Black cohosh for hot flashes in breast cancer survivors

Black cohosh for hot flashes in breast cancer survivors – Women’s Health Update

Tori Hudson

Eighty-five patients who had completed their primary treatment for breast cancer were randomly assigned to black cohosh extract or placebo. Fifty-nine were on tamoxifen and 26 not on tamoxifen. Patients were asked to take one 20 mg tablet twice daily with meals for 8 weeks. They were also asked to record the number and intensity of hot flashes and score as mild, moderate or severe for 3 days before starting to take any study pills and then again on days 27-30 and days 57-60. At the beginning and end of the study, subjects completed a detailed menopausal symptom index and a scale rating overall health and well-being.

Upon analysis of the results, both the treatment group and the placebo group experienced a benefit in terms of reduced number and intensity of hot flashes. Both the treatment and placebo groups, whether using tamoxifen or not, had a reduction in intensity and frequency, that was similar. Of the menopausal symptoms assessed, only sweating was different between treatment and placebo groups at the end of the study.

Comment: For breast cancer survivors, this data provide little evidence of benefit from using black cohosh to control hot flashes, although a reduction in sweating may be important to some individuals. Previous non-controlled observational studies have demonstrated that black cohosh completely ameliorates hot flashes in 50% of women and another 30-35% receive some degree of relief. Other nutritional/herbal treatments for breast cancer patients suffering from hot flashes include bioflavonoids with vitamin C, vitamin E, red clover, acupuncture, herbal combination products – wild yam, dong quai, burdock root, motherwort, licorice root, chaste tree. Conventional options include megesterol acetate, venlafaxine and clonidine.

Jacobson J, Troxed A, Evans J, et al. Randomized trial of block cohosh for the treatment of hot flashes among women with a history of breast cancer. J Clinical Oncology 2001;19(10):2739-2745.

COPYRIGHT 2002 The Townsend Letter Group

COPYRIGHT 2002 Gale Group