Cognitive Behavioral Therapy, Exercise Benefit Women with Treatment-Induced Menopause

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(ChemotherapyAdvisor) – Cognitive behavioral therapy (CBT) and physical exercise have “salutary effects” on endocrine symptoms in women with breast cancer who experience treatment-induced menopause, according to a study in Journal of Clinical Oncology online October 8.

Both interventions also improve sexuality and physical function, noted Neil K. Aaronson, PhD, of The Netherlands Cancer Institute, Amsterdam, The Netherlands.

The study randomly assigned 422 women to CBT (n=109), physical exercise (n=104), the two interventions combined (n=106), or a control arm (n=103). Each patient completed a self-report questionnaire at baseline, 12 weeks, and 6 months.

Mean age was 48.2 years and 81% were in a relationship. Approximately half had undergone a mastectomy, 91.2%, chemotherapy, and 85.5%, hormonal therapy. “More than 80% of the women had completed their chemotherapy more than 1 year before study start and 85% were still undergoing hormonal therapy,” the authors wrote.

The groups that received CBT, physical exercise, or the combination showed a significant decrease in levels of endocrine symptoms vs the control arm on the Functional Assessment of Cancer Therapy–Endocrine Symptoms (P<0.001); also significantly reduced were urinary symptoms, as assessed on the Bristol Female Lower Urinary Tract Symptoms Questionnaire (P=0.002). Significant improvement in physical functioning on the 36-Item Short Form Health Survey physical functioning subscale was observed (P=0.002).

Those who received CBT had a “significant decrease in the perceived burden of hot flashes and night sweats,” as assessed on the problem rating scale of the Hot Flush Rating Scale (P<0.001), “and an increase in sexual activity,” as shown on the Sexual Activity Questionnaire habit subscale (P=0.027).

“Most of these effects were observed at both the 12-week and 6-month follow-ups,” they noted, adding “future work is needed to improve the design and the planning of these interventions to improve program adherence.”

An accompanying editorial noted “…much more work needs to be completed to best understand the ideal way to clinically apply nonpharmacologic therapies for the treatment of hot flashes, night sweats, and other estrogen deficiency symptoms.”

Abstract

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