Research Article
No access
Published Online: 18 October 2010

Using Traditional Acupuncture for Breast Cancer-Related Hot Flashes and Night Sweats

Publication: The Journal of Alternative and Complementary Medicine
Volume 16, Issue Number 10

Abstract

Objectives: Women taking tamoxifen experience hot flashes and night sweats (HF&NS); acupuncture may offer a nonpharmaceutical method of management. This study explored whether traditional acupuncture (TA) could reduce HF&NS frequency, improve physical and emotional well-being, and improve perceptions of HF&NS.
Design/settings/location: This was a single-arm observational study using before and after measurements, located in a National Health Service cancer treatment center in southern England.
Subjects: Fifty (50) participants with early breast cancer completed eight TA treatments. Eligible women were ≥35 years old, ≥6 months post active cancer treatment, taking tamoxifen ≥6 months, and self-reporting ≥4 HF&NS incidents/24 hours for ≥3 months.
Interventions: Participants received weekly individualized TA treatment using a core standardized protocol for treating HF&NS in natural menopause.
Outcome measures: Hot Flash Diaries recorded HF&NS frequency over 14-day periods; the Women's Health Questionnaire (WHQ) assessed physical and emotional well-being; the Hot Flashes and Night Sweats Questionnaire (HFNSQ) assessed HF&NS as a problem. Measurements taken at five points over 30 weeks included baseline, midtreatment, end of treatment (EOT), and 4 and 18 weeks after EOT.
Results for the primary outcome: Mean frequency reduced by 49.8% (95% confidence interval 40.5–56.5, p < 0.0001, n = 48) at EOT over baseline. Trends indicated longer-term effects at 4 and 18 weeks after EOT. At EOT, seven WHQ domains showed significant statistical and clinical improvements, including Anxiety/Fears, Memory/Concentration, Menstrual Problems, Sexual Behavior, Sleep Problems, Somatic Symptoms, and Vasomotor Symptoms. Perceptions of HF&NS as a problem reduced by 2.2 points (standard deviation = 2.15, n = 48, t = 7.16, p < 0.0001).
Conclusions: These results compare favorably with other studies using acupuncture to manage HF&NS, as well as research on nonhormonal pharmaceutical treatments. In addition to reduced HF&NS frequency, women enjoyed improved physical and emotional well-being, and few side-effects were reported. Further research is warranted into this approach, which offers breast cancer survivors choice in managing a chronic condition.

Get full access to this article

View all available purchase options and get full access to this article.

