Hot Flashes and Possible Treatments
Hot flashes are a common and chronic problem for many women who are also dealing with breast cancer. We know that both chemotherapy and hormonal therapy can cause a sudden and early menopause. We also know that some women who have already experienced a natural menopause have the "good luck" of getting to do it a second time after these medications.
Hot flashes are an excellent example of "everyone is different"--meaning that no two women experience the exact same syndrome. Some women have none, some women have few or minor ones, and some women are tortured. Women who have intense hot flashes often complain of interrupted sleep, sometimes many times/night, and/ or turning beet red and sweaty while in the company of others.
As I have written before, Charles Loprinzi, MD at the Mayo Clinic is the hot flash maven for women who have had breast cancer. If you Google his name, you will get a long list of articles that you can read if you choose. The bottom line is that there are many treatments that help some women some of the time, and no single treatment that helps everyone forever.
This is a report from Reuters about the growing choice of women post breast cancer to treat their hot flashes with anti-depressants (WARNING: if you are taking Tamoxifen, talk carefully with your doctor about this as there are a few anti-depressants that may interfere with Tamoxifen's efficacy). I am including an excerpt and then a link to read more:
Cancer patients pick antidepressant for hot flashes
Mon, Nov 8 2010
By Frederik Joelving
NEW YORK (Reuters Health) - Breast cancer survivors who struggle with hot flashes may find respite in an antidepressant, according to a new study that suggests the medication should be the go-to drug when the overheating is severe.
Most women get hot flashes when their estrogen levels start to plummet in menopause, but the symptoms may be especially taxing for breast cancer patients who've received chemotherapy or estrogen-blocking drugs.
However, doctors are reluctant to prescribe hormone replacement therapy -- the standard drug therapy -- to such women, because it might fuel tumor growth.
Instead, they've begun using antidepressants and gabapentin (Neurontin), an epilepsy medicine also used to treat certain types of pain.
The new study, published in the Journal of Clinical Oncology, shows for the first time that although gabapentin was just as effective and safe as the antidepressant venlafaxine (Effexor), most women chose the latter.
"For some people, venlafaxine works better than gabapentin and for others, gabapentin works better," said Dr. Charles Loprinzi, a breast cancer researcher at the Mayo Clinic in Rochester, Minnesota, who worked on the new study.
"The patients in the end preferred venlafaxine by two-thirds to one-third," he said.