Menopause after breast cancer : a randomised controlled trial of relaxation training to reduce hot flushes
This study was set up to test the effectiveness of relaxation techniques to reduce hot flushes and to find out more about the experience of menopause after breast cancer. A randomised, controlled trial was conducted on 150 women to investigate whether relaxation training reduces hot flushes in women with breast cancer. A diary was devised and tested in order to gather accurate data on hot flushes. A purposeful sample of eight women were selected for interview and information was gathered about the experience of hot flushes in the context of breast cancer through the interviews and diaries. From the interviews it was found that there was much uncertainty about menopausal difficulties after breast cancer. The women faced profound changes in their bodies, which could bring feelings of being out of control. Ultimately they found that menopause was secondary in relation to having cancer and that they were expected to adapt, although menopausal difficulties could remain for many years. Menopausal difficulties after breast cancer were found to be a major problem for many women, causing severe disruption to life. Hot flushes were experienced by 68% of women and continued for more than five years in 34% of women. Women in this sample experienced a median of five flushes per day. Sleep disruption was a major problem with 72% of women having disturbed sleep. There was a diurnal pattern to flushes, with more occurring in the morning and the evening. This pattern was more marked in women taking tamoxifen. Relaxation was found to be an effective intervention, which significantly reduced the incidence of hot flushes by 22% (p<0.001), the severity of flushes (p<0.01) and the distress caused by flushes (p=0.01). The actual reduction in flushing was relatively small, being the equivalent of one flush per day. It was therefore recommended that relaxation be incorporated into a programme of self-management measures to relieve hot flushes, which can be adopted by women who have had breast cancer.