References

1.
Early Breast Cancer Trialists' Collaborative Group. Effects of chemotherapy and hormonal therapy for early breast cancer on recurrence and 15-year survival. An overview of the randomised trialsLancet20053651687-1717. 1. Early Breast Cancer Trialists' Collaborative Group: Effects of chemotherapy and hormonal therapy for early breast cancer on recurrence and 15-year survival. An overview of the randomised trials. Lancet 2005;365:1687–1717.
2.
Langer AS. Talking with the breast cancer patient about tamoxifenJordan VCTamoxifen: A Guide for Clinicians and PatientsHuntington, NYPRR1996127-134. 2. Langer AS. Talking with the breast cancer patient about tamoxifen. In: Jordan VC, ed. Tamoxifen: A Guide for Clinicians and Patients. Huntington, NY: PRR, 1996:127–134.
3.
Love RRCameron LConnell BL et al. Symptoms associated with tamoxifen treatment in postmenopausal womenArch Intern Med19911511842-1847. 3. Love RR, Cameron L, Connell BL, et al. Symptoms associated with tamoxifen treatment in postmenopausal women. Arch Intern Med 1991;151:1842–1847.
4.
Hunter MGrunfeld EAMittal S et al. Menopausal symptoms in women with breast cancer: Prevalence and treatment preferencesPsychooncology200413769-778. 4. Hunter M, Grunfeld EA, Mittal S, et al. Menopausal symptoms in women with breast cancer: Prevalence and treatment preferences. Psychooncology 2004;13:769–778.
5.
Cancer Research UKCancerStats—Breast Cancer UKMay2009http://publications.cancerresearchuk.org/WebRoot/crukstoredb/CRUK_PDFs/CSBREA09.pdfJuly72009. 5. Cancer Research UK. CancerStats—Breast Cancer UK May 2009. Online document at: http://publications.cancerresearchuk.org/WebRoot/crukstoredb/CRUK_PDFs/CSBREA09.pdf Accessed July 7, 2009.
6.
Miller HGLi RM. Measuring hot flashes: Summary of a National Institutes of Health WorkshopMayo Clin Proc200479668-670. 6. Miller HG, Li RM. Measuring hot flashes: Summary of a National Institutes of Health Workshop. Mayo Clin Proc 2004;79:668–670.
7.
Kronenberg F. Hot flashes: Epidemiology and physiologyAnn N Y Acad Sci199059252-86. 7. Kronenberg F. Hot flashes: Epidemiology and physiology. Ann N Y Acad Sci 1990;592:52–86.
8.
Sturdee DW. The menopausal hot flush: Anything new?Maturitas20086042-49. 8. Sturdee DW. The menopausal hot flush: Anything new? Maturitas 2008;60:42–49.
9.
Hunter MLiao KL. A psychological analysis of menopausal hot flushesBr J Clin Psychol199534589-599. 9. Hunter M, Liao KL. A psychological analysis of menopausal hot flushes. Br J Clin Psychol 1995;34:589–599.
10.
Swartzman LCEdelberg RKemmann E. Impact of stress on objectively recorded menopausal hot flushes and on flush report biasHealth Psychol19909529-545. 10. Swartzman LC, Edelberg R, Kemmann E. Impact of stress on objectively recorded menopausal hot flushes and on flush report bias. Health Psychol 1990;9:529–545.
11.
National Institutes of Health State-of-the-Science Panel. National Institutes of Health State-of-the-Science Conference statement: Management of menopause-related symptomsAnn Intern Med200514212, pt 11003-1013. 11. National Institutes of Health State-of-the-Science Panel. National Institutes of Health State-of-the-Science Conference statement: Management of menopause-related symptoms. Ann Intern Med 2005;142(12, pt 1):1003–1013.
12.
Carpenter JSAndrykowski MAFreedman RR et al. Feasibility and psychometrics of an ambulatory hot flash monitoring deviceMenopause19996209-215. 12. Carpenter JS, Andrykowski MA, Freedman RR, et al. Feasibility and psychometrics of an ambulatory hot flash monitoring device. Menopause 1999;6:209–215.
13.
Carpenter JSJohnson DHWagner LJ et al. Hot flushes and related outcomes in breast cancer survivors and matched comparison womenOncol Nurs Forum20022916-25. 13. Carpenter JS, Johnson DH, Wagner LJ, et al. Hot flushes and related outcomes in breast cancer survivors and matched comparison women. Oncol Nurs Forum 2002;29:16–25.
14.
Love RRFeyzi JM. Reductions in vasomotor symptoms from tamoxifen over timeJ Natl Cancer Inst199385673-674. 14. Love RR, Feyzi JM. Reductions in vasomotor symptoms from tamoxifen over time. J Natl Cancer Inst 1993;85:673–674.
15.
Jordan VCTamoxifen: A Guide for Clinicians and PatientsHuntington, NYPRR1996. 15. Jordan VC, ed. Tamoxifen: A Guide for Clinicians and Patients. Huntington, NY: PRR, 1996.
