'Cool' New Treatment for Hot Flashes in Breast Cancer Survivors

Study shows marked reduction in frequency, severity of hot flashes and sleep
disturbances using neural block

CHICAGO, May 14 /PRNewswire/ -- An anesthetic injection into a collection
of nerves in the neck of breast cancer survivors may reduce the severity and
frequency of debilitating hot flashes and night awakenings associated with
breast cancer treatment, according to a new study published online today by
The Lancet Oncology and appearing in its June issue.
Hot flashes and sleep dysfunctions often plague breast cancer survivors,
especially those who take anti-estrogen medications. Conventional treatments
have been only partially effective and may carry serious risks. Previous
research has shown that hot flashes experienced by breast cancer survivors are
significantly more frequent, severe, and of greater duration than those in
menopausal women.
Eugene G. Lipov, MD, and Jaydeep R. Joshi, MD, of Advanced Pain Centers,
Hoffman Estates (Chicago), Ill., and co-authors, conducted a pilot study of
the safety and efficacy of the stellate ganglion block in 13 breast cancer
survivors. It is called a "stellate" block as it describes the star-shaped
collection of nerves in the neck which regulates body temperature and
therefore may affect quality of sleep. The block, used by practitioners for
over 60 years, is an injection of a numbing solution near the C6 vertebrae
that can be performed under either local anesthesia or with "twilight"
sedation. The injection is given with the aid of fluoroscopy (guided X-ray)
to ensure correct and safe placement of the needle. The procedure takes
approximately 10 minutes to perform in an outpatient setting.
"Estrogen-depleting drugs used in the fight against breast cancer often
leave women's bodies defenseless against debilitating hot flashes and the
sleep disturbances they cause," says Dr. Lipov. "This small pilot study
conducted in breast cancer survivors confirms our earlier research on healthy
menopausal women that the stellate ganglion block can effectively 'shut off'
these troubling symptoms. Since these symptoms are generally more severe in
women who have undergone breast cancer treatment, the block is a significant
arsenal in helping estrogen-depleted women feel better with few or no side
effects."
Women on hormone replacement therapy were excluded from the study. The 13
study patients were 30 to 70 years of age (mean age, 53 years). Four of the
13 patients had been diagnosed with Stage 0 breast cancer (or infiltrating
ductal carcinoma in situ, the earliest, and noninvasive, cancer stage), 4 had
Stage 1 cancer, 4 had Stage 2, and 1 had Stage 3. Using two standardized
measures, each patient recorded the severity and intensity of her hot flashes
and the number of night awakenings for 1 week before the procedure and weekly
for 12 weeks postprocedure. The investigators applied a statistically-sound
estimating equation to analyze the number of hot flashes and night awakenings
over time.
If the effect of the stellate ganglion block on hot flashes and night
awakenings did not last throughout the 12-week study period, the block was
repeated. The decision to repeat the block was made by the patient if she
felt her symptoms were returning. (Multiple blocks have been used for decades
without increased risk.) Of the 13 women, 5 had only 1 stellate ganglion
block and 8 women had 2 blocks. Women who had 2 blocks generally reported
more lasting relief of symptoms than after the first procedure.
The total number of hot flashes decreased from a mean of 79.4 per week
before the procedure to a mean of 49.9 per week during the first 2 weeks after
the treatment. After 2 weeks, the total number of hot flashes continued to
decline and stabilized at 8.1 per week from weeks 3 through 12. The severity
of the hot flashes similarly decreased, with the most dramatic drop-off in
severity occurring within 1 day to 1 week after treatment; the rate of "very
severe" flashes remained near zero for the remainder of the follow-up period.
The total number of night awakenings decreased by about two-thirds within
2 weeks after treatment, from 19.5 per week before the block to 7.3 per week
afterwards. This number continued to decline throughout the follow-up period
and stabilized at 1.4 per week. All results were highly statistically
significant.
"Hot flashes are a frequent and serious side effect of pharmacological
treatments for breast cancer. They may even contribute to cancer recurrence
by discouraging compliance with treatment regimens, as 50% of these patients
may become noncompliant after 6 months," Dr. Joshi explains. "Long-term relief
of symptoms has the potential to improve overall quality of life and increase
compliance with anti-estrogen medications for breast cancer."
Disclosure statement: This study was self-funded and no sponsorship is
declared.
To contact Dr. Lipov and/or his coauthors please call Patti Davis, MPH, of
DAVIS MEDPR, Inc. at 630.920.8042 (CT) or email patti@davismedpr.com. More
information on the stellate block is available at
http://www.hotflashescure.com. Dr. Lipov is fluent in Russian. Further
information on Drs. Lipov and Joshi and Advanced Pain Centers can be found at
http://www.painmngt.com.
SOURCE DAVIS MEDPR, Inc.

Patti Davis, MPH, of DAVIS MEDPR, Inc., +1-630-920-8042, patti@davismedpr.com