Cognitive behaviour therapy for menopausal symptoms following breast cancer treatment
Myra Hunter
King's College London, London, UK
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.