16.
Fenlon DRCorner JHaviland JS. Menopausal hot flushes after breast cancerEur J Cancer Care (Engl)200918140-148. 16. Fenlon DR, Corner J, Haviland JS. Menopausal hot flushes after breast cancer. Eur J Cancer Care (Engl) 2009;18:140–148.
17.
Atkins LFallowfield L. Intentional and non-intentional non-adherence to medication amongst breast cancer patientsEur J Cancer2006422271-2276. 17. Atkins L, Fallowfield L. Intentional and non-intentional non-adherence to medication amongst breast cancer patients. Eur J Cancer 2006;42:2271–2276.
18.
MacLennan AHBroadbent JLLester S et al. Oral oestrogen and combined oestrogen/progestogen therapy versus placebo for hot flushes (Cochrane Review)Cochrane Database Syst Rev20044CD002978. 18. MacLennan AH, Broadbent JL, Lester S, et al. Oral oestrogen and combined oestrogen/progestogen therapy versus placebo for hot flushes (Cochrane Review). Cochrane Database Syst Rev 2004;4:CD002978.
19.
Hickey MDavis SRSturdee DW. Treatment of menopausal symptoms: What shall we do now?Lancet2005366409-421. 19. Hickey M, Davis SR, Sturdee DW. Treatment of menopausal symptoms: What shall we do now? Lancet 2005;366:409–421.
20.
Ringa V. Menopause and treatmentsQual Life Res200096a695-707. 20. Ringa V. Menopause and treatments. Qual Life Res 2000;9(6a):695–707.
21.
Holmberg LAnderson H. HABITS (hormonal replacement therapy after breast cancer—Is it safe?): A randomised comparison. Trial stoppedLancet2004363453-455. 21. Holmberg L, Anderson H. HABITS (hormonal replacement therapy after breast cancer—Is it safe?): A randomised comparison. Trial stopped. Lancet 2004;363:453–455.
22.
Biglia NCozzarella MCacciari F et al. Menopause after breast cancer: A survey on breast cancer survivorsMaturitas20034529-38. 22. Biglia N, Cozzarella M, Cacciari F, et al. Menopause after breast cancer: A survey on breast cancer survivors. Maturitas 2003;45:29–38.
23.
Hickey MSaunders CMStuckey BGA. Non-hormonal treatments for menopausal symptomsMaturitas20075785-89. 23. Hickey M, Saunders CM, Stuckey BGA. Non-hormonal treatments for menopausal symptoms. Maturitas 2007;57:85–89.
24.
Lyttleton J. Topics in gynaecology: Part one. MenopauseJ Chin Med1990335-9. 24. Lyttleton J. Topics in gynaecology: Part one. Menopause. J Chin Med 1990;33:5–9.
25.
Maciocia GObstetrics and Gynecology in Chinese MedicineEdinburghChurchill Livingstone1998. 25. Maciocia G. Obstetrics and Gynecology in Chinese Medicine. Edinburgh: Churchill Livingstone, 1998.
26.
Deadman PAl-Khafaji MBaker KA Manual of AcupunctureHove, UKJournal of Chinese Medicine Publications1998. 26. Deadman P, Al-Khafaji M, Baker K. A Manual of Acupuncture. Hove, UK: Journal of Chinese Medicine Publications, 1998.
27.
Gascoigne SThe Clinical Medicine Guide: A Holistic PerspectiveClonakility, IrelandJigme Press2001. 27. Gascoigne S. The Clinical Medicine Guide: A Holistic Perspective. Clonakility, Ireland: Jigme Press, 2001.
28.
Ross JAcupuncture Point Combinations: The Key to Clinical SuccessEdinburghChurchill Livingstone1995. 28. Ross J. Acupuncture Point Combinations: The Key to Clinical Success. Edinburgh: Churchill Livingstone, 1995.
29.
Wyon YLindgren RHammar M et al. Acupuncture against climacteric disorders? Lower number of symptoms after menopause [in Swedish with English abstract]Lakartidningen1994912318-2322. 29. Wyon Y, Lindgren R, Hammar M, et al. Acupuncture against climacteric disorders? Lower number of symptoms after menopause [in Swedish with English abstract]. Lakartidningen 1994;91:2318–2322.
30.
Wyon YWijma KNedstrand E et al. A comparison of acupuncture and estradiol treatment of vasomotor symptoms in postmenopausal womenClimacteric20047153-164. 30. Wyon Y, Wijma K, Nedstrand E, et al. A comparison of acupuncture and estradiol treatment of vasomotor symptoms in postmenopausal women. Climacteric 2004;7:153–164.
31.
Cohen SMRousseau MECarey B. Can acupuncture ease the symptoms of menopause?Holist Nurs Pract200317295-299. 31. Cohen SM, Rousseau ME, Carey B. Can acupuncture ease the symptoms of menopause? Holist Nurs Pract 2003;17:295–299.
32.
