Menopausal symptoms following breast cancer treatment: A qualitative investigation of cognitive and behavioural responses

Objectives: Menopausal symptoms - hot flushes and night sweats (HF/NS) - are particularly troublesome for women who have undergone breast cancer treatment. Non-medical treatments, such as cognitive behaviour therapy, are being developed but there is a lack of information about cognitive and behavioural reactions to HF/NS in breast cancer patients. Methods: Thirty-five women who had completed active breast cancer treatment with at least 10 HF/NS per week completed questionnaires assessing HF/NS, mood and beliefs, and took part in interviews to elicit cognitive and behavioural reactions and a thematic content analysis used to analyse the data. Results: The mean weekly frequency of HF/NS was 76 (SD=46) (57 HF and 19 NS). Smokers reported significantly more night sweats, but BMI and mood were not associated with HF/NS frequency. Cognitive and behavioural responses were varied but broadly similar to those of well women. The main cognitive themes were: embarrassment/social anxiety, loss of control, beliefs about NS, sleep and tiredness, and the main behaviours were: carry on and ignore them, cool down, avoidance, communication with others. Conclusions: The results are discussed within a cognitive behavioural framework and might inform the development of psychological interventions for these treatment related symptoms. (C) 2009 Elsevier Ireland Ltd. All rights reserved.