Breathing Exercises Studied to Ease Hot Flashes in Breast Cancer

Division of Cancer Control and Population Sciences

Hot flashes associated with treatment-induced menopause in breast cancer survivors can cause stress, sleep disturbances, and otherwise negatively affect the quality of life for many women. The current medications and hormone therapies used to alleviate this bothersome condition are often not particularly effective or may not be a medical option for some survivors. This has led to an increase in research for nonpharmacological interventions for hot flashes.

Slow, deep breathing has previously been recommended as a first-line treatment for hot flashes by the North American Menopause Society. However, the recommendation was based on two, small clinical studies in healthy women. “We thought we should repeat the studies on a larger scale, looking at a similar intervention in the breast cancer survivor community rather than just in menopausal women,” noted Janet S. Carpenter, Ph.D., R.N., professor of adult health at Indiana University School of Nursing.

Under a grant from NCI*, Dr. Carpenter is conducting a randomized, controlled clinical study to evaluate a simple CD-ROM/DVD-based at-home training and practice program for a breathing intervention to relieve hot flashes. The study is enrolling 91 breast cancer survivors and 91 healthy women who are randomly assigned to one of the three study arms: 1) breathing program 1 (40% of enrollees); 2) breathing program 2 (40%); or 3) a non-treatment group (20%).

The previous clinical studies showed that if women practiced the technique for 15 minutes, twice-a-day and also applied the technique at the time of a hot flash, the frequency and severity of hot flashes decreased. “This effect may be due to the technique’s impact on balancing the parasympathetic and sympathetic nervous systems. We may apply for a supplement to our grant in order to determine how the intervention might be working,” Dr. Carpenter said.

All of the women in the study are assessed when they enroll in the study and at 8-and 16 weeks after the intervention ended. For a subset of women, a portable respiratory monitor will help evaluate if they are correctly applying the breathing technique. The women will also wear a small device that will serve as an electronic “diary” in which they will record the frequency and severity of hot flashes they have during the study period.

“My early research shows that hot flashes result in negative mood, interference with daily life, and sleep disturbances,” Dr. Carpenter noted. “So we’re also measuring all of those outcomes in this study. What we’re hoping to do is get to a point where we’ve tested a series of interventions, so we can actually direct women to the best interventions for their cluster of symptoms.”