Patients in the comprehensive program received a detailed assessment of their symptoms and extensive education by a nurse practitioner, followed by counseling on behavioral strategies to relieve symptoms, referrals to a psychologist, if necessary, and non-estrogen medications as needed. The nurse practitioner also was available by phone to advise patients in between visits. In contrast, patients in the standard care group had no further contact with the nurse practitioner after their physical examinations. They underwent symptom evaluations and received education and health counseling only at the end of the study. During their participation in the study, they were not prevented from seeking medical or non-medical help to relieve their symptoms, but they were not encouraged to do so.
Many women take estrogen replacement therapy to alleviate menopausal symptoms.
Although estrogen replacement therapy is considered standard treatment for healthy women with menopausal symptoms, researchers are not certain that it is safe for breast cancer survivors to take because it may increase their risk of breast cancer development or recurrence, Ganz said. So postmenopausal breast cancer survivors, who report higher rates of hot flashes, vaginal dryness and urinary incontinence than healthy postmenopausal women, often feel at a loss about what they can do to manage severe symptoms. Laura Zibecchi, the clinical research nurse practitioner involved in the study, said many of the participants were reluctant to try some of the conventional medications used to relieve menopausal symptoms because of potential side effects. So it's critical to find ways to help breast cancer survivors manage their symptoms more effectively, both medically and psychologically, even if it's as basic as helping a woman identify lifestyle changes that she can make. It's all about trying to minimize the impact of symptoms on women's everyday lives.