Psychotherapy May Ease Hot Flashes After Breast Cancer

TUESDAY, Feb. 14 (HealthDay News) -- After breast cancer treatment, many women suffer from hot flashes and night sweats, but a type of "talk therapy" might relieve these symptoms for some women, British researchers suggest.

In a new study, women who received this form of psychotherapy, known as cognitive behavioral therapy, had reduced their symptoms by half within six months.

"Hot flashes and night sweats are distressing symptoms, which cause social embarrassment and sleep problems, and they are challenging to treat, especially for women who have had breast cancer" because hormone replacement therapy is generally not recommended for these women, explained lead researcher Myra Hunter.

According to background information in the study, which is published in the Feb. 15 online edition of The Lancet Oncology, 65 percent to 85 percent of women have hot flashes after breast cancer treatment.

Group cognitive behavioral therapy is a safe and effective treatment for women who have hot flashes and night sweats following breast cancer treatment, Hunter said, with additional benefits to mood, sleep and quality of life.

"The women in this trial reported frequent and problematic symptoms and relatively low quality of life," said Hunter, a professor of clinical health psychology at King's College London's Institute of Psychiatry.

Hunter's team randomly assigned 96 women who had been treated for breast cancer and suffered from night sweats and hot flashes to either "talk therapy" or usual care.

The 47 women who received the therapy attended weekly 90-minute sessions for six weeks. For the others, usual care consisted of access to nurses and oncologists, telephone support and cancer support services, the researchers noted.

The therapy sessions included psycho-education, paced breathing, and behavioral strategies to manage hot flashes and night sweats, as well as interactive PowerPoint presentations, group discussion, handouts and weekly homework, Hunter said.

In addition, participants learned how to handle the stress associated with hot flashes and night sweats, and found new ways to decrease anxiety, she explained.

The women were also taught to manage hot flashes in social situations and to understand night sweats and improve sleep habits using mental and behavioral strategies.

The investigators found that the women who had received the cognitive behavioral therapy significantly reduced the number of hot flashes and night sweats they experienced in the nine weeks after the start of the study.

This reduction in symptoms lasted for 26 weeks. At nine weeks there was a 46 percent reduction in symptoms and a 52 percent reduction at 26 weeks, Hunter's team found.

However, among women receiving usual care, hot flashes and night sweats decreased by 19 percent after nine weeks and 25 percent after 26 weeks.

"These reductions were sustained and associated with significant improvements in mood, sleep and quality of life," Hunter said. "This is a safe, acceptable and effective treatment option, which can be incorporated into breast cancer survivorship programs and delivered by trained breast cancer nurses."

Holly Prigerson, director of the Center for Psycho-Oncology and Palliative Care Research at the Dana-Farber Cancer Institute in Boston, wrote an accompanying journal editorial.

"Hot flashes and night sweats are very common, distressing and persistent -- women reported being troubled by them for an average of two years after breast cancer treatment," Prigerson said.

She noted that the new study provides sound evidence upon which to recommend cognitive behavioral therapy for breast cancer patients suffering from these symptoms.

"Adaptations to an online, self-management version of the intervention would allow for more flexible scheduling and greater access at potentially lower cost of delivery," Prigerson said. "Combining the intervention with medications that effectively treat hot flashes and night sweats might produce the most dramatic effects with reductions in symptoms as well as the distress caused by them."

Prigerson said this type of therapy might also be used to treat postmenopausal women suffering from these symptoms.

"Of course, scientifically, we can't generalize beyond the sample of women who experience menopausal symptoms as a result of treatment for breast cancer," she said. "But given that they found that [this type of therapy] worked on the distress associated with hot flashes and night sweats, then it would seem likely to generalize to menopausal symptoms experienced outside of this context."

More information

For more about psychotherapy, visit the U.S. National Institute of Mental Health.

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Radiation After Lung Cancer Surgery Doesn't Help All: Study

MONDAY, Feb. 13 (HealthDay News) -- For older people with a certain type and stage of lung cancer, administering radiation treatment after surgery may not extend survival, according to a new study.

Radiation is not without risks, and the new study "questions the benefit of this treatment," said study leader Dr. Juan Wisnivesky, an associate professor of medicine at Mount Sinai School of Medicine in New York City.

He and his team looked at survival outcomes in more than 1,300 lung cancer patients with locally advanced disease, 710 of whom got the postoperative radiation therapy. It is routinely given in an attempt to prevent recurrence.

No substantial survival benefits were found at one year or three years.

"We found in this group of elderly patients, many of whom received the treatment, the use of the treatment did not appear to help them live longer," he said.

Patients in the study, all 65 or older, had stage 3 non-small cell lung cancer and involvement of N2 lymph nodes. Their cancer had spread but not widely. All had been diagnosed from 1992 through 2005 and were included in the U.S. Surveillance, Epidemiology, and End Results database, which is linked to Medicare.

