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Breast Cancer (Expert Forum)
CHEMO INDUCED MENOPAUSE/NIGHT SWEATS
Questions posted in the Breast Cancer Forum are answered by medical professionals from The Cleveland Clinic. Topics include Breast Biopsy, Chemotherapy, Hormone Therapy, Lumps, Lumpectomy, Lymph node dissection, Lymphedema, Mammograms, Mastectomy, Radiation Therapy, Reconstruction, Self Breast Exam, and Surgery.
CHEMO INDUCED MENOPAUSE/NIGHT SWEATS
by Orneville, May 21, 2003 12:00AM
I AM ON THE 4TH ROUND OF 6 ROUNDS OF ACT, AND THE NIGHT SWEATS ARE THAT STARTED OUT MILD ARE NOW EVERY 2 HOURS AS SOON AS I GO TO BED, AND ARE JUST ABOUT UNBEARABLE, BUT HOT FLASHES DURING DAY NOT A PROBLEM. I TAKE 800MG OF VIT E AND A AT 20000MG, SELENIUM, B12,CALCIUM WITH D AND A MULTI DAILY, ALONG WITH GALLONS OF WATER. CAFFEINE IS LIMITED TO 1 DIET COKE PER DAY, RED MEAT IS LIMITED TO 1-2 TIMES PER WEEK. I DON'T WANT ANOTHER DRUG FROM DOCTOR, SO I WAS HOPING FOR INFO ON SOMETHING NATURAL THAT WILL NOT INTERFERE WITH THE CHEMO. MY ONCO IS ONLY SUGGESTING RX. SOMEONE HAS SUGGESTED FLAX SEED OIL. ANY INPUT/INFO IS GREATLY APPRICIATED. THIS SITE HAS BEEN VERY VALUABLE GETTING ME THRU THE ADVENTURE IN BREAST CANCER. THANK YOU VERY MUCH.
Doctor's Answer
by CCF-RN,MSN-rf, May 21, 2003 12:00AM
Dear Orneville: I have two recommendations. One is to check out www.chemocare.com. On this site, click on managing side effects, scroll down to menopause and chemotherapy. Hot Flashes is a part of this. Also, I have attached a recent article we have written.
The exact mechanism as to what leads to a hot flash event is not entirely known, so finding the best way of treating this symptom has proven to be challenging. The most effective way known to manage hot flashes is through the use of hormone replacement therapy. However, in women with a personal history of breast cancer the use of hormone replacement is not recommended.
Several non-hormonal treatments for hot flashes have been tried. These include non-pharmacologic therapies such as relaxation, acupuncture, diet, exercise, herbal preparations, and vitamins. Several prescription drugs have also been studied, for example anti-depressant medications such as venlafaxine (Effexor®), gabapentin (Neurontin®), paroxetine (Paxil®), or over-the-counter preparations such as ibuprophen.
What has been found with any of the various treatments is there is no magic answer that will eliminate hot flashes entirely. Some preparations or strategies work better for some women than others and there is no “one-size-fits-all” approach. In studies that have been done with many of the treatments, the improvement that came was not total elimination of hot flashes but a decrease in the number or severity of the experience. Another finding is that a certain therapy might work for a while then lose effectiveness. The good news is there are many ways to approach this side effect.
Treatment of hot flashes is not a simple process. Goals to decrease the severity and incidence may involve some trial and error of different methods. Perhaps the answer for one woman will be the combination of Vitamin E and exercise, another woman may find relief with a prescription medication. Care needs to be taken regarding any treatment being used, as there might be some unwanted effects even with preparations that are deemed “safe” and without side effects. For example, certain herbal preparations such as black cohosh or red clover have mild estrogen-binding properties to them so they may not be recommended in people with estrogen dependent tumors. The take home message is to work with your health care team to find the regimen that works best for you and is less likely to cause unwanted effects.
The exact mechanism as to what leads to a hot flash event is not entirely known, so finding the best way of treating this symptom has proven to be challenging. The most effective way known to manage hot flashes is through the use of hormone replacement therapy. However, in women with a personal history of breast cancer the use of hormone replacement is not recommended.
Several non-hormonal treatments for hot flashes have been tried. These include non-pharmacologic therapies such as relaxation, acupuncture, diet, exercise, herbal preparations, and vitamins. Several prescription drugs have also been studied, for example anti-depressant medications such as venlafaxine (Effexor®), gabapentin (Neurontin®), paroxetine (Paxil®), or over-the-counter preparations such as ibuprophen.
What has been found with any of the various treatments is there is no magic answer that will eliminate hot flashes entirely. Some preparations or strategies work better for some women than others and there is no “one-size-fits-all” approach. In studies that have been done with many of the treatments, the improvement that came was not total elimination of hot flashes but a decrease in the number or severity of the experience. Another finding is that a certain therapy might work for a while then lose effectiveness. The good news is there are many ways to approach this side effect.
Treatment of hot flashes is not a simple process. Goals to decrease the severity and incidence may involve some trial and error of different methods. Perhaps the answer for one woman will be the combination of Vitamin E and exercise, another woman may find relief with a prescription medication. Care needs to be taken regarding any treatment being used, as there might be some unwanted effects even with preparations that are deemed “safe” and without side effects. For example, certain herbal preparations such as black cohosh or red clover have mild estrogen-binding properties to them so they may not be recommended in people with estrogen dependent tumors. The take home message is to work with your health care team to find the regimen that works best for you and is less likely to cause unwanted effects.
Member Comments (2)
by swalcott, May 22, 2003 12:00AM
I was in your place back in January during my chemo. The night sweats were interfering so much with my sleep that I could barely function! I started with 1200 mg of Vit E but it only helped for a short while. When I started Rads my oncologist made me stop the Vit E anyway. I was very very reluctant to take a prescription drug but finally gave in and I am so glad I did! I am taking 30 mg of Celexa each day and it has almost eliminated the hot flashes. I can sleep through the night with little trouble now and I really don't feel any different from taking this med. I have experienced no side effects. I have heard that Celexa has less side effects than the more popular Effexor. I keep thanking this wonderful doctor who convinced me to at least give it a try because I have a MUCH better quality of life now. I will keep taking it with Tamoxifen until I feel I don't need it anymore. It is so worth it to me. Good Luck.
