Hot Flush Beliefs Scale and SF36.

Results
Hot flushes and night sweats reduced significantly following treatment and improvements were maintained at the 3 month follow up (49% reduction in frequency and 59% reduction in problem rating). Depressed mood, anxiety and sleep improved, as did emotional role functioning and vitality (SF36). Negative beliefs about hot flushes and night sweats also reduced following the cognitive behaviour therapy.

Conclusion
These results suggest that CBT delivered in groups might offer a viable option for women with troublesome menopausal symptoms following breast cancer treatments. Clinically significant improvements were maintained at 3 months follow up. A randomised controlled trial is now being carried out which includes physiological measures of hot flushes. This will be described.