From the Guidelines
Evening primrose oil is generally not contraindicated when taken with Arimidex (anastrozole) for a patient experiencing hot flushes while in breast cancer remission, but patients should exercise caution and consult their oncologist before starting evening primrose oil supplements. While evening primrose oil is sometimes used to manage menopausal symptoms like hot flushes, the evidence for its effectiveness is limited and inconsistent, as noted in the 2017 guidelines for survivorship 1. For breast cancer patients specifically, Arimidex works by reducing estrogen levels, which causes hot flushes as a side effect. Evening primrose oil contains gamma-linolenic acid but doesn't appear to have estrogenic effects that would interfere with Arimidex's mechanism of action.
Alternative Management Strategies
Alternative management strategies for hot flushes that may be safer include:
- Lifestyle modifications (wearing layered clothing, avoiding triggers like spicy foods and alcohol)
- Mind-body practices (meditation, yoga)
- Non-hormonal medications like certain antidepressants (venlafaxine, paroxetine) or gabapentin if symptoms are severe. The safety profile of any supplement should be carefully considered in breast cancer patients, and medical supervision is essential, as emphasized in the practical clinical guidelines for assessing and managing menopausal symptoms after breast cancer 1.
Considerations for Breast Cancer Patients
It's crucial to assess the likely cause for the menopausal symptoms in breast cancer patients, considering factors such as the natural menopause, stopping hormone therapy, and the effects of endocrine therapies and chemotherapy on ovarian function 1. Given the potential for severe and long-lasting menopausal symptoms in these patients, careful consideration of all management options, including lifestyle modifications, mind-body practices, and non-hormonal medications, is necessary to optimize adherence to therapy and quality of life.
From the Research
Contraindications for Using Evening Primrose (EPO) and Arimidex (Anastrozole)
- There is no direct evidence in the provided studies that suggests a contraindication to using Evening Primrose (EPO) and Arimidex (Anastrozole) in a patient with hot flashes and breast cancer in remission 2, 3, 4, 5, 6.
- However, it is noted that hormonal replacement therapy is generally contraindicated for breast cancer patients, and Arimidex (Anastrozole) is an aromatase inhibitor used to treat hormone-dependent breast cancer in postmenopausal women 5.
- The use of non-hormonal pharmacological interventions, such as selective serotonin reuptake inhibitors and serotonin-norepinephrine reuptake inhibitors, is recommended for managing hot flashes in breast cancer patients 2, 3, 4.
- Evening Primrose (EPO) is not mentioned in the provided studies as a treatment for hot flashes in breast cancer patients.
- The studies suggest that non-hormonal alternatives, such as centrally active agents, are recommended for the treatment of hot flashes in breast cancer survivors 3, 4.
Treatment Options for Hot Flashes in Breast Cancer Survivors
- Centrally active agents, such as venlafaxine, paroxetine, and gabapentin, have shown clinical effectiveness in reducing hot flashes in breast cancer patients 2, 3, 4.
- Other agents, such as clonidine, pregabalin, and selective serotonin reuptake inhibitors, have also been found to be effective in treating hot flashes 2, 3, 4.
- Non-pharmacologic approaches, such as lifestyle changes and complementary alternative medicine therapies, have limited effectiveness in treating hot flashes in breast cancer survivors 3, 4.
- Stellate ganglion block (SGB) has been suggested as a potential treatment option for hot flashes in breast cancer patients, but more research is needed to determine its efficacy 6.