title: Pilot study of acupuncture for the treatment of joint symptoms related to adjuvant aromatase inhibitor therapy in postmenopausal breast cancer patients.
abstract: 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.
authors.affiliation: Department of Medicine, College of Physicians and Surgeons, Columbia University, New York, NY, USA.
authors.forename: Katherine D
authors.initials: KD
authors.lastname: Crew
authors.forename: Jillian L
authors.initials: JL
authors.lastname: Capodice
authors.forename: Heather
authors.initials: H
authors.lastname: Greenlee
authors.forename: Arlyn
authors.initials: A
authors.lastname: Apollo
authors.forename: Judith S
authors.initials: JS
authors.lastname: Jacobson
authors.forename: George
authors.initials: G
authors.lastname: Raptis
authors.forename: Kimberly
authors.initials: K
authors.lastname: Blozie
authors.forename: Alex
authors.initials: A
authors.lastname: Sierra
authors.forename: Dawn L
authors.initials: DL
authors.lastname: Hershman
mesh_terms: 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
chemical_list: D047072:Aromatase Inhibitors