Acupuncture and Menopausal Memory Changes in Women with Breast Cancer

Monday, 9 November 2015

Elizabeth Cole Collins, PhD, RN, WHNP-BC, IBCLC
School of Nursing, Stony Brook University, Stony Brook, NY, USA
L. Kathleen Sekula, PhD, RN, PMHCNS-BC, FAAN
School of Nursing, Duquesne University, Pittsburgh, PA, USA
Susan M. Cohen, PhD, RN, CRNP, FAAN
Health Promotion and Development, University of Pittsburgh School of Nursing, Pittsburgh, PA, USA

Menopausal symptoms are a concern for peri- and postmenopausal women, and for women who have been treated for breast cancer. Changes in memory are a commonly reported menopausal symptom which can interfere with daily activities, occurring in women who experience natural menopause as well as in women who have an abrupt onset of menopause following treatment for breast cancer. Menopause hormone therapy may be contraindicated or unacceptable for many women, reinforcing the need for well-tolerated, non-hormonal treatments for menopausal symptoms. The purpose of this study was to examine the efficacy of acupuncture to improve the menopausal symptom of memory changes in breast cancer survivors, and was a secondary analysis of a placebo-controlled, randomized clinical trial. The Framework for Interactions between the Individual and the Environment was the conceptual framework that guided the study.        

Subjects in the parent study were randomized to either the experimental group (symptom-specific acupuncture), control group (non-symptom-specific acupuncture), or enhanced usual care group (instruction on health-related topics). Each group received twelve intervention sessions over an 8-week period. Sixty subjects indicating a positive response to memory items on instruments at baseline were selected for this secondary analysis. The Daily Symptom Diary, Kupperman Index, and Menopause-Specific Quality of Life Questionnaire (MENQOL) measured frequency or severity of perceived memory changes at baseline, midpoint, and end of treatment.

Frequency distributions were used to summarize the data. There were no statistically significant results from the Daily Symptom Diary. Improvement in the enhanced usual care group compared to the acupuncture groups was seen on the Kupperman Index, and validity concerns for this instrument were reviewed. Analysis of the MENQOL data revealed more positive change in the acupuncture groups in improvement of memory than in the enhanced usual care group. These findings support the need for further exploration of targeted interventions such as acupuncture to improve memory difficulties for menopausal women and breast cancer survivors, particularly as advances are made in the understanding of the mechanisms of cognitive change. Acupuncture remains promising as a non-hormonal treatment for menopausal symptoms and merits further investigation.