The multidisciplinary management of menopausal symptoms after breast cancer: a unique model of care.
OBJECTIVE
The aim of this study was to describe a unique model of multidisciplinary care for women with menopausal symptoms after breast cancer and present preliminary data for 653 women.


METHODS
The nature and severity of menopausal symptoms in women with breast cancer were measured using a standardized scale.


RESULTS
A total of 578 women with breast cancer were managed at the Menopausal Symptoms After Cancer Clinic between January 2003 and December 2008. The most common reasons for these women to seek treatment were hot flushes (41%), night sweats (36%), loss of interest in sex (30%), difficulty sleeping (25%), and fatigue (22%). Extreme vaginal dryness was also reported in 19% of these women. Chemotherapy-induced ovarian failure was reported by 29% of the breast cancer patients seen. A range of management approaches were offered, with 55% of the women prescribed nonhormonal pharmacological therapies for vasomotor symptoms, including vitamin E 400 IU twice daily (21%), venlafaxine 75 mg CR once daily (13%), clonidine 50 microg twice daily (11%), or gabapentin 300 mg three times daily (4%).


CONCLUSIONS
Vasomotor symptoms, sexual dysfunction, and sleep disturbance are the most distressing menopausal symptoms requiring management after breast cancer. Menopausal symptom management after breast cancer may be complex, and we present a novel model of care using a multidisciplinary approach. Additional benefits of this multidisciplinary approach include education opportunities, improved communication and networking opportunities, and decision making in line with evidence-based guidelines.
School of Women's and Infants' Health, King Edward Memorial Hospital, The University of Western Australia, Crawley, WA, Australia.
Martha
M
Hickey
Laura I
LI
Emery
Jane
J
Gregson
Dorota A
DA
Doherty
Christobel M
CM
Saunders
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000554:Ambulatory Care Facilities; D000588:Amines / Q000627:therapeutic use; D014151:Anti-Anxiety Agents / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000503:physiopathology*; D003000:Clonidine / Q000627:therapeutic use; D003509:Cyclohexanecarboxylic Acids / Q000627:therapeutic use; D003511:Cyclohexanols / Q000627:therapeutic use; D005221:Fatigue / Q000503:physiopathology / Q000628:therapy; D005260:Female; D000077206:Gabapentin; D019584:Hot Flashes / Q000503:physiopathology / Q000628:therapy; D006801:Humans; D007989:Libido / Q000502:physiology; D008593:Menopause / Q000502:physiology*; D008875:Middle Aged; D010348:Patient Care Team; D010353:Patient Education as Topic; D017060:Patient Satisfaction; D018802:Patient-Centered Care; D017410:Practice Guidelines as Topic; D012017:Referral and Consultation; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use; D012893:Sleep Wake Disorders / Q000503:physiopathology / Q000628:therapy; D013546:Sweating / Q000502:physiology; D013565:Sympatholytics / Q000627:therapeutic use; D000069470:Venlafaxine Hydrochloride; D014810:Vitamin E / Q000627:therapeutic use; D014815:Vitamins / Q000627:therapeutic use; D005680:gamma-Aminobutyric Acid / Q000627:therapeutic use
D000588:Amines; D014151:Anti-Anxiety Agents; D003000:Clonidine; D003509:Cyclohexanecarboxylic Acids; D003511:Cyclohexanols; D000077206:Gabapentin; D017367:Selective Serotonin Reuptake Inhibitors; D013565:Sympatholytics; D000069470:Venlafaxine Hydrochloride; D014810:Vitamin E; D014815:Vitamins; D005680:gamma-Aminobutyric Acid