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Hot Flushes in Breast Cancer Patients

Gordon Cameron

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Hot flushes or hot flashes in breast cancer patients are a common problem.

Many breast cancers are sensitive to circulating estrogen levels and for many women, suppressing the production or the effects of estrogen on the body is a major strategy in their treatment. A lack of estrogen will produce symptoms identical to the menopause and the most unpleasant of these are hot flushes, sweats or hot flashes.

A new research project has looked at the effect of a drug called Megace or megesterol acetate in treating hot flushes in women with breast cancer.

They studied nearly three hundred patients with breast cancer who had completed surgery and chemotherapy and at least four months of tamoxifen treatment for their condition.

Before they took part in the study the women had to have experienced at least ten hot flashes of any severity or at least five severe episodes each week. When the research data was looked at, eighty five percent of the women who took part were on tamoxifen, and forty percent had more than sixty hot flushes per week. Three quarters of them had experienced sweats and flashes for more than six months before they started in the study.

The women were divided into three groups. One group were given a placebo tablet, one group got 20mg of Megace and the other received 40mg of Megace each day. They all took their medicine for three months. A good outcome was defined as completion of treatment with a seventy five percent or greater reduction in hot flushes from that womens starting point.

If the treatment they were on worked well the women were given another three months of the same medication and dose. If they did not get benefit after three months then they were given 20mg a day of Megace on top of what they were already taking.

Reduction of flushings of seventy fiver percent or more was reported in

  • only 14% of those women who were on placebo medication
  • 65% of those women who were on the 20 mg dose
  • 48% of the women who were on the 40 mg dose of drug

    In addition, most successes at three months were maintained at six months in seventy seven percent of the women on 20 mg and in eighty one percent of the women on 40 mg per day - but there was no significant impact on other menopausal symptoms like vaginal dryness or joint pains.

    For the women taking Megace the main side effects were fluid retention and weight gain, fatigue and sometimes mild depression.

    The researchers concluded that Megace was very successful in alleviating sweats and flushes in breast cancer survivors with lasting results at 6 months. They recommended the twenty milligram dose for most women and said that this treatment should be considered for all women with menopause flushing symptoms after breast cancer treatment.

    Gordon Cameron is a physician in Edinburgh Scotland. He has a special interest in the symptoms of breast cancer .

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