A trial looking at cognitive behavioural therapy to reduce the impact of hot flushes and night sweats (MENOS4)

Cancer type:

Breast cancer

Status:

Results

Phase:

Phase 3

This trial was done to see if CBT could be used within the NHS to help women who have hot flushes or night sweats after treatment for breast cancer.

The trial was open for people to join between 2017 and 2018. The research team published the results in 2020.

More about this trial

Many people with breast cancer have hot flushes and night sweats after their treatment. This can affect their quality of life and ability to sleep.

There are medications that can help. But these can have unpleasant side effects.

When this trial was done, research had shown that a type of therapy called cognitive behavioural therapy (CBT) could:

help reduce the impact of hot flushes and night sweats
improve mood
improve quality of life

But only some of the women in the trials had breast cancer. And the CBT sessions were run by a clinical psychologist.

The research team wanted to find out if CBT sessions could:

be run by specially trained nurses in the NHS
help with hot flushes and night sweats for women who have had treatment for breast cancer

Summary of results

The team found that NHS nurses could run cognitive behavioural therapy sessions to help people having hot flushes and night sweats after breast cancer treatment.

Trial design
This trial was for women who’d had treatment for breast cancer and were having at least 7 hot flushes or night sweats each week.

Breast care nurses were trained in how to run cognitive behavioural therapy (CBT) sessions. The women who took part went to group CBT sessions, once a week for up to 6 weeks. Each session lasted about an hour and a half.

They filled out a questionnaire about how hot flushes were affecting their quality of life before they started the sessions. And again 6 months later.

Results
A total of 127 people took part in this trial. They were put into 1 of 2 groups at random and there were:

61 people in the CBT group
66 people in the usual care group

Diagram 1

More than 6 out of 10 people (61%) in the CBT group went to at least 4 CBT sessions.

The research team looked at the scores for different aspects of quality of life. They found that the scores improved more for people who’d taken part in the CBT sessions.

They looked at how much of problem the hot flushes and night sweats were when people joined the trial, and 6 months later. This is called the problem rating, and the scale goes from 0 to 10.

The average problem rating went down more for those who had CBT. On average, it dropped by:

3.2 points for those who had CBT (a 46% drop)
1.0 point for those who had usual care (a 15% drop)

Bar Chart 1

The team also looked at the number of hot flushes people had in a week. They compared the number people had when they joined the trial, and 6 months later.

They found on average that women had:

16 fewer hot flushes a week if they’d had CBT (a 28% drop)
7 fewer hot flushes a week if they’d had usual care (an 11% drop)

Diagram 2

The research team found that people who had CBT also had:

better sleep quality
less anxiety
less depression

Conclusion
The research team concluded that nurses could run cognitive behavioural therapy sessions within the NHS. And that this could help people having hot flushes and night sweats after breast cancer treatment.

They suggest CBT could be a useful alternative to medication for this group of patients.

Where this information comes from
We have based this summary on information from the research team. The information they sent us has been reviewed by independent specialists (peer reviewed Open a glossary item ) and published in a medical journal. The figures we quote above were provided by the trial team who did the research. We have not analysed the data ourselves.