Dong HLudicke FComte I et al. An exploratory pilot study of acupuncture on the quality of life and reproductive hormone secretion in menopausal womenJ Altern Complement Med20017651-658. 32. Dong H, Ludicke F, Comte I, et al. An exploratory pilot study of acupuncture on the quality of life and reproductive hormone secretion in menopausal women. J Altern Complement Med 2001;7:651–658.
33.
Grilli MLamma AMacchiagodena C et al. Therapeutic use of acupuncture in the menopause: Experiences of the hospital of Ravenne and of Bologne [in French]Rev Française Méd Trad Chin198913365-66. 33. Grilli M, Lamma A, Macchiagodena C, et al. Therapeutic use of acupuncture in the menopause: Experiences of the hospital of Ravenne and of Bologne [in French]. Rev Française Méd Trad Chin 1989;133:65–66.
34.
Di Conchetto G. Diagnostic and therapeutic guidance for Chinese medicine in climacteric syndrome [in French]Rev Française Méd Trad Chin198913355-56. 34. Di Conchetto G. Diagnostic and therapeutic guidance for Chinese medicine in climacteric syndrome [in French]. Rev Française Méd Trad Chin 1989;133:55–56.
35.
Tukmachi E. Treatment of hot flushes in breast cancer patients with acupunctureAcupunct Med20001822-27. 35. Tukmachi E. Treatment of hot flushes in breast cancer patients with acupuncture. Acupunct Med 2000;18:22–27.
36.
Tukmachi E. Treatment by acupuncture and dietary modification: Hot flushes in breast cancer patientsJ Chin Med20006422-31. 36. Tukmachi E. Treatment by acupuncture and dietary modification: Hot flushes in breast cancer patients. J Chin Med 2000;64:22–31.
37.
Cumins SMBrunt AM. Does acupuncture influence the vasomotor symptoms experienced by breast cancer patients taking tamoxifen?Acupunct Med20001828. 37. Cumins SM, Brunt AM. Does acupuncture influence the vasomotor symptoms experienced by breast cancer patients taking tamoxifen? Acupunct Med 2000;18:28.
38.
Towlerton GFilshie JO'Brien M et al. Acupuncture in the control of vasomotor symptoms caused by tamoxifenPalliat Med199913445. 38. Towlerton G, Filshie J, O'Brien M, et al. Acupuncture in the control of vasomotor symptoms caused by tamoxifen. Palliat Med 1999;13:445.
39.
Alfhaily FEwies AA. Acupuncture in managing menopausal symptoms: Hope or mirage?Climacteric200710371-380. 39. Alfhaily F, Ewies AA. Acupuncture in managing menopausal symptoms: Hope or mirage? Climacteric 2007;10:371–380.
40.
Smith JRichardson JFilshie J et al.Acupuncture for Hot Flushes as a Result of Cancer Treatment: A systematic reviewhttp://rccm.org.uk/cameol/Default.aspxOctober182005. 40. Smith J, Richardson J, Filshie J, et al. Acupuncture for Hot Flushes as a Result of Cancer Treatment: A systematic review. Online document at: http://rccm.org.uk/cameol/Default.aspx Accessed October 18, 2005.
41.
Porzio GTrapasso TMartelli S et al. Acupuncture in the treatment of menopause-related symptoms in women taking tamoxifenSupport Care Cancer200210128-130. 41. Porzio G, Trapasso T, Martelli S, et al. Acupuncture in the treatment of menopause-related symptoms in women taking tamoxifen. Support Care Cancer 2002;10:128–130.
42.
Filshie JBolton TBrowne D et al. Acupuncture and self-acupuncture for long-term treatment of vasomotor symptoms in cancer patients: Audit and treatment algorithmAcupunct Med200523171-180. 42. Filshie J, Bolton T, Browne D, et al. Acupuncture and self-acupuncture for long-term treatment of vasomotor symptoms in cancer patients: Audit and treatment algorithm. Acupunct Med 2005;23:171–180.
43.
Nedstrand EWijma KWyon Y et al. Vasomotor symptoms decrease in women with breast cancer randomized to treatment with applied relaxation or electro-acupuncture: A preliminary studyClimacteric20058243-250. 43. Nedstrand E, Wijma K, Wyon Y, et al. Vasomotor symptoms decrease in women with breast cancer randomized to treatment with applied relaxation or electro-acupuncture: A preliminary study. Climacteric 2005;8:243–250.
44.
Deng GVickers AYeung KS et al. Randomized, controlled trial of acupuncture for the treatment of hot flashes in breast cancer patientsJ Clin Oncol2007255584-5590. 44. Deng G, Vickers A, Yeung KS, et al. Randomized, controlled trial of acupuncture for the treatment of hot flashes in breast cancer patients. J Clin Oncol 2007;25:5584–5590.
45.
