Nonpharmacological therapies for the management of menopausal vasomotor symptoms in breast cancer survivors.

Breast cancer survivors often experience severe hot flashes and night sweats due to treatment-induced menopause, and hormone therapy is typically not recommended for them. Researchers reviewed studies of non-drug treatments to help manage these symptoms, focusing on options like cognitive behavioral therapy (CBT), hypnosis, yoga, mindfulness, acupuncture, and lifestyle changes.

The review included twelve studies specifically involving breast cancer survivors. The strongest evidence supported cognitive behavioral therapy, which helps women change their thought patterns and reactions to hot flashes and night sweats. CBT reduced both the symptoms themselves and how much they bothered women, and it was found to be cost-effective. Hypnosis also showed promise, with two high-quality studies demonstrating its effectiveness for reducing hot flashes in breast cancer patients.

For acupuncture, the review found that it may help reduce how often hot flashes occur and how bothersome they are to women. However, the evidence was not as strong as for CBT and hypnosis. Yoga also showed potential benefits. Interestingly, exercise studies in healthy menopausal women did not show improvement in hot flashes, though these weren't specifically in breast cancer survivors.

What this means for patients: If you're a breast cancer survivor struggling with hot flashes and night sweats and want to avoid medications, acupuncture is a reasonable option to consider, particularly combined with other approaches like CBT or hypnosis. While more research is needed to fully understand acupuncture's effectiveness, current evidence suggests it may provide some relief with minimal side effects. If considering acupuncture, seek a licensed acupuncturist with experience treating cancer survivors.

This narrative review evaluated nonpharmacological interventions for vasomotor symptoms in breast cancer survivors, analyzing twelve randomized controlled trials meeting inclusion criteria. Cognitive behavioral therapy demonstrated the strongest evidence base, significantly reducing vasomotor symptom frequency and perceived impact while proving cost-effective. Two RCTs supported hypnosis efficacy for hot flash management in this population. Acupuncture showed potential for reducing vasomotor symptom frequency and burden, though evidence strength was moderate compared to CBT and hypnosis. Yoga demonstrated possible benefits, while exercise studies in healthy menopausal women (three studies included) failed to show vasomotor symptom improvement. The review did not report specific sample sizes or effect sizes for individual modalities. Clinical implications: CBT and hypnosis represent first-line nonpharmacological interventions with robust evidence. Acupuncture may serve as an adjunctive therapy for breast cancer survivors seeking non-hormonal, non-pharmacological management of treatment-induced menopausal symptoms, particularly for patients preferring integrative approaches or those with contraindications to standard pharmacotherapy.