Many young women experience symptoms precipitated by breast cancer treatment-induced menopause. Chemotherapy, surgical removal of the ovaries and hormonal therapy all affect the female reproductive system and can instigate the onset of menopause. Of the many symptoms that can occur during menopause, hot flushes and night sweats are considered the most bothersome and disruptive.
Thoughts and triggers
In 2012, the research group of behavioral scientist Neil Aaronson from the Netherlands Cancer Institute demonstrated that cognitive behavioral therapy provided in face-to-face group sessions had a positive impact on hot flushes and night sweats. However, the results also indicated that many woman found it inconvenient to have to attend these group sessions. As a result, the program was translated into an online format.
The recent study, conducted by the same research group, shows that women with breast cancer treatment-induced menopausal symptoms benefit from internet-based cognitive behavioral therapy. In total, 254 women participated in the study. PhD candidate Vera Atema: "These women were divided into three groups: online cognitive behavioral therapy with weekly online counselling, online cognitive behavioral therapy without counselling and a waiting list control group. During the six week program women received educational materials and were given homework assignments to help them learn to cope better with their symptoms."
Triggers
The study results indicate that women who followed the online program experienced significantly fewer menopausal symptoms, and in particular fewer and less disruptive hot flushes and night sweats, as well as improved sleep quality. One of the participants wrote: 'I gained more insight into my hot flushes and felt supported by the program. I also received useful tips and information, especially about sleep and sleep problems and things that trigger hot flushes.' Last week the results of this study were published in the prestigious Journal of Clinical Oncology.
The online therapy has not yet been implemented in routine clinical practice. Neil Aaronson: "We are currently analyzing the cost-effectiveness of the therapy and hope that the results will convince health insurers to reimburse the costs of the program. In the future, we would also like to offer the program to older, post-menopausal women whose symptoms are exacerbated by their breast cancer treatment."
This research was done in collaboration with Marieke van Leeuwen, Hester Oldenburg and Marc van Beurden of the Netherlands Cancer Institute, and Myra Hunter of King's College in London. The online counselling was provided by social medical workers and psychologists from the Netherlands Cancer Institute and the Ingeborg Douwes Centre in Amsterdam.
This study was financed by the Dutch Cancer Society and the Pink Ribbon Foundation.