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Cancer Control Research

Abstract

DESCRIPTION (provided by applicant): Among breast cancer survivors, hot flashes are prevalent and have an intensity and intrusiveness that exceeds levels among healthy women. Hot flashes, especially when severe, negatively affect the quality of life of breast cancer survivors. Preliminary evidence suggests that in menopausal women, greater anxiety is associated with more severe and frequent hot flashes, but anxiety is also associated with discrepancies between reported and objectively recorded hot flashes. Understanding the underlying psychological and biological mechanisms of hot flashes is essential to finding treatments which are acceptable and effective for breast cancer survivors. This pilot project will further assess the relationship between psychological variables and hot flashes by evaluating a model in which anxiety sensitivity, the fear of arousal symptoms, is a key individual difference variable contributing to reports of the occurrence and severity of hot flashes among breast cancer survivors. Samples of breast cancer survivors will be recruited, provided with a packet of questionnaires and a daily diary, and fitted with a Biolog monitor to record sternal skin conductance, the current gold standard for assessing objective hot flashes. Chart abstractions will be used to obtain clinical information. The overarching goal is not only to understand the psychological dimensions of the production and experience of hot flashes, but to provide a rationale for specific, new management strategies. This model provides a basis for identifying individuals most at risk for disturbing hot flashes, and can serve as a basis for developing novel, cognitive-behavioral interventions for hot flashes. Additionally, findings of individual differences in discrepancies between reported and objectively recorded hot flash will have broader implications for the design and interpretation of clinical trials testing medical treatments. Besides breast cancer survivors, results will have implications for hot flashes experienced by prostate cancer survivors and the general population of women, the majority of whom also at some point experience hot flashes. Furthermore, the results of this study may have implications for the management of other forms of cancer-related symptom distress. This project examines why some women being treated for breast cancer experience more intense and frequent hot flashes than by healthy women during natural menopause. The goal is to develop better strategies for the self-management of hot flashes using cognitive-behavioral techniques.