Acupuncture to treat hot flushes experienced by cancer patients

Cancer is a unique condition that isn’t caused by bacteria or viruses as many other diseases are. Instead the condition develops as cells, the fundamental building blocks of life, undergo changes in how they grow and replicate themselves. These changes are part of a process called ‘transformation’, during which normal, healthy cells are transformed into tumour or cancer cells.

What makes cancer cells distinctive and so difficult to treat is that they are still human cells that are a part of your body, and not invading cells with surface characteristics that make them targets for treatment and our body’s natural defences. Cancer cells are essentially normal cells that are no longer regulated in terms of how they grow and divide, and the result is the formation of abnormal masses called tumours. These tumours hijack resources needed by other cells, and grow to a point where they disrupt the structure of organs and tissues, affecting their function and causing symptoms.

The complexity of cancer as a disease has limited the progress of treatments, and many standard cancer treatments cause severe side effects. In this article we look at a particular set of side effects that primarily affect sufferers of prostate and breast cancers, and in particular how acupuncture can be used as a complementary treatment to manage these symptoms.

What are hot flushes in cancer?

Hot flashes are described by sufferers as an acute feeling of heat on the upper body and face. This symptoms is usually experienced alongside or after other distinct symptoms like anxiety, weakness, dizziness, and a sense of suffocation. The hot flush often leaves patients sweating heavily and reddened, and the experience can vary in its intensity. Each occurrence or episode can typically last anywhere between 2 and 30 minutes and their regularity can vary immensely with some people experiencing a hot flush every hour while others go through them weekly or even monthly.

A hot flush is actually more commonly experienced as part of menopause, and it is estimated that about 3 quarters of women going through menopause will experience hot flushes. The symptom is caused by changes in testosterone levels. During menopause and as a consequence of certain cancer treatments, the level of testosterone drops sharply, and the result is often hot flushes.

About 70% of women receiving breast cancer treatment will experience hot flushes as a side effect, and the chances of experiencing hot flushes are increased if a woman is going through menopause when she receives her treatment.

Men who experience hot flushes are almost exclusively sufferers of prostate cancer. This condition is treated by a class of drugs called LHRH (luteinising hormone release) blockers, and these cause a massive drop in testosterone as the hormone’s production is stopped completely. These flushes can be relieved through the administration of another hormone called progesterone, however this may not always be used.

How are hot flushes after cancer treatment usually treated?

Because breast and prostate cancers are fairly prevalent, there are a number of strategies that can be employed to manage hot flushes.

If you suffer from this side effect you should avoid substances like nicotine, alcohol, and caffeine (in tea and coffee), these can worsen a hot flush or help its onset. You should also keep your rooms at low temperatures, using a fan or air conditioning can often help. During a hot flush, using a water spray can help manage your temperature, as can wearing light and loose clothing that you can just remove if the heat becomes too great.

Clothing made from natural materials like cotton or even silk is more advisable than man made fabrics like nylon. The latter can retain heat more than cotton and silk, which can make a hot flush worse.

Cold drinks and showers are can also be very comforting during a hot flush, and it might help to keep a towel handy or on your bed if you are susceptible to sweating a lot during a hot flush.

There are some medications that can help with hot flushes, but unfortunately the only way to get rid of them is to stop any cancer treating medication to restore a normal hormonal balance, or to replace certain hormones that are lacking through hormone replacement therapy (HRT). These options are not advisable if you are suffering from a cancer, and HRT is thought to increase the risk of a prostate or breast cancer recurring.

Vitamin E has been shown to reduce the number of hot flushes experienced, however its mechanisms are not fully understood. Certain antidepressants (like Prozac and Seroxat) have shown some level of effectiveness in reducing both the severity and frequency of hot flushes. A recent trial has shown that venlafaxine (an antidepressant) can reduce the incidence of hot flushes in men suffering from prostate cancer by about 50%.

Other medications like gabapentin and clonidine have shown some success in reducing hot flushes, however they are associated with their own side effects like constipation, dizziness, and drowsiness. For many people psychological approaches like cognitive behaviour therapy (CBT) have proven effective in supplying sufferers with the tools they need to cope with hot flushes. CBT is particularly useful where hot flushes come on as a result of certain feelings or emotions.

Because of the huge variation in responses to these management techniques, a number of complementary therapies are available that can provide valuable alternatives to those suffering from hot flushes and struggling to manage them. One of these approaches is acupuncture, and in the following section we will look at how acupuncture can be used as a means by which hot flushes can be managed.

How can acupuncture help treat hot flushes caused by cancer treatment?

An ancient Chinese medical tradition which has made its way into more widespread usage in the past century, acupuncture remains a subject of much disagreement as to its usefulness in the medical community. Despite the level of controversy still associated with acupuncture, scientific research has supported its use in certain areas, although further work is still needed for more solid conclusions in many areas..

Studies in 2005, 2006, and 2009 performed on women suffering from hot flushes showed that acupuncture could provide a long term solution to hot flushes. These studies indicated that acupunctural treatment could improve how women felt psychologically and also reduce the frequency and intensity of hot flushes.

These reports indicate that acupuncture can be used as a means by which to treat hot flushes, and other studies suggest that this treatment may be at least as effective as certain drugs like venlafaxine (but without the side effects).

The mechanisms by which acupuncture can achieve these goals remain unclear. The traditional Chinese philosophy suggests that acupuncture stimulates and restores the healthy flow of a vital life force called Qi, however no research performed thus far has supported the existence of Qi. Western medical sources argue that the effects observed as a consequence of acupuncture treatment are because of acupuncture’s stimulation of the nervous system to release natural painkillers.

While we may not understand how it does so, the evidence available to date does suggest that acupuncture can be used to manage hot flushes that are an unpleasant side effect of the treatment of breast and prostate cancers. Acupuncture is a valuable strategy that can complement existing cancer management approaches.

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