Frisk JCarlhäll SKällström A-C et al. Long-term follow-up of acupuncture and hormone therapy on hot flushes in women with breast cancer: A prospective, randomized, controlled multicentre trialClimacteric200811166-174. 45. Frisk J, Carlhäll S, Källström A-C, et al. Long-term follow-up of acupuncture and hormone therapy on hot flushes in women with breast cancer: A prospective, randomized, controlled multicentre trial. Climacteric 2008;11:166–174.
46.
Hervik JMjåland P. Acupuncture for the treatment of hot flashes in breast cancer patients, a randomized, controlled trialBreast Cancer Res Treat2009116311-316. 46. Hervik J, Mjåland P. Acupuncture for the treatment of hot flashes in breast cancer patients, a randomized, controlled trial. Breast Cancer Res Treat 2009;116:311–316.
47.
Medical Research Council. A Framework for Development and Evaluation of RCTs for Complex Interventions to Improve HealthLondonMRC Health Services and Public Health Research Board2000. 47. Medical Research Council. A Framework for Development and Evaluation of RCTs for Complex Interventions to Improve Health. London: MRC Health Services and Public Health Research Board, 2000.
48.
Campbell NCMurray EDarbyshire J et al. Designing and evaluating complex interventions to improve health careBMJ2007334455-459. 48. Campbell NC, Murray E, Darbyshire J, et al. Designing and evaluating complex interventions to improve health care. BMJ 2007;334:455–459.
49.
Carpenter JS. Comparison of objective measures to self-reported data in ambulatory studiesAssessing and Improving Measures of Hot FlashesBethesda, MDNational Institutes of Health2004. 49. Carpenter JS. Comparison of objective measures to self-reported data in ambulatory studies. In: Assessing and Improving Measures of Hot Flashes. Bethesda, MD: National Institutes of Health, 2004.
50.
Webster J. Promising sensor technologiesAssessing and Improving Measures of Hot FlashesBethesda, MDNational Institutes of Health2004. 50. Webster J. Promising sensor technologies. In: Assessing and Improving Measures of Hot Flashes. Bethesda, MD: National Institutes of Health, 2004.
51.
Stone AAShiffman SSchwartz JE et al. Patient non-compliance with paper diariesBMJ20023241193-1194. 51. Stone AA, Shiffman S, Schwartz JE, et al. Patient non-compliance with paper diaries. BMJ 2002;324:1193–1194.
52.
Sloan JALoprinzi CLNovotny PJ et al. Methodological lessons learned from hot flash studiesJ Clin Oncol2001194280-4290. 52. Sloan JA, Loprinzi CL, Novotny PJ, et al. Methodological lessons learned from hot flash studies. J Clin Oncol 2001;19:4280–4290.
53.
Hunter M. The Women's Health Questionnaire: A measure of mid-aged women's perceptions of their emotional and physical healthPsychol Health1992745-54. 53. Hunter M. The Women's Health Questionnaire: A measure of mid-aged women's perceptions of their emotional and physical health. Psychol Health 1992;7:45–54.
54.
Hunter M. The Women's Health Questionnaire (WHQ): Frequently asked questions (FAQ)Health Qual Life Outcomes2003141. 54. Hunter M. The Women's Health Questionnaire (WHQ): Frequently asked questions (FAQ). Health Qual Life Outcomes 2003;1:41.
55.
Girod IAbetz Lde la Loge C et al.WHQ Women's Health Questionnaire User ManualLyonMAPI Research Institute2004. 55. Girod I, Abetz L, de la Loge C, et al. WHQ Women's Health Questionnaire User Manual. Lyon: MAPI Research Institute, 2004.
56.
Mole P. What is Five Element Constitutional Acupuncture? And how can it be integrated into the practice of TCM?J Chin Med20078526-30. 56. Mole P. What is Five Element Constitutional Acupuncture? And how can it be integrated into the practice of TCM? J Chin Med 2007;85:26–30.
57.
Worsely JR. Traditional Acupuncture: Volume IITraditional DiagnosisRoyal Leamington SpaThe College of Traditional Acupuncture1990. 57. Worsely JR. Traditional Acupuncture: Volume II. Traditional Diagnosis. Royal Leamington Spa: The College of Traditional Acupuncture, 1990.
58.
Maciocia GThe Foundations of Chinese Medicine: A Comprehensive Text for Acupuncturists and HerbalistsEdinburghChurchill Livingstone1989. 58. Maciocia G. The Foundations of Chinese Medicine: A Comprehensive Text for Acupuncturists and Herbalists. Edinburgh: Churchill Livingstone, 1989.
59.
Hicks AHicks JMole PFive Element Constitutional AcupunctureEdinburghChurchill Livingstone2004. 59. Hicks A, Hicks J, Mole P. Five Element Constitutional Acupuncture. Edinburgh: Churchill Livingstone, 2004.
