title: A case of aromatase inhibitor (anastrozole)-induced side-effects successfully treated with Kampo medicines.
abstract: OBJECTIVE
  Breast cancer is the fourth most frequent cause of death, and it is currently the most frequent cause of death among Japanese women. As to breast cancer therapy, lengthy hormonal therapy is very important for the treatment and prevention of recurrence. Aromatase inhibitors (AIs) are the initial drug of choice for postoperative adjuvant therapy of breast cancer in Japan. AIs require long-term use and occasionally cause serious side-effects. In this report, the effects of Kampo medicines (Japanese traditional medicines) on AIs-induced side-effects are described.
  
  
  METHODS
  A 55-year-old woman visited the Kampo outpatient department of Chiba University Hospital for atypical genital bleeding and arthralgia. At the age of 54, she suffered from left breast cancer and underwent left total mastectomy followed by chemotherapy for 6 months. Afterwards, 1 mg/day of anastrozole, one of the AIs, was used for therapy. Three (3) months later, atypical genital bleeding from vaginal mucosa and joint pains of bilateral hands and knees occurred as side-effects of anastrozole. Her attending doctor could only prescribe nonsteroidal external medicine for the inflammation of vaginal mucosa and do close follow-up. However, her symptoms showed no improvement.
  
  
  RESULTS
  Her deficiency of both ki (qi) and ketsu (Blood) was diagnosed based on Kampo diagnostics. Juzentaihoto was used for treatment. After taking juzentaihoto for 5 weeks, the atypical genital bleeding disappeared, and she no longer need topical medicine. Because her arthralgia showed no improvement, powdered processed aconitine root was added. After taking 3.0 g/day of this medication, her arthralgia almost completely disappeared.
  
  
  CONCLUSIONS
  Controlling the side-effects is a clinical issue from the viewpoint of adherence to drug treatment. Kampo therapy should be considered one of the choices for side-effects in the process of cancer treatment.
authors: Department of Frontier Japanese-Oriental (Kampo) Medicine, Graduate School of Medicine, Chiba University, Chiba City, Chiba, Japan. chinoppi@faculty.chiba-u.jp
authors: Atsushi
authors: A
authors: Chino
authors: Hideki
authors: H
authors: Okamoto
authors: Yoshiro
authors: Y
authors: Hirasaki
authors: Keigo
authors: K
authors: Ueda
authors: Keiko
authors: K
authors: Ogawa
authors: Takao
authors: T
authors: Namiki
mesh_terms: D000157:Aconitine / Q000627:therapeutic use; D031841:Aconitum / Q000737:chemistry; D000077384:Anastrozole; D018931:Antineoplastic Agents, Hormonal / Q000009:adverse effects; D047072:Aromatase Inhibitors / Q000009:adverse effects*; D018771:Arthralgia / Q000139:chemically induced / Q000188:drug therapy*; D001943:Breast Neoplasms / Q000188:drug therapy / Q000601:surgery; D017024:Chemotherapy, Adjuvant; D004365:Drugs, Chinese Herbal / Q000627:therapeutic use*; D005260:Female; D006470:Hemorrhage / Q000139:chemically induced / Q000188:drug therapy*; D006801:Humans; D020835:Medicine, Kampo; D008875:Middle Aged; D009092:Mucous Membrane / Q000187:drug effects / Q000473:pathology; D009570:Nitriles / Q000009:adverse effects*; D008517:Phytotherapy; D019413:Qi; D014230:Triazoles / Q000009:adverse effects*; D014621:Vagina / Q000187:drug effects / Q000473:pathology
chemical_list: D018931:Antineoplastic Agents, Hormonal; D047072:Aromatase Inhibitors; D004365:Drugs, Chinese Herbal; D009570:Nitriles; D014230:Triazoles; C063587:juzentaihoto; D000077384:Anastrozole; D000157:Aconitine