The study, published online Feb. 13 in the journal Cancer, was funded by the U.S. National Cancer Institute.

About 226,000 new cases of lung cancer will be diagnosed in the United States this year, 90 percent of which will be non-small cell, according to the American Cancer Society. Within non-small cell cancers, there are three main subtypes.

Previous studies looking into the survival benefits of post-op radiation for this group of patients have produced mixed results, Wisnivesky said.

However, in his study, he found no substantial differences between those who had the treatment and those who didn't. And, radiation therapy carries risks. Besides the inconvenience of the additional treatments, the therapy can cause irritation of the lungs and inflammation of the esophagus, he said.

"Patients need to be well informed," he said. "They have to have a good discussion with their doctor about what are the potential benefits," he said. They also need to discuss possible side effects.

Another expert, Dr. Dan Raz, an assistant professor of surgery at City of Hope Comprehensive Cancer Center in Duarte, Calif., emphasized that the study is not talking about all stage 3 lung cancer patients, but only a specific group, those with stage 3 non-small cell and involvement of the N2 lymph nodes.

"It's a small subset of patients" of all lung cancer patients, he said, adding that it's a challenging group.

Some previous small studies have also suggested that post-op radiation may be unnecessary in these patients, and the new findings add to that argument, he said.

"In the end, survival and quality of life are the most important things for patients," Raz said. But recurrence, a key factor, was not addressed in the study, he said.

The new finding "wouldn't change the way I treat patients, but I think it raises a very important point."

What's needed is a trial comparing use of post-operative radiation and its non-use in this group of patients, Raz said. According to Wisnivesky, such a study is under way in France, but will take several years to finish.

More information

For more on radiation therapy, go to the American Cancer Society.

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After diabetes diagnosis, US celebrity chef feels heat

US cooking star Paula Deen, self-proclaimed "Queen of Southern Cuisine" famous for her dishes smothered in butter, has met a storm of outrage after revealing she has diabetes and is hawking a drug to treat the disease.

Deen, who famously showed off trademark high-fat, high-calorie meals including such creations as a hamburger wedged between a doughnut, was diagnosed with Type 2 diabetes three years ago -- but continued her show on the Food Network promoting what critics slammed as an outrageously unhealthy diet.

Detractors have lambasted the jovial cooking host in a country that is battling an obesity epidemic. According to recent studies one-in-three adults in America are obese, as are one-in-six children -- a grave, growing problem despite efforts to combat it with healthy eating campaigns.

Further sullying her image, however, 64-year-old Deen came out last month as a spokesperson for the pharmaceutical giant Novo Nordisk and its diabetes treatment Victoza, hawking the drug in a new campaign "Diabetes in a New Light."

Fellow US cooking celebrity Anthony Bourdain, a chef and host of Travel Channel show "No Reservations," took to Twitter to vent over Deen's decision.

"Thinking of getting into the leg-breaking business, so I can profitably sell crutches later," he quipped on the popular microblogging site.

Amid the US obesity crisis, Bourdain has laid into Deen before, due to her high-fat creations calling her "the worst, most dangerous person to America."

Known as "The Lady," Deen has become something of an institution for her heavy, no-apologies approach to cuisine, with a decade-long cooking show, 15 cookbooks, a well-known restaurant in Savannah, Georgia and a profitable lines of cooking wares sold in stores and online.

She has garnered a reputation for heavy, rich, fried southern dishes -- cooking up a combination of almost anything with the most butter, cream, sugar.

On savory dishes, she famously piles high the meat, heavily salted, drawing accusations of being in cahoots with giant meat firms that have in turn been blamed for rising cases of diabetes in the United States in recent years.

Her move to join "big pharma" and tout a diabetes drug has caused an uproar, not least because US authorities had approved the treatment Victoza in January 2010 despite evidence of a link to thyroid cancer. It also costs hundreds of dollars a month, compared to similar, less expensive options.

"I am here today to let the world know that it is not a death sentence," Deen said in announcing her diabetes diagnosis.

There was, however, little sympathy for her from fans and critics alike.

She had waited "three years before revealing she had developed diabetes -- three years of serving up ever-more carb-and-fat laden meals, dragging her legions down with her. And then, voila! She has the "magic bullet," ready for them to pop in their mouth," wrote one outraged viewer on an Internet forum.

Those closest to her meanwhile reportedly jumped ship over her decision to campaign for the dubious diabetes drug -- her publicist Nancy Assuncao Sanchez is said to have quit over the move.

Even her sons are apparently "furious" with her. The New York Post said Deen's children Jamie and Bobby -- the latter also hosts a cooking show called "Not My Mama's Meals" -- were worried that switching from a successful treatment to the new drug, for the sake of some millions of dollars in the endorsement deal, could endanger her health further.

Her defenders, however, pointed out the problem was not with Deen.

"She is not responsible for how people eat," insisted one commentator Gary Finger, on a blog for USA Today, saying she was simply geared towards giving people what they already wanted.

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