60.
Fairclough DL. Analysing studies with missing dataFayers PHays RAssessing Quality of Life in Clinical TrialsOxfordOxford University Press2005179-194. 60. Fairclough DL. Analysing studies with missing data. In: Fayers P, Hays R, eds. Assessing Quality of Life in Clinical Trials. Oxford: Oxford University Press, 2005:179–194.
61.
Bland MAn Introduction to Medical Statistics2ndOxfordOxford University Press1995. 61. Bland M. An Introduction to Medical Statistics. 2nd ed. Oxford: Oxford University Press, 1995.
62.
Armitage PBerry GMatthews JNSStatistical Methods in Medical Research4thOxfordBlackwell Science2002. 62. Armitage P, Berry G, Matthews JNS. Statistical Methods in Medical Research. 4th ed. Oxford: Blackwell Science, 2002.
63.
Walker Gde Valois BYoung T et al. The experience of receiving traditional Chinese acupunctureEJOM2004459-65. 63. Walker G, de Valois B, Young T, et al. The experience of receiving traditional Chinese acupuncture. EJOM 2004;4:59–65.
64.
MacPherson HThomas KJWalters S et al. The York acupuncture safety study: Prospective survey of 34 000 treatments by traditional acupuncturistsBMJ20013234876-4877. 64. MacPherson H, Thomas KJ, Walters S, et al. The York acupuncture safety study: Prospective survey of 34 000 treatments by traditional acupuncturists. BMJ 2001;323:4876–4877.
65.
de Valois B. Turning points: Clearing blocks to treatment in women with early breast cancerEJOM2008510-15. 65. de Valois B. Turning points: Clearing blocks to treatment in women with early breast cancer. EJOM 2008;5:10–15.
66.
Zell BHirata JAlon M et al. Diagnosis of symptomatic postmenopausal women by traditional Chinese medicine practitionersMenopause20007129-134. 66. Zell B, Hirata J, Alon M, et al. Diagnosis of symptomatic postmenopausal women by traditional Chinese medicine practitioners. Menopause 2000;7:129–134.
67.
Park J-ELee MSJung S et al. Moxibustion for treating menopausal hot flashes: A randomized clinical trialMenopause200916660-665. 67. Park J-E, Lee MS, Jung S, et al. Moxibustion for treating menopausal hot flashes: A randomized clinical trial. Menopause 2009;16:660–665.
68.
Paterson CBritten N. Acupuncture for people with chronic illness: Combining qualitative and quantitative outcome assessmentJ Altern Complement Med20039671-681. 68. Paterson C, Britten N. Acupuncture for people with chronic illness: Combining qualitative and quantitative outcome assessment. J Altern Complement Med 2003;9:671–681.
69.
Gould AMacpherson H. Patient perspectives on outcomes after treatment with acupunctureJ Altern Complement Med20017261-268. 69. Gould A, Macpherson H. Patient perspectives on outcomes after treatment with acupuncture. J Altern Complement Med 2001;7:261–268.
70.
Cassidy C. Chinese Medicine users in the United States: Part II. Preferred aspects of careJ Altern Complement Med19984189-202. 70. Cassidy C. Chinese Medicine users in the United States: Part II. Preferred aspects of care. J Altern Complement Med 1998;4:189–202.
71.
Walker Gde Valois BDavies R et al. Opinions of research participants about study paperworkBull Med Ethics200520521-24. 71. Walker G, de Valois B, Davies R, et al. Opinions of research participants about study paperwork. Bull Med Ethics 2005;205:21–24.
72.
Birch S. A review and analysis of placebo treatments, placebo effects, and placebo controls in trials of medial procedures when sham is not inertJ Altern Complement Med200612303-310. 72. Birch S. A review and analysis of placebo treatments, placebo effects, and placebo controls in trials of medial procedures when sham is not inert. J Altern Complement Med 2006;12:303–310.
73.
Kaptchuk TJKelley JMConboy LA et al. Components of placebo effect: Randomised controlled trial in patients with irritable bowel syndromeBMJ2008336999-1003. 73. Kaptchuk TJ, Kelley JM, Conboy LA, et al. Components of placebo effect: Randomised controlled trial in patients with irritable bowel syndrome. BMJ 2008;336:999–1003.
74.
Dincer FLinde K. Sham interventions in randomized clinical trials of acupuncture: A reviewComplement Ther Med200311235-242. 74. Dincer F, Linde K. Sham interventions in randomized clinical trials of acupuncture: A review. Complement Ther Med 2003;11:235–242.
75.
