Procedure May Reduce Hot Flushes For Breast Cancer Survivors

A stellate-ganglion block is a numbing of the star-shaped collection of
nerves in the neck that is thought to affect both temperature and sleep
control. A new study published in The Lancet Oncology
reports that breast cancer survivors who are treated with a
stellate-ganglion block can achieve long-term relief from hot flushes
and sleep problems.



A common and serious side-effect of breast cancer drug treatments, hot
flushes are characterized as a feeling of intense heat with sweating
and rapid heartbeat. Breast cancer survivors who take anti-estrogen
medications risk cancer recurrence if hot flushes discourage patients
from complying with treatment programs. It has been shown that over
half of these patients are likely to be not compliant within six
months. Sufferers of hot flushes can also have their sleep disrupted
and can face irritability during the day, effecting daily
living routines.



To test the effects of the stellate-ganglion block, Drs. Eugene Lipov
and Jay Joshi (Advanced Pain Centers, Hoffman Estates, IL, USA) and
colleagues conducted a study with 13 breast cancer survivors that had
severe hot flushes. Each patient was injected with stellate-ganglion
block. A measure of the number and intensity of hot flushes was used to
develop a "Hot-Flash" Score and the Pittsburgh Sleep Quality
Index served as a way to measure night awakenings and sleep
disturbances. The first measurement was taken a week before the
procedure, and subsequent measures occurred weekly for 12 weeks.



After the stellate-ganglion block was administered, no adverse events
were noted. Before the procedure, the patients average a
total of 79.4 hot flushes per week, and this number decreased to 49.9
during the first two weeks following the procedure. In weeks 3 through
12, the decrease continued until about 8.1 hot flushes per person per
week. At the end of week 12, the number of very severe hot flushes fell
to almost zero.



Similar results were found for night awakenings. Before the procedure,
patients reported about 19.5 night awakenings per person per week, and
this number decreased to 7.3 during the first two weeks following the
procedure. The decrease continued over the 12 weeks and stabilized at
about 1.4 night awakenings per person per week.



"The findings of this study suggest that stellate-ganglion block can
provide survivors of breast cancer with long-term relief from hot
flushes and sleep dysfunction with few or no side-effects. Long-term
relief of symptoms has the potential to improve overall quality of life
and increase compliance with anti-oestrogen medications for breast
cancer," conclude the authors.



Effects of stellate-ganglion block on hot flushes and night
awakenings in survivors of breast cancer: a pilot study

Eugene G Lipov, Jaydeep R Joshi, Sarah Sanders, Kris Wilcox, Sergei
Lipov, Hui Xie, Robert Maganini, Konstantin Slavin

The Lancet Oncology (June 2008).

DOI:10.1016/S1470-2045(08)70131-1

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Written by: Peter M Crosta