Chemotherapy for
breast cancer is associated with the development of
hot flashes, which can cause the patient considerable discomfort.
Estrogen replacement therapy alleviates the number and severity of
hot flashes but is contraindicated in such cases. Alternative methods to treat
hot flashes are, therefore, urgently needed. Goodwin et al. have performed a 6-month, double-blind, randomized, placebo-controlled trial of
megestrol acetate in 286 women with
breast cancer. After 3 months, 65% of the patients receiving 20 mg
megestrol acetate daily had achieved an appreciable reduction in the number of
hot flashes (> or = 75% from baseline), compared with 48% in the 40 mg
megestrol acetate group and 14% in the placebo group. The positive effects of
megestrol acetate on hot flash frequency were maintained at 6 months. In this Practice Point commentary, I discuss the key findings of Goodwin et al. and place them into clinical context, highlighting the need for additional studies of hormonal
therapies in women with
breast cancer.