White PLinde KSchnyer RN. Investigating the components of acupuncture treatmentMacPherson HHammerschlag RLewith G et al.Acupuncture Research: Strategies for Establishing an Evidence BaseLondonChurchill Livingstone2008. 75. White P, Linde K, Schnyer RN. Investigating the components of acupuncture treatment. In: MacPherson H, Hammerschlag R, Lewith G, et al., eds. Acupuncture Research: Strategies for Establishing an Evidence Base. London: Churchill Livingstone, 2008.
76.
MacPherson HPeters DZollman C. Closing the evidence gap in integrative medicineBMJ2009339763-764. 76. MacPherson H, Peters D, Zollman C. Closing the evidence gap in integrative medicine. BMJ 2009;339:763–764.
77.
Barry C. The role of evidence in alternative medicine: Contrasting biomedical and anthropological approachesSoc Sci Med2006622646-2657. 77. Barry C. The role of evidence in alternative medicine: Contrasting biomedical and anthropological approaches. Soc Sci Med 2006;62:2646–2657.
78.
Paterson CDieppe P. Characteristic and incidental (placebo) effects in complex interventions such as acupunctureBMJ20053301202-1205. 78. Paterson C, Dieppe P. Characteristic and incidental (placebo) effects in complex interventions such as acupuncture. BMJ 2005;330:1202–1205.
79.
Alraek TBorud EGrimsgaard S et al. Menopause: What's new?Maturitas200860257. 79. Alraek T, Borud E, Grimsgaard S, et al. Menopause: What's new? Maturitas 2008;60:257.
80.
MacPherson H. Pragmatic clinical trialsComplement Ther Med200412136-140. 80. MacPherson H. Pragmatic clinical trials. Complement Ther Med 2004;12:136–140.
81.
Lee MSKim K-HChoi S-M et al. Acupuncture for treating hot flashes in breast cancer patients: A systematic reviewBreast Cancer Res Treat2009115497-503. 81. Lee MS, Kim K-H, Choi S-M, et al. Acupuncture for treating hot flashes in breast cancer patients: A systematic review. Breast Cancer Res Treat 2009;115:497–503.
82.
Kaptchuk TJChinese Medicine: The Web That Has No WeaverLondonRider2000. 82. Kaptchuk TJ. Chinese Medicine: The Web That Has No Weaver. London: Rider, 2000.
83.
Avis NEPian-Smith MCM. Acupuncture for hot flashesMenopause20071410-13. 83. Avis NE, Pian-Smith MCM. Acupuncture for hot flashes. Menopause 2007;14:10–13.
84.
Loprinzi CLKugler JWSloan JA et al. Venlafaxine in the management of hot flashes in survivors of breast cancer: A randomized controlled trialLancet20003562059-2063. 84. Loprinzi CL, Kugler JW, Sloan JA, et al. Venlafaxine in the management of hot flashes in survivors of breast cancer: A randomized controlled trial. Lancet 2000;356:2059–2063.
85.
Stearns VBeebe KLIyengar M et al. Paroxetine controlled release in the treatment of menopausal hot flashes: A randomized controlled trialJAMA20032892827-2834. 85. Stearns V, Beebe KL, Iyengar M, et al. Paroxetine controlled release in the treatment of menopausal hot flashes: A randomized controlled trial. JAMA 2003;289:2827–2834.
86.
Loprinzi CLSloan JAPerez EA. Phase III evaluation of fluoxetine for treatment of hot flashesJ Clin Oncol2002201578-1583. 86. Loprinzi CL, Sloan JA, Perez EA. Phase III evaluation of fluoxetine for treatment of hot flashes. J Clin Oncol 2002;20:1578–1583.
87.
Hickey MSaunders CMStuckey BGA. Management of menopausal symptoms in patients with breast cancer: An evidence-based approachLancet Oncol20056687-695. 87. Hickey M, Saunders CM, Stuckey BGA. Management of menopausal symptoms in patients with breast cancer: An evidence-based approach. Lancet Oncol 2005;6:687–695.
88.
Pandya KJRaubertas RFFlynn PJ et al. Oral clonidine in postmenopausal patients with breast cancer experiencing tamoxifen-induced hot flashes: A University of Rochester Cancer Center Community Clinical Oncology Program studyAnn Intern Med2000132788-793. 88. Pandya KJ, Raubertas RF, Flynn PJ, et al. Oral clonidine in postmenopausal patients with breast cancer experiencing tamoxifen-induced hot flashes: A University of Rochester Cancer Center Community Clinical Oncology Program study. Ann Intern Med 2000;132:788–793.
89.
Goldberg RMLoprinzi CLO'Fallon JR et al. Transdermal clonidine for ameliorating tamoxifen-induced hot flashesJ Clin Oncol199412155-158. 89. Goldberg RM, Loprinzi CL, O'Fallon JR, et al. Transdermal clonidine for ameliorating tamoxifen-induced hot flashes. J Clin Oncol 1994;12:155–158.

