Hot flushes and sleep deprivation in breast cancer survivors reduced by stellate-ganglion block

May 14, 2008

Giving breast cancer survivors a stellate-ganglion block* -- an injection into the nerves of the neck which regulate temperature -- could provide these patients with long-term relief from both hot flushes and sleep deprivation. These are the conclusions of authors of a pilot study in an Article published early Online and in the June edition of The Lancet Oncology.

Hot flushes are a frequent and serious side-effect of drug treatments for breast cancer. In survivors of breast cancer taking antioestrogen medications, hot flushes can even contribute to cancer recurrence by discouraging compliance with treatment programmes. Data show that more than 50% of such patients might be non-compliant after 180 days. Hot flushes can also have a substantial effect on daily living, by disrupting sleep and causing fatigue and irritability during the day.

Dr Eugene Lipov and Dr Jay Joshi, Advanced Pain Centers, Hoffman Estates, IL, USA, and colleagues did a pilot study of 13 survivors of breast cancer with severe hot flushes. Each was treated with stellate-ganglion block. Hot flushes were recorded using the 'Hot-Flash' Score (a measure of the number and intensity of flushes), and night awakenings by use of the Pittsburgh Sleep Quality Index (a record of the number of sleep disturbances). Both measures were used one week before the procedure and then weekly after the procedure for 12 weeks.

The researchers found there were no adverse events resulting from the stellate-ganglion block. The total number of hot flushes decreased from a mean of 79.4 per patient per week (pppw) before the procedure to a mean of 49.9 pppw during the first 2 weeks after the procedure. This number continued to decrease in weeks 3-12, and stabilised at a mean of 8.1 hot flushes pppw. The number of very severe hot flushes decreased to near zero by the end of week 12. Night awakenings decreased from a mean of 19.5 pppw before the procedure to a mean of 7.3 pppw during the first two weeks after the procedure. The total number of night awakenings continued to decrease over the remaining follow-up period and stabilised at a mean of 1.4 pppw.

The authors conclude: "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 antioestrogen medications for breast cancer."
Notes to editors: *Stellate-ganglion block: numbing up the collection of nerves in the neck , that looks like a star (stellate) that is believed to reset both temperature control and be involved in sleep control

Dr Eugene Lipov, Advanced Pain Centers, Hoffman Estates, IL, USA T) +1 847-742-8596 E) elipovmd@aol.com


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