Biobehavioral management of hot flashes in a 48-year-old breast cancer survivor

Hot flashes are among the most severe and frequent menopausal symptom experienced by postmenopausal women and breast cancer survivors. In fact, over 66% of healthy menopausal women and 78% of women treated for breast cancer experience hot flashes. Kronenberg et al. described a hot flash as a transient episode of flushing, sweating, and a sensation of heat, often accompanied by palpitations and a feeling of anxiety, and sometimes followed by chills. The onset of a hot flash is sometimes preceded by an aura, but it often manifests itself suddenly. The initial symptoms typically included a rise in heart rate and peripheral blood flow. The sensation of a wave of heat spreads over a person's body, especially the upper body, causing him or her to sweat. Although there is a sensation of heat, evaporation of sweat from the forehead and chest results in a drop in temperature in these areas. As a result, the flash is sometimes followed by a chilled feeling. Several studies have identified hot flashes as the most frequently reported physiological and psychological experiences associated with menopause. Hot flashes can be severe and interfere with daily activities. For example, in a study examining the symptoms associated with hot flashes among breast cancer survivors, 89 of 102 women reported having severe hot flashes. Some physical symptoms included weakness, feeling faint, rapid heartbeat, and itching sensations. Over one third (37%) noted that the hot flashes interfered with their routines and disrupted their sleep. Thirty-seven percent of the women indicated that these hot flashes interfered with their daily activities and disrupted sleep. Pansini et al. reported similar symptom presentation of hot flashes and also identified headaches, irritability, palpitations, and vertigo as common symptoms.