Information & Authors

Information

Published In

cover image The Journal of Alternative and Complementary Medicine
The Journal of Alternative and Complementary Medicine
Volume 16Issue Number 10October 2010
Pages: 1047 - 1057
PubMed: 20954961

History

Published online: 18 October 2010
Published in print: October 2010

Permissions

Request permissions for this article.

Topics

Authors

Affiliations

Beverley A. de Valois
Supportive Oncology Research Team (SORT), Lynda Jackson Macmillan Centre (LJMC), Mount Vernon Hospital, Middlesex, United Kingdom.
Teresa E. Young
Supportive Oncology Research Team (SORT), Lynda Jackson Macmillan Centre (LJMC), Mount Vernon Hospital, Middlesex, United Kingdom.
Nicola Robinson
Centre for Complementary Healthcare and Integrated Medicine, Thames Valley University (TVU), Middlesex, United Kingdom.
Christine McCourt
Faculty of Health & Human Sciences, Thames Valley University (TVU), Middlesex, United Kingdom.
Elizabeth J. Maher
Supportive Oncology Research Team (SORT), Lynda Jackson Macmillan Centre (LJMC), Mount Vernon Hospital, Middlesex, United Kingdom.

Notes

Address correspondence to:Beverley A. de Valois, PhDSupportive Oncology Research TeamLynda Jackson Macmillan CentreMount Vernon HospitalRickmansworth RoadNorthwood, Middlesex HA6 2RNUnited Kingdom
E-mail: [email protected]

Disclosure Statement

No competing financial interests exist.

Metrics & Citations

Metrics

Citations

Export citation

Select the format you want to export the citations of this publication.

View Options

Access content

To read the fulltext, please use one of the options below to sign in or purchase access.

Society Access

If you are a member of a society that has access to this content please log in via your society website and then return to this publication.

Restore your content access

Enter your email address to restore your content access:

Note: This functionality works only for purchases done as a guest. If you already have an account, log in to access the content to which you are entitled.

View options

PDF/EPUB

View PDF/EPUB

Full Text

View Full Text

Figures

Tables

Media

Share

Share

Copy the content Link

Share on social media

Back to Top