Annals of Oncology Advance Access published online on October 14, 2009
Annals of Oncology, doi:10.1093/annonc/mdp394
Menopausal symptoms in women undergoing chemotherapy-induced and natural menopause: a prospective controlled study
1 Division of Medical Oncology and Hematology, Princess Margaret Hospital and University of Toronto, Toronto, Ontario, Canada
2 Department of Medical Oncology, Princess Alexandra Hospital, Brisbane, Queensland, Australia
3 Department of Medical Oncology, Institut Bergonié, Bordeaux, France
4 Department of Biostatistics, Canadian Blood Services, Ottawa, Ontario, Canada
5 Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada
* Correspondence to: Dr I. F. Tannock, Division of Medical Oncology and Hematology, Princess Margaret Hospital and University of Toronto, 610 University Avenue, Suite 5-218, Toronto, Ontario, Canada M5G 2M9. Tel: +1-416-946-2245; Fax: +1-416-946-6546; E-mail: ian.tannock{at}uhn.on.ca
Background: Women with breast cancer frequently undergo menopause following adjuvant chemotherapy. Here, we investigated whether they have more severe symptoms than women undergoing natural menopause.
Patients and methods: Forty-one women who had undergone menopause as a result of chemotherapy and 57 healthy women who had undergone recent natural menopause were evaluated on two occasions 1 year apart. The primary end point was the summed score of the self-report Functional Assessment of Cancer Therapy, endocrine symptoms (FACT-ES) scale. Quality of life was evaluated by the FACT-G questionnaire and fatigue by the FACT-F subscale.
Results: There was a strong trend for patients to report worse FACT-ES scores than controls at the first (P = 0.05) and second (P = 0.04) time points. More patients had moderate/severe hot flashes than controls undergoing natural menopause (51% versus 19%, P = 0.003). Patients reported worse fatigue than controls at the first assessment (P = 0.04), with no difference at the second. Menopausal symptoms were associated with fatigue for both groups. There was no difference between patients and controls in the quality-of-life scale, although assessment of patients is likely subject to adaptation and response-shift bias.
Conclusions: Women undergoing chemotherapy-induced menopause may experience worse symptoms than women undergoing natural menopause.
breast cancer, chemotherapy, fatigue, menopause, quality of life
Formerly with the Ontario Breast Screening Program, Toronto, Ontario, Canada. Received for publication June 30, 2008. Revision received April 16, 2009. Revision received June 17, 2009. Accepted for publication July 8, 2009.