The most debilitating adverse effects of chemotherapy and hormone therapy for women with breast cancer are vasomotor symptoms (hot flushes, night sweats). This randomised controlled preliminary study evaluated the safety and efficacy of venlafaxine and acupuncture, which has been found to be effective in reducing vasomotor symptoms in menopausal women.
A total of fifty women with stage 0-III pre- or postmenopausal breast cancer on hormone therapy with tamoxifen or arimidex, were randomised to twelve weeks of acupuncture (n = 25) or venlafaxine (n = 25) treatment. Patients in the control arm took venlafaxine 37.5 mg orally at night for 1 week, then 75 mg, if tolerated, at night for the remaining 11 weeks. Patients in the acupuncture arm received treatments twice per week for the first 4 weeks, then once per week for the remaining 8 weeks. The primary end point was hot flush frequency. Both groups were followed up for one year.
Both groups exhibited significant decreases in hot flushes (50% reduction), depressive symptoms, and other quality-of-life symptoms, including significant improvements in mental health from pre- to post-treatment. These changes were similar in both groups, suggesting that acupuncture was as effective as venlafaxine, however by 2 weeks post-treatment, the venlafaxine group experienced significant increases in hot flushes, whereas the number of hot flushes in the acupuncture group remained at low levels (no absolute data available).
The venlafaxine group experienced 18 incidences of adverse effects whereas the acupuncture group experienced no adverse effects and an increase in positive benefits eg increased sex drive in some women, improvement in their energy, clarity of thought, and sense of well-being.
The authors concluded that their results demonstrate that acupuncture appears to be equivalent to venlafaxine and it may provide additional and longer term benefits without adverse effects for vasomotor symptoms secondary to long-term anti- oestrogen hormone use in women with breast cancer.