title: Aromatase inhibitor associated arthralgia: the importance of oncology provider-patient communication about side effects and potential management through physical activity.
abstract: Breast cancer survivors on aromatase inhibitors (AI) often experience side effects of joint pain, stiffness, or achiness (arthralgia). This study presents findings from a qualitative study of survivors on an AI regarding their knowledge of potential joint pain side effects and how both AI side effects and their management through moderate physical activity could be discussed during routine visits with their oncology provider.
  
  
  
  Qualitative data from semi-structured interviews were content analyzed for emergent themes. Descriptive statistics summarize sample characteristics.
  
  
  
  Our sample included 36 survivors, mean age of 67 (range 46-87); 86 % Caucasian and 70 % had education beyond high school. AI experience are as follows: 64 % anastrozole/Arimidex, 48 % letrozole/Femara, and 31 % exemestane/Aromasin. Participants expressed interest in having more information about potential joint pain side effects when the AI was prescribed so they could understand their joint symptoms when they appeared or intensified. They were relieved to learn that their joint symptoms were not unusual or "in their head." Participants would have been especially motivated to try walking as a way to manage their joint pain if physical activity had been recommended by their oncologist.
  
  
  
  Breast cancer survivors who are prescribed an AI as part of their adjuvant treatment want ongoing communication with their oncology provider about the potential for joint pain side effects and how these symptoms may be managed through regular physical activity. The prescription of an AI presents a "teachable moment" for oncologists to recommend and encourage their patients to engage in regular physical activity.
authors.affiliation: Division of Hematology and Oncology, School of Medicine, University of North Carolina at Chapel Hill, CB 7305, Chapel Hill, NC, 27599-7305, USA. kirsten_nyrop@med.unc.edu.|Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA. kirsten_nyrop@med.unc.edu.|Department of Medicine, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA. kirsten_nyrop@med.unc.edu.
authors.forename: Kirsten A
authors.initials: KA
authors.lastname: Nyrop
authors.affiliation: Department of Medicine, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.|Thurston Arthritis Research Center, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.|Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.|Department of Social Medicine, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
authors.forename: Leigh F
authors.initials: LF
authors.lastname: Callahan
authors.affiliation: Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.|Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
authors.forename: Christine
authors.initials: C
authors.lastname: Rini
authors.affiliation: Center for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
authors.forename: Mary
authors.initials: M
authors.lastname: Altpeter
authors.affiliation: Thurston Arthritis Research Center, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
authors.forename: Betsy
authors.initials: B
authors.lastname: Hackney
authors.affiliation: Division of Hematology and Oncology, School of Medicine, University of North Carolina at Chapel Hill, CB 7305, Chapel Hill, NC, 27599-7305, USA.|Department of Medicine, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
authors.forename: Amy
authors.initials: A
authors.lastname: DePue
authors.affiliation: , Chapel Hill, NC, USA.
authors.forename: Anne
authors.initials: A
authors.lastname: Wilson
authors.affiliation: , Chapel Hill, NC, USA.
authors.forename: Arielle
authors.initials: A
authors.lastname: Schechter
authors.affiliation: Division of Hematology and Oncology, School of Medicine, University of North Carolina at Chapel Hill, CB 7305, Chapel Hill, NC, 27599-7305, USA.|Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.|Department of Medicine, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
authors.forename: Hyman B
authors.initials: HB
authors.lastname: Muss
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D047072:Aromatase Inhibitors / Q000009:adverse effects*; D018771:Arthralgia / Q000139:chemically induced*; D001943:Breast Neoplasms / Q000188:drug therapy*; D003142:Communication; D064420:Drug-Related Side Effects and Adverse Reactions / Q000628:therapy*; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D008875:Middle Aged; D011369:Professional-Patient Relations; D036301:Qualitative Research; D017741:Survivors; D016138:Walking
chemical_list: D047072:Aromatase Inhibitors
keywords: Adaptation; Aromatase inhibitor; Pain; Physical activity