Therapy, exercise aid chemo-related menopause

PHOTO: Therapy, exercise aid chemo-related menopause

Younger women who are thrust into menopause because of breast cancer treatment may get some relief from talk therapy and regular exercise, according to a study from the Netherlands.

Menopause symptoms such as hot flashes often come on gradually for women who go through natural menopause, as the body's production of hormones slowly dwindles. But that's not often the case for women diagnosed with breast cancer and treated with chemotherapy and other potent drugs.

"Oftentimes with women with breast cancer who experience treatment-induced menopause, the symptoms are much more severe than in natural menopause," said Neil Aaronson from The Netherlands Cancer Institute in Amsterdam, who worked on the study.

In addition, those women can't take replacement hormones to ease the symptoms, an effective but controversial treatment for menopause-related symptoms, since the hormones can put them at risk for a cancer recurrence.

For the study, which appeared in the Journal of Clinical Oncology, Aaronson and his colleagues randomly assigned 422 women with breast cancer and treatment-induced menopause to one of four groups.

One group went to six weekly therapy sessions, another consulted with physiotherapists and started tailored exercise programs, a third did both therapy and exercise and the final group was put on a waitlist.

The type of group treatment, known as cognitive behavioural therapy, included relaxation exercises and addressed symptoms as well as body image and sexuality issues.

Six months later, women in the talk therapy, exercise and combined groups reported an improvement in treatment-related symptoms, each gaining about five points on a 73-point scale compared to fewer than two points among waitlisters.

Women who'd had therapy also said they were bothered less by their hot flashes and night sweats, though they had them just as often.

"With the cognitive behavioural therapy, we were primarily targeting the subjective experience of the symptoms, and helping women to cope with the symptoms," Aaronson told Reuters Health.

For women who have been treated for breast cancer and have menopause-related symptoms, antidepressants and other medications may also offer some help. But by that point, Aaronson said, many women aren't interested in taking any more drugs or dealing with any more potential side effects.

He and his colleagues are working on translating the therapy sessions into an online programme that people can do on their own time.

"More research is needed on behavioural interventions such as relaxation therapy and cognitive behavioural therapy to understand more about how these things are helpful and for whom," said Debra Barton from the Mayo Clinic, who co-wrote an editorial accompanying the article.

"However, so far the data appear very promising."