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The effect of acupuncture on Health Related Quality of Life and sleep
Linköping University, Department of Clinical and Experimental Medicine, Obstetrics and gynecology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre for Surgery, Orthopaedics and Cancer Treatment, Department of Surgery in Östergötland.
Linköping University, Department of Clinical and Experimental Medicine, Surgery. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre for Surgery, Orthopaedics and Cancer Treatment, Department of Urology in Östergötland.
Östergötlands Läns Landsting, Centre for Surgery, Orthopaedics and Cancer Treatment, Department of Urology in Östergötland.
Linköping University, Department of Clinical and Experimental Medicine, Obstetrics and gynecology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Department of Gynecology and Obstetrics in Linköping.
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(English)Manuscript (preprint) (Other academic)
Abstract [en]

Hot flushes are well-known, disturbing side effects of Androgen  Deprivation Therapy (ADT) in men with advanced prostate cancer, and the hot flushes negatively affect HRQoL and sleep. Acupuncture has been shown effective and without side effects, as treatment for hot flushes in men with (ADT). The effect on flushes lasts up to nine months after treatment has ended, but little is known about its effect on HRQoL and sleep. This study adds knowledge about the association between hot flushes, HRQoL and sleep. It shows that the number of hot flushes /night decrease significantly for up to 12 months. It concludes however, that there are many other factors that affect the patients general HRQoL, and perhaps that is one reason why we cannot show an improvement in general HRQoL.

Objective:

  • To evaluate the effect of electro-acupuncture (EA) and traditional acupuncture (TA)on HRQoL and sleep in men with castrationally treated prostate cancer and hotflushes.

Patients:

  • thirty-one men were randomized to traditional acupuncture (TA; n=16) or electrostimulated acupuncture (EA;n=15) for 12 weeks, with a study period of 12 months.

Methods:

  • TA or EA was given for 30 minutes, twice a week for two weeks, and then once a week for 10 weeks. The patients were seen at the outpatient clinic before treatment, after 12 weeks of treatment, and at 6, 9, and 12 months follow up.
  • Log books , where the patients recorded number of and distress by hot flushes, tiredness, depressed mood, number of hours slept/night , and times woken up/night, were filled in before treatment, daily during the 12 weeks of treatment, and then one week before the 6, 9, and 12 months follow up visit.
  • Psychological and General Well-Being Index (PGWB) measured HRQoL at baseline, 12 weeks of treatment, and 6, 9 and 12 months follow up.
  • A six week waiting list with eight patients served as a control for changes in log-bookdata

Results:

  • The number of hot flushes/night decreased significantly in both groups at all measuring points, except at nine months in the TA group.
  • No changes in hot flushes and times woken up/night during a six weeks pretreatment waiting list in eight patients, but significant changes in these patients after four weeks of treatment.
  • HRQoL, measured by log-book data and PGWB did neither improve nor deteriorate over 12 months. (A clinically significant change in PGWB was seen in 8/29 patients after 12 weeks of treatment, and a deterioration in 11/29).
  • The patients reported no change in hours slept/night, and times woken up/night decreased significantly only in the EA group after 12 weeks of treatment.
  • There is a strong association between numbers of hot flushes, sleep and HRQoL.

Conclusion:

  • HF are associated with HRQoL and sleep, and EA/TA decrease hot flush numbers and distress, and thereby possibly increase sleep quality. This may sustain HRQoL.
  • HRQoL neither improved nor deteriorated during 12 months follow up, which may in this patient group, be explained by other factors, probably related to the advanced PCa, that have negative impact on HRQoL.
  • EA/TA merits further evaluation regarding the effects on HRQoL with a rigid measure of signs of disease progression, and also using a prostate cancer or hormone deprivation specific HRQoL questionnaire.
Keyword [en]
Hot flushes, Prostate cancer, acupuncture, HRQoL, sleep
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:liu:diva-68805OAI: oai:DiVA.org:liu-68805DiVA: diva2:421118
Available from: 2011-06-07 Created: 2011-06-07 Last updated: 2011-08-30Bibliographically approved
In thesis
1. Acupuncture treatment for hot flushes in women with breast cancer and men with prostate cancer
Open this publication in new window or tab >>Acupuncture treatment for hot flushes in women with breast cancer and men with prostate cancer
2011 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Background: The group of women and men with a history of cancer and distressing hot flushes and sweating is growing. The flushes negatively affect Health Related Quality of Life (HRQoL), perhaps partially by disturbing sleep. Treatments that are effective, tolerable and safe need to be developed. There are a number of treatment alternatives that are often not very effective or associated with more or less serious side-effects. Based on theories on the mechanisms behind hot flushes and acupuncture, treatment with acupuncture has been tried in menopausal women with hot flushes and in a few studies in women with breast cancer (BCa).

