Cancers (Mar 2024)

Multimodal, Technology-Assisted Intervention for the Management of Menopause after Cancer Improves Cancer-Related Quality of Life—Results from the Menopause after Cancer (Mac) Study

  • Fionán Donohoe,
  • Yvonne O’Meara,
  • Aidin Roberts,
  • Louise Comerford,
  • Ivaila Valcheva,
  • Una Kearns,
  • Marie Galligan,
  • Michaela J. Higgins,
  • Alasdair L. Henry,
  • Catherine M. Kelly,
  • Janice M. Walshe,
  • Martha Hickey,
  • Donal J. Brennan

DOI
https://doi.org/10.3390/cancers16061127
Journal volume & issue
Vol. 16, no. 6
p. 1127

Abstract

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Background: Vasomotor symptoms (VMSs) associated with menopause represent a significant challenge for many patients after cancer treatment, particularly if conventional menopausal hormone therapy (MHT) is contraindicated. Methods: The Menopause after Cancer (MAC) Study (NCT04766229) was a single-arm phase II trial examining the impact of a composite intervention consisting of (1) the use of non-hormonal pharmacotherapy to manage VMS, (2) digital cognitive behavioral therapy for insomnia (dCBT-I) using Sleepio (Big Health), (3) self-management strategies for VMS delivered via the myPatientSpace mobile application and (4) nomination of an additional support person/partner on quality of life (QoL) in women with moderate-to-severe VMS after cancer. The primary outcome was a change in cancer-specific global QoL assessed by the EORTC QLC C-30 v3 at 6 months. Secondary outcomes included the frequency of VMS, the bother/interference of VMS and insomnia symptoms. Results: In total, 204 women (82% previous breast cancer) with a median age of 49 years (range 28–66) were recruited. A total of 120 women completed the protocol. Global QoL scores increased from 62.2 (95%CI 58.6–65.4) to 70.4 (95%CI 67.1–73.8) at 6 months (p n = 204) and from 62 (95%CI 58.6–65.4) to 70.4 (95%CI 67.1–73.8) at 6 months (p n = 120). At least 50% reductions were noticed in the frequency of VMS as well as the degree of bother/interference of VMS at six months. The prevalence of insomnia reduced from 93.1% at the baseline to 45.2% at 6 months (p p p < 0.001) in the PP cohort. Conclusions: A targeted composite intervention improves the quality of life for cancer patients with frequent and bothersome vasomotor symptoms with additional benefits on frequency, the bother/interference of VMS and insomnia symptoms.

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