title: Electroacupuncture for fatigue, sleep, and psychological distress in breast cancer patients with aromatase inhibitor-related arthralgia: a randomized trial.
abstract: BACKGROUND
  Although fatigue, sleep disturbance, depression, and anxiety are associated with pain in breast cancer patients, it is unknown whether acupuncture can decrease these comorbid symptoms in cancer patients with pain. The objective of this study was to evaluate the effect of electroacupuncture (EA) on fatigue, sleep, and psychological distress in breast cancer survivors who experience joint pain related to aromatase inhibitors (AIs).
  
  
  METHODS
  The authors performed a randomized controlled trial of an 8-week course of EA compared with a waitlist control (WLC) group and a sham acupuncture (SA) group in postmenopausal women with breast cancer who self-reported joint pain attributable to AIs. Fatigue, sleep disturbance, anxiety, and depression were measured using the Brief Fatigue Inventory (BFI), the Pittsburgh Sleep Quality Index (PSQI), and the Hospital Anxiety and Depression Scale (HADS). The effects of EA and SA versus WLC on these outcomes were evaluated using mixed-effects models.
  
  
  RESULTS
  Of the 67 randomly assigned patients, baseline pain interference was associated with fatigue (Pearson correlation coefficient [r]=0.75; P < .001), sleep disturbance (r=0.38; P=.0026), and depression (r=0.58; P < .001). Compared with the WLC condition, EA produced significant improvements in fatigue (P=.0095), anxiety (P=.044), and depression (P=.015) and a nonsignificant improvement in sleep disturbance (P=.058) during the 12-week intervention and follow-up period. In contrast, SA did not produce significant reductions in fatigue or anxiety symptoms but did produce a significant improvement in depression compared with the WLC condition (P=.0088).
  
  
  CONCLUSIONS
  Compared with usual care, EA produced significant improvements in fatigue, anxiety, and depression; whereas SA improved only depression in women experiencing AI-related arthralgia.
authors: Abramson Cancer Center, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania; Department of Biostatistics and Epidemiology, Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia, Pennsylvania; Department of Family Medicine and Community Health, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania.
authors: Jun J
authors: JJ
authors: Mao
authors: John T
authors: JT
authors: Farrar
authors: Deborah
authors: D
authors: Bruner
authors: Jarcy
authors: J
authors: Zee
authors: Marjorie
authors: M
authors: Bowman
authors: Christina
authors: C
authors: Seluzicki
authors: Angela
authors: A
authors: DeMichele
authors: Sharon X
authors: SX
authors: Xie
mesh_terms: D000368:Aged; D000077384:Anastrozole; D000730:Androstadienes / Q000009:adverse effects; D001007:Anxiety / Q000523:psychology / Q000628:therapy*; D047072:Aromatase Inhibitors / Q000009:adverse effects*; D018771:Arthralgia / Q000139:chemically induced* / Q000150:complications / Q000523:psychology; D001943:Breast Neoplasms / Q000150:complications / Q000188:drug therapy* / Q000523:psychology; D003863:Depression / Q000523:psychology / Q000628:therapy*; D015671:Electroacupuncture / Q000379:methods*; D005221:Fatigue / Q000150:complications / Q000523:psychology / Q000628:therapy*; D005260:Female; D006801:Humans; D000077289:Letrozole; D008875:Middle Aged; D009570:Nitriles / Q000009:adverse effects; D011788:Quality of Life; D012893:Sleep Wake Disorders / Q000150:complications / Q000523:psychology / Q000628:therapy*; D013315:Stress, Psychological / Q000523:psychology / Q000628:therapy; D016896:Treatment Outcome; D014230:Triazoles / Q000009:adverse effects
chemical_list: D000730:Androstadienes; D047072:Aromatase Inhibitors; D009570:Nitriles; D014230:Triazoles; D000077384:Anastrozole; D000077289:Letrozole; C056516:exemestane
keywords: acupuncture; aromatase inhibitors; breast neoplasm; fatigue; psychological distress; sleep