Aim: The general aim of the research leading to this thesis was to evaluate the effect of acupuncture on hot flushes, HRQoL and sleep in men with prostate cancer (PCa) and women with BCa. To evaluate the effect in women with BCa of 12 weeks of electrostimulated acupuncture (EA) and two years of hormone therapy (HT) on number of, and distress caused by, hot flushes, and on HRQoL and sleep. To evaluate whether acupuncture therapy could be used to treat hot flushes in men with PCa treated with castration therapy, and then to evaluate in men with PCa and hot flushes the effect of 12 weeks of traditional acupuncture (TA) or EA on number of, and distress caused by, hot flushes and on urinary excretion of CGRP, HRQoL and sleep.

Subjects and methods: Forty-five women with a history of BCa were randomized to oral HT for two years or EA for 12 weeks and were followed up till two years after start of therapy. Thirty-eight men with PCa and hot flushes were treated with acupuncture. Seven men were treated with EA for 10 to 12 weeks in a pilot study. After positive results from this study 31 men were randomized between EA and TA for 12 weeks and followed up till nine months after end of treatment. Hot flushes, HRQoL and sleep were monitored by means of log books and validated questionnaires.

Results: The pilot study showed that 10 to 12 weeks of EA in men with PCa reduced number of hot flushes to below 50% of baseline with persistent effects at a follow up three months later. The two randomized studies showed that treatment with acupuncture in women with a history of BCa, and men with PCa was associated with a decrease in both the number of and distress caused by hot flushes by at least 50%. HT almost eliminated the hot flushes. There was no difference in reduction of hot flushes between men receiving EA or TA. Reduction of the number of hot flushes and distress caused by hot flushes probably leads to decreased disturbances at night, and was associated in women with a significant improvement in HRQoL and sleep variables. The improvement in HRQoL was as great in women treated with EA as in women receiving HT although the latter group had a more substantial reduction in number of flushes than the EA group suggesting that EA might have other effects in addition to those on hot flushes. In the men HRQoL did not change significantly. We saw very few and non-serious side-effects in the acupuncture groups and no signs that acupuncture activated the cancer or ovarian/testicular function.

Conclusions: Acupuncture reduced the number of hot flushes and distress caused by hot flushes with at least 50% in women and men with hot flushes and a cancer disease and also improved HRQoL and sleep at least in women. Acupuncture should be further evaluated in these patient groups and could be a treatment alternative in patients with troublesome symptoms.

Place, publisher, year, edition, pages
Linköping: Linköping University Electronic Press, 2011. 110 p.
Series
Linköping University Medical Dissertations, ISSN 0345-0082 ; 1245
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-68806 (URN)978-91-7393-180-9 (ISBN)
Public defence
2011-06-10, Berzeliussalen, Hälsouniversitetet, Campus US, Linköpings universitet, Linköping, 13:00 (Swedish)
Opponent
Supervisors
Available from: 2011-06-07 Created: 2011-06-07 Last updated: 2011-06-07Bibliographically approved

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Frisk, JessicaHjertberg, HansSpetz, Anna-ClaraHammar, Mats

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Obstetrics and gynecologyFaculty of Health SciencesDepartment of Surgery in ÖstergötlandSurgeryDepartment of Urology in ÖstergötlandDepartment of Gynecology and Obstetrics in Linköping
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