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Oncology Times:
doi: 10.1097/01.COT.0000433552.68932.71
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Severe Menopausal Symptoms Found Twice as Likely in Cancer Survivors

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Cancer survivors had more severe and more frequent hot flashes, night sweats, and other menopausal symptoms, according to a study led by researchers in Australia.

The lead author, Jennifer Marino, MPH, PhD, of the Department of Obstetrics and Gynecology of the University of Melbourne and the Royal Women's Hospital Melbourne, said in a news release that the study was the largest of its kind to assess the impact of menopausal symptoms on the quality of life of cancer survivors.

The study, now available online ahead of print in the journal Menopause (doi: 10.1097/GME.0b013e3182976f46 ) included approximately 1,000 cancer survivors (mostly breast cancer) and 155 non-cancer patients age 40 to 60, who attended the Menopause Symptoms After Cancer Clinic at King Edward Memorial Hospital in Western Australia. The women were surveyed to determine a range of factors including severity of menopausal symptoms, impact on quality of life, and sexual function.

The cancer survivors had twice as many hot flushes (six compared with three in 24 hours) and were twice as likely to report severe or very severe hot flashes as the non-cancer patients were. More than 200 cancer survivors reported experiencing more than 10 hot flashes a day.

Interestingly, she said, the mental health of the cancer survivors appeared to be better than those in the study who did not have cancer.

“The cancer survivors were less troubled by symptoms of anxiety and depression than women attending the menopause service who had never had cancer,” she said.

The study's senior author, Martha Hickey, MD, noted that menopausal symptoms are a frequent and distressing effect of cancer treatments in women.

“In women with hormone-sensitive cancer such as breast cancer, effective treatments reduce estrogen levels and this commonly leads to menopausal symptoms.”

The researchers noted that many of the cancer survivors in the study presented with menopausal symptoms many years since their original diagnosis, indicating the persistence and prevalence of menopausal symptoms in this population.

“We were surprised to find that sexual dysfunction symptoms did not differ by cancer status, but severe vaginal dryness, pain during sexual intercourse, and loss of interest in sex were very common and troublesome in both groups,” the researchers wrote. “This contrasts with the few studies comparing women with a breast cancer history or cervical cancer, which found worse gynecologic and sexual functions, but most of these studies did not account for menopause status.

“A relatively high proportion of the non-cancer participants (41%) had gone through surgical menopause,” the team continued. “It is well recognized that surgical menopause may be more likely than natural menopause to lead to sexual dysfunction, and this may have contributed to our observations.

“Accurate information about the nature and severity of menopausal symptoms after cancer is needed to inform the development of appropriate evaluation and management protocols,” they concluded.

Wolters Kluwer Health | Lippincott Williams & Wilkins

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