Cancer Survivors Suffer Worse Hot Flashes Than Other Menopausal Women, But Report Better Social And Mental Wellbeing

doctor and patient
Cancer survivors are twice as likely to experience severe menopause but their sexual activity and symptoms are about the same as women who do not have a history of the disease. National Cancer Institute

According to a study conducted by researchers at King Edward Memorial Hospital in Western Australia, cancer survivors report more frequent, severe, and troubling hot flashes than other women with menopausal symptoms. Yet, there is a silver lining: those women who have survived cancer fare better psychologically and report a better quality of life than the women without cancer. Another surprise: both the survivors and women without cancer have about the same levels of sexual activity and function.

"Both expected and surprising, these results highlight that all menopausal women, including cancer survivors, need effective treatment options for their hot flashes and sexual symptoms," said Dr. Margery Gass, North American Menopause Society Executive Director.

After treatment for cancer, menopausal symptoms are common, but poorly understood. For this reason, the researchers set out to determine how frequently women experience hot flashes and night sweats.

Research and Results

Within the general menopause service for a large women's hospital, the Menopause Symptoms After Cancer Clinic provides menopause advice and management services for women with a history of cancer. Using various assessment tests and questionnaires, the researchers recorded the menopausal symptoms as well as sexual activity and symptoms among a group of volunteer participants.

The 934 cancer survivors and 155 noncancer participants did not significantly differ by age at menopause (46 years old) or age at first clinic visit (51 years old). Yet the cancer survivors reported themselves more severely troubled by vasomotor symptoms (hot flushes and night sweats) than the women without a history of cancer. Seventy-six percent reported having hot flashes in the past 24 hours, compared with 54 percent of women without cancer. And 60 percent reported those hot flashes were severe or very severe, compared with 40 percent of the women without cancer.

The authors pointed out that menopausal symptoms also seem to persist much longer in the cancer survivors, who often complained of menopausal symptoms many years after their cancer diagnosis.

Psychological Strength

Despite the greater severity of their symptoms, the cancer survivors reported better quality of life than the women without cancer. In fact, the cancer survivors were less likely to have severe mood swings or sadness and were generally less troubled by psychological and physical symptoms. In fact, they reported significantly better social and family well-being, which, the authors of the study suggest, may be the result of the enhanced social and psychological support available for cancer survivors.

The cancer survivors had about the same levels of sexual activity and function, with just about as many who reported severe vaginal dryness (49 percent) as women without cancer (47 percent). However, the survivors were more likely than the women without a history of cancer to attribute their sexual inactivity to "a physical problem that makes sexual relations difficult or uncomfortable."

There are about 37.5 million women reaching or currently at menopause (ages 40 to 59), according to U.S. Census data from 2000. Doctors define menopause, which is the permanent end of menstruation and fertility, as occurring 12 months after a woman's last menstrual period. Although it most commonly occurs when a woman is in her 40s or 50s, the average age is 51 in the U.S.

Cancer Stats

A cancer survivor, according to the Centers for Disease Control and Prevention, is a person who has been diagnosed with cancer, from the time of diagnosis to the end of his or her life. Cancer survivors largely consist of people who are 65 years of age or older and women. Of the 11.7 million people living with cancer in 2007, 6.3 million were women, and the largest group of cancer survivors were breast cancer survivors (22 percent).

The three most common cancers among American women are breast cancer, which ranks as the most common cancer for all races of women as well as Hispanic origin populations, lung cancer, and colorectal cancer. Lung cancer is the second most common cancer among white, black, and American Indian/Alaska Native women, and third among Asian/Pacific Islander and Hispanic women. Colorectal cancer is the second most common cancer among Asian/Pacific Islander and Hispanic women, and third among white, black, and American Indian/Alaska Native women.

In Australia where this study was conducted, more than 151,000 (around one in 25) women are cancer survivors and one third of these are breast cancer survivors.

 

Source: Marino JL, Saunders CM, Emery LI, Green H, Doherty DA, Hickey M. Nature and severity of menopausal symptoms and their impact on quality of life and sexual function in cancer survivors compared with women without a cancer history. Menopause. 2013.

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