Submitted to: The Journal of the North American Menopause Society
Publication Type: Peer reviewed journal
Publication Acceptance Date: 12/4/2003
Publication Date: 2/15/2004
Citation: Carpenter, J.S., Gilchrist, J.M., Chen, K., Gautam, S., Freedman, R.R. 2004. Hot flashes, core body temperature, and metabolic parameters in breast cancer survivors. The Journal of the North American Menopause Society. 11(4):375-381. Interpretive Summary: Hot flashes are common among breast cancer survivors (BCS). Little is known about what causes hot flashes. We do not know how hot flashes differ between BCS and healthy menopausal women. Without this knowledge, it is difficult to design and test appropriate treatments. We studied hot flashes, core body temperature, and metabolic rate among 9 BCS. We compared our results to those from a study of healthy menopausal women. During 24-hours in the Metabolic Room, the BCS had an average of 13.2 hot flashes. Core body temperature increased before hot flashes. Metabolic rate increased during hot flashes. Hot flashes among BCS do not follow a circadian rhythm. This may be due to changes in sleep patterns among BSC. Further study of the mechanisms of hot flashes is needed.
Technical Abstract: Objective: To examine core body temperature, energy expenditure, and respiratory quotient amoung breast cancer survivors experiencing hot flashes and compare these data to published studies from healthy women. Design: In an observational study, nine breast cancer survivors with daily hot flashes who met specified criteria spent 24 hours in a temperature- and humidity-controlled whole-room indirect calorimeter (ie, metabolic room). Demographic and disease/treatment informatoin were obtained and the following were measured: hot flashes via sternal skin conductance monitoring (sampled every second); core body temperature via an ingested radiotelemetry pill (sampled every 10 seconds); and energy expenditure and respitory quotient via a whole-room indirect calorimeter (calculated every minut). Results: Circadian analysis of core temperature indicated wide variability with disrupted circadian rhythm noted in all women. Core temperature began to rise 20 minutes pre-flash to 7 minutes pre-flash (0.99 degrees C increase). Increases in energy expenditure and respiratory quotient increased with each hot flash. Conclusions: Findings are comparable to published data from healthy women and warrant replication in larger, more diverse samples of women treated for breast cancer.