London, May 15 : Now a jab in the neck may help relieve the severity of unbearable hot flashes and night awakenings that come with breast cancer treatment, says a new study.
This nerve block, named "stellate" ganglion block, given in the neck of breast cancer survivors may reduce hot flashes and sleep dysfunctions that plague breast cancer survivors, especially those who take anti-estrogen medications. This will outdo conventional treatments, which are not fully effective and may carry serious risks.
Early research has indicated that the severity, frequency and duration of these hot flashes experienced by breast cancer survivors are much higher than those in menopausal women.
The study conducted by Eugene G. Lipov, MD, and Jaydeep R. Joshi, MD, of Advanced Pain Centers, Hoffman Estates (Chicago), Ill., focussed on the safety and efficacy of the stellate ganglion block in 13 breast cancer survivors. "Stellate" block gets its name by the star-shaped collection of nerves in the neck, which regulates body temperature and thus influencing quality of sleep.
In use since more than 60 years, the block is a numbing solution injection near the C6 vertebrae, which can be administered under either local anaesthesia or with "twilight" sedation. The safe placement of the needle is ensured by giving it by using fluoroscopy (guided X-ray). It takes only 10 minutes to perform in an outpatient setting.
"Estrogen-depleting drugs used in the fight against breast cancer often leave women's bodies defenseless against debilitating hot flashes and the sleep disturbances they cause. This small pilot study conducted in breast cancer survivors confirms our earlier research on healthy menopausal women that the stellate ganglion block can effectively 'shut off' these troubling symptoms. Since these symptoms are generally more severe in women who have undergone breast cancer treatment, the block is a significant arsenal in helping estrogen-depleted women feel better with few or no side effects," Lancet quoted Lipov, as saying.
For the study, the researchers excluded women on hormone replacement therapy and focussed on 13 study patients at different stages of breast cancer and who were between 30 to 70 years of age (mean age, 53 years).
Each patient used two standardized measures to record the severity and intensity of her hot flashes and the number of night awakenings for 1 week before the procedure and weekly for 12 weeks postprocedure. The number of hot flashes and night awakenings over time were then analysed by using a statistically-sound estimating equation
It was found that out of the 13 women, 5 had only 1 stellate ganglion block and 8 women had 2 blocks. Also, women having 2 blocks recorded more lasting relief of symptoms than after the first procedure.
During the first 2 weeks after the treatment, total number of hot flashes came down from a mean of 79.4 week before the procedure to a mean of 49.9 per week. After the initial 2 weeks, the total number of hot flashes continued to decline and stabilized at 8.1 per week from weeks 3 through 12.
A decrease in the severity of the hot flashes was also recorded, and the most dramatic drop-off in severity occurred within 1 day to 1 week after treatment. The rate of "very severe" flashes was nil during rest of the follow-up period.
Within 2 weeks after treatment, the total number of night awakenings decreased by about two-thirds, from 19.5 per week before the block to 7.3 per week afterwards. A similar decline in this number continued throughout the follow-up period and stabilized at 1.4 per week.
"Hot flashes are a frequent and serious side effect of pharmacological treatments for breast cancer. They may even contribute to cancer recurrence by discouraging compliance with treatment regimens, as 50% of these patients may become noncompliant after 6 months. Long-term relief of symptoms has the potential to improve overall quality of life and increase compliance with anti-estrogen medications for breast cancer," explained Joshi.
The study was published by The Lancet Oncology.