Pilot study of acupuncture for the treatment of joint symptoms related to adjuvant aromatase inhibitor therapy in postmenopausal breast cancer patients.
BACKGROUND
Aromatase inhibitors (AIs) have become the standard of care for the adjuvant treatment of postmenopausal, hormone-sensitive breast cancer. However, patients receiving AIs may experience joint symptoms, which may lead to early discontinuation of this effective therapy. We hypothesize that acupuncture is a safe and effective treatment for AI-induced arthralgias.


METHODS
Postmenopausal women with early-stage breast cancer who had self-reported musculoskeletal pain related to adjuvant AI therapy were randomized in a crossover study to receive acupuncture twice weekly for 6 weeks followed by observation or vice-versa. The intervention included full body and auricular acupuncture, and a joint-specific point prescription. Outcome measures included the Brief Pain Inventory-Short Form (BPI-SF), Western Ontario and McMaster Universities Osteoarthritis (WOMAC) index, the Functional Assessment of Cancer Therapy-General (FACT-G) quality of life measure, and serum levels of inflammatory markers, IL-1 beta and TNF-alpha.


RESULTS
Twenty-one women were enrolled and two discontinued early. From baseline to the end of treatment, patients reported improvement in the mean BPI-SF worst pain scores (5.3 to 3.3, p = 0.01), pain severity (3.7 to 2.5, p = 0.02), and pain-related functional interference (3.1 to 1.7, p = 0.02), as well as the WOMAC function subscale and FACT-G physical well-being (p = 0.02 and 0.04, respectively). No adverse events were reported.


CONCLUSIONS
In this pilot study, acupuncture reduced AI-related joint symptoms and improved functional ability and was well-tolerated.


CONCLUSIONS
Musculoskeletal side effects are common among breast cancer survivors on adjuvant AI therapy, therefore, effective treatments are needed for symptom relief and to improve adherence to these life-saving medications.
Crew
Katherine D
KD
Department of Medicine, College of Physicians and Surgeons, Columbia University, New York, NY, USA.
Capodice
Jillian L
JL
Greenlee
Heather
H
Apollo
Arlyn
A
Jacobson
Judith S
JS
Raptis
George
G
Blozie
Kimberly
K
Sierra
Alex
A
Hershman
Dawn L
DL
D026881:Acupuncture; D000368:Aged; D047072:Aromatase Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000150:complications* / Q000188:drug therapy; D017024:Chemotherapy, Adjuvant / Q000009:adverse effects*; D004651:Employment / Q000706:statistics & numerical data; D005260:Female; D006304:Health Status; D006801:Humans; D007249:Inflammation / Q000503:physiopathology; D007592:Joint Diseases / Q000139:chemically induced* / Q000503:physiopathology / Q000628:therapy*; D008875:Middle Aged; D010147:Pain Measurement; D010865:Pilot Projects; D017698:Postmenopause; D044469:Racial Groups; D012919:Social Behavior; D011795:Surveys and Questionnaires
D047072:Aromatase Inhibitors