From the Guidelines
Breast cancer patients in remission should not combine Manhae with Arimidex (anastrozole) without medical supervision due to potential interactions that could compromise the efficacy of cancer treatment. The primary concern is that Manhae, a traditional Korean herbal medicine, contains phytoestrogens and other bioactive compounds that may interfere with the mechanism of action of Arimidex, an aromatase inhibitor that reduces estrogen production to prevent cancer recurrence 1.
Managing Hot Flashes
To manage hot flashes in breast cancer patients on Arimidex, evidence-based pharmacological treatments such as venlafaxine, paroxetine, and gabapentin are recommended, as they have been shown to be effective in reducing hot flash symptoms without compromising cancer treatment 1. These options should be considered based on the severity of symptoms and patient preferences, keeping in mind that side effects are relatively common with these agents.
Non-Pharmacological Approaches
In addition to pharmacological treatments, non-pharmacological approaches can be beneficial in managing hot flashes. These include:
- Avoiding triggers such as spicy foods, alcohol, and caffeine
- Dressing in layers to maintain a comfortable body temperature
- Maintaining a cool environment These methods can help alleviate symptoms without interfering with the anticancer effects of prescribed medications.
Priority in Treatment
The priority in managing breast cancer patients should always be to maintain the efficacy of anticancer treatments while effectively managing side effects through clinically validated methods. Therefore, any decision to use complementary therapies like Manhae should be made under the guidance of a healthcare provider to ensure that the treatment plan prioritizes both the management of menopausal symptoms and the prevention of cancer recurrence.
From the Research
Interaction between Manhae and Arimidex (anastrozole) in Managing Hot Flashes
There is no direct evidence available regarding the interaction between Manhae and Arimidex (anastrozole) in managing hot flashes in breast cancer patients in remission.
Available Evidence on Hot Flash Management
- Studies have shown that serotonin-norepinephrine reuptake inhibitors, selective serotonin reuptake inhibitors, antihypertensives, and anticonvulsants can significantly reduce the frequency and severity of hot flashes in breast cancer patients 2, 3, 4.
- Non-hormonal alternatives are recommended for breast cancer survivors due to the contribution of sex hormones to breast cancer 5, 3.
- Centrally active agents such as venlafaxine, paroxetine, and gabapentin have shown clinical effectiveness in treating hot flashes in breast cancer survivors 3.
- The pathophysiologic mechanisms leading to hot flashes are poorly understood, but estrogen withdrawal, serotonin, and norepinephrine seem to be involved in hot flush induction 4.