July 23, 1999

Magnets, acupressure studied to ease cancer therapy ‘hot flashes’

Magnets, acupressure studied to ease cancer therapy 'hot flashes'

Hot flashes, a well-known symptom of menopause, can be a very bothersome side effect of treatment for many breast cancer survivors – and one with few good options for relief.

Now, a Vanderbilt University School of Nursing researcher in the Vanderbilt-Ingram Cancer Center is taking a cue from Chinese medicine in an effort to develop a safe, effective strategy to ease cancer therapy-induced hot flashes.

Janet S. Carpenter, Ph.D., assistant professor of Nursing, is investigating magnetic devices placed on strategic acupressure points to gauge their potential ability to relieve hot flashes – periods of overheating, sweating and flushing triggered by fluctuations in hormone levels.

"Almost two-thirds of women who have been treated for breast cancer have hot flashes," said Carpenter, who published a paper in the journal Cancer last year documenting the prevalence and severity of hot flashes among breast cancer survivors.

"In our study, 65 percent said they'd experienced hot flashes in the previous two weeks. In addition, 59 percent said they were extremely severe and 44 percent said they were extremely bothered by them."

Using a 24-hour monitoring device, Carpenter and her colleagues at the University of Kentucky also found that women experienced hot flashes throughout the night. Some breast cancer survivors experienced seven to eight hot flashes each night.

"Even if these women do not wake up, their sleep is probably being disturbed," said Carpenter, who joined Vanderbilt's School of Nursing and Cancer Center last August. "Fatigue can be a significant side effect of cancer treatment. Hot flashes, and the sleep disruption that results, could contribute to that fatigue as well as lead to feelings of depression."

Menopausal symptoms including hot flashes but night sweats, vaginal dryness, sleep disturbances and mood alteration are also a significant problem for patients, said Dr. Brenda P. Nicholson, assistant professor of Medicine and breast cancer specialist in the Vanderbilt-Ingram Cancer Center.

Carpenter's research, which is also aimed at learning more about intensity, initiation and duration of hot flashes among breast cancer survivors, will be very helpful in better defining the extent of the extent of the problem, Nicholson said.

In menopause, hot flashes are triggered by natural hormonal fluctuations that occur as the ovaries stop producing the female hormone estrogen. For pre-menopausal breast cancer survivors, hot flashes may be the result of early artificial menopause triggered by chemotherapy and/or radiation therapy. In addition, many women with breast cancer also take the estrogen-like drug tamoxifen for five years after completion of their initial treatment in an effort to prevent cancer recurrence. Tamoxifen commonly causes hot flashes.

For healthy women, menopausal symptoms are often alleviated with hormone replacement therapy. However, hormone replacement is not generally recommended for women with a history of breast cancer because of concern that it will increase the risk of recurrence.

"Alternatives to hormone replacement, such as plant estrogens, are not well-researched for their safety in any women, but particularly in this group," Carpenter said.

Other researchers at Vanderbilt Medical Center have demonstrated effectiveness of magnetic therapy in the treatment of chronic pain and nausea, Carpenter said, adding that in those cases, placement of the magnets has correlated with acupressure points for those symptoms.

"There are also acupressure points for hot flashes," she said. "Magnetic therapy has not been studied in the treatment of hot flashes before, but magnetic devices really have no negative side effects in comparison to medications. We also suspect, based on the pain research, that they will act quickly, in a matter of hours. Some medications for hot flashes take three or four weeks to take effect."

The Vanderbilt-Ingram Cancer Center is funding the pilot study, which will compare the experiences of 20 women using two different magnetic devices. VUMC's Institutional Review Board, which must authorize any research involving patients, has approved the study.

To be eligible, women must have completed or be completing first-time treatment for breast cancer and experiencing hot flashes.

After a 24-hour monitoring period, participants will wear six of one type of magnetic devices on acupressure points on their ankles, lower abdomen and lower back for three days, followed by a post-treatment measurement. After a 10-day resting period, they will switch to the other device and follow the same routine.

Carpenter is also conducting a survey of 70 breast cancer survivors to learn more about the initiation, duration and intensity of hot flashes. She is recruiting healthy women, ages 50-80, to complete the survey as a comparison group.

Women will each receive $5 to complete the survey and return it by mail. The survey takes about 30 minutes to complete, and any of the healthy women who are experiencing hot flashes will be asked to keep a two-day diary of their symptoms.

To learn more about the intervention study or to participate in the survey, contact Janet Carpenter at 322-0282 or the Vanderbilt-Ingram Cancer Center Information Program at 1-800-811-8480.