Tamoxifen, Hot Flashes and the Power of Acupuncture

When I read the results of a study published in the Journal of Clinical Oncology, on August 24^th, I was fascinated to learn that when it comes to relieving the hot flashes of tamoxifen acupuncture beats pills.

If, like me, you took tamoxifen for five years following active treatment for breast cancer to reduce the possibility of having a recurrence, or are taking it now, you know that no description is needed when speaking about the hot flashes that accompany this hormone therapy regime. If you have not taken tamoxifen, no description can adequately convey the sensations and feelings of this medication’s hot flashes.

If you are not a breast cancer survivor, but have been through natural menopause, please know that the hot flashes experienced by breast cancer patients, on tamoxifen, are more common, more severe and longer lasting than menopausal hot flashes. Intense hot flashes several times a day, just add more discomfort to the other side effects of taking tamoxifen such as weight gain, insomnia, and mood swings.

Dr. Jun Mao, an associate professor of family medicine and community health at the University of Pennsylvania in Philadelphia and other members of the study team conducted the testing on 120 women, all breast cancer survivors, who were taking tamoxifen and having hot flashes for a minimum of twice a day. The study divided the women into the following groups:

• Those that received actual acupuncture treatment

• Those that received a sham acupuncture

• Those that received pills(gabapentin) as treatment

• Those who received placebo pills

During 8 weeks of treatment, and for 16 additional weeks following active treatment, the women kept records of their hot flashes making notes about the severity and duration of each episode.

The researchers used a hot flash score to see how much frequency and severity changed from when the study started to what the women reported at 8, 12 and 24 weeks.

Acupuncture was most effective on the hot flash scores at 8 weeks, when all the different types of interventions came to an end. Following acupuncture’s success was sham acupuncture and then the pill, gabapentin. At 24 weeks, 16 weeks after treatments ended, acupuncture was still getting the most significant results in reducing hot flashes. Women who had sham acupuncture or placebo pills had greater drops in hot flash scores at 24 weeks than those who took gabapentin.

Given the findings of this study, questions about using acupuncture as an alternative to prescribing medication for tamoxifen related hot flashes are sure to include:

• Will private insurance cover acupuncture as a treatment
• Will Medicaid and Medicare cover acupuncture
• Given that tamoxifen is taken for 5 years, how often would women need to have acupuncture treatment to keep hot flashes to a minimum
• What is the difference in cost between acupuncture treatments and oral medication

It won’t be long before women going through natural menopause will want to know if acupuncture that’s helpful for hot flashes experienced by breast cancer patients might be helpful for the hot flashes they are having.