Procedure May Reduce Hot Flushes For Breast Cancer Survivors

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Main Category: Breast Cancer
Also Included In: Neurology / Neuroscience;  Women's Health / Gynecology;  Cancer / Oncology
Article Date: 14 May 2008 - 16:00 PDT

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A stellate-ganglion block is a numbing of the star-shaped collection of nerves in the neck that is thought to affect both temperature and sleep control. A new study published in The Lancet Oncology reports that breast cancer survivors who are treated with a stellate-ganglion block can achieve long-term relief from hot flushes and sleep problems.

A common and serious side-effect of breast cancer drug treatments, hot flushes are characterized as a feeling of intense heat with sweating and rapid heartbeat. Breast cancer survivors who take anti-estrogen medications risk cancer recurrence if hot flushes discourage patients from complying with treatment programs. It has been shown that over half of these patients are likely to be not compliant within six months. Sufferers of hot flushes can also have their sleep disrupted and can face irritability during the day, effecting daily living routines.

To test the effects of the stellate-ganglion block, Drs. Eugene Lipov and Jay Joshi (Advanced Pain Centers, Hoffman Estates, IL, USA) and colleagues conducted a study with 13 breast cancer survivors that had severe hot flushes. Each patient was injected with stellate-ganglion block. A measure of the number and intensity of hot flushes was used to develop a "Hot-Flash" Score and the Pittsburgh Sleep Quality Index served as a way to measure night awakenings and sleep disturbances. The first measurement was taken a week before the procedure, and subsequent measures occurred weekly for 12 weeks.

After the stellate-ganglion block was administered, no adverse events were noted. Before the procedure, the patients average a total of 79.4 hot flushes per week, and this number decreased to 49.9 during the first two weeks following the procedure. In weeks 3 through 12, the decrease continued until about 8.1 hot flushes per person per week. At the end of week 12, the number of very severe hot flushes fell to almost zero.

Similar results were found for night awakenings. Before the procedure, patients reported about 19.5 night awakenings per person per week, and this number decreased to 7.3 during the first two weeks following the procedure. The decrease continued over the 12 weeks and stabilized at about 1.4 night awakenings per person per week.

"The findings of this study suggest that stellate-ganglion block can provide survivors of breast cancer with long-term relief from hot flushes and sleep dysfunction with few or no side-effects. Long-term relief of symptoms has the potential to improve overall quality of life and increase compliance with anti-oestrogen medications for breast cancer," conclude the authors.

Effects of stellate-ganglion block on hot flushes and night awakenings in survivors of breast cancer: a pilot study
Eugene G Lipov, Jaydeep R Joshi, Sarah Sanders, Kris Wilcox, Sergei Lipov, Hui Xie, Robert Maganini, Konstantin Slavin
The Lancet Oncology (June 2008).
DOI:10.1016/S1470-2045(08)70131-1
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Written by: Peter M Crosta
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