Acupuncture Relieves Joint Pain for Breast Cancer Survivors Who Take Aromatase Inhibitors
Joint pain is a vexing problem for women who need to take aromatase inhibitors to prevent recurrences. Acupuncture looks like the most effective treatment to date.
By Shari Roan
Don't Miss This
Sign Up for OurCancer Care and PreventionNewsletter
Thanks for signing up!You might also like these other newsletters:
July 10, 2019
One of the most scientifically rigorous studies to date on acupuncture in breast cancer survivors has found the traditional Chinese medical therapy provides modest improvements in joint pain commonly caused by drugs known as aromatase inhibitors, which are widely used to prevent breast cancer from recurring.
The study, published July 10, 2019, in theJournal of the American Medical Association,found that after 12 weeks of acupuncture treatments, 60 percent of the women experienced a two-point improvement on a 10-point pain severity scale.
The practice involves inserting fine, sterile, single-use needles in specific places for a short period of time before removing the needles.
“We would say a two-point reduction is a very large reduction,” says Dawn L. Hershman, MD, lead author of the study, who is head of the breast cancer program at NewYork–Presbyterian and Columbia University Medical Center in New York City.
Joint Pain: A Deal-Breaking Side Effect for Some Women
Aromatase inhibitors (AIs), a category of drugs that includes Femara (letrozole) and Arimidex (anastrozole), to lower the risk that the cancer will recur.
Previous studies show that aromatase inhibitors have a significant impact in reducing the risks of a second cancer by lowering estrogen in the body, a hormone that can promote cancer growth. Moreover, a study published in 2019 in theNew England Journal of Medicineshowed that the risk of cancer recurrence or developing cancer in the other breast was 34 percent lower in women taking aromatase inhibitors for 10 years compared with those who stopped taking the drugs after five years.
“A larger number of women are now candidates for aromatase inhibitors,” Dr. Hershman says. But about 50 percent of women who take the medication experience joint pain and stiffness, especially in the wrists and knees.
“The first thing people say is ‘This medication makes me feel like an old lady. I can’t get up from a chair. I can’t open a jar. I can’t exercise like I want to,’” Hershman says. “For some women, it’s so severe they stop taking the medication. That is what we are most concerned about in the breast cancer community.”
Solutions Have Been Difficult to Find
Oncologists have recommended exercise to help with joint pain and stiffness as well as vitamin D and omega-3 fatty acid supplements, although those remedies have produced only limited relief for some patients. Oncologists don’t like to prescribe opiates or anything addictive for pain.
Doctors sometimes prescribe Cymbalta (duloxatine) to relieve pain, but this medication is also associated with side effects, including dry mouth, nausea, and drowsiness.
Earlier small studies have suggested that acupuncture can help. The new study, which was funded by the National Cancer Institute, was intended to apply rigorous scientific methodology to ensure the results would be credible, Hershman says.
The study took place at 11 centers and involved 226 women — 110 who received true acupuncture and 59 who received sham acupuncture, which involved inserting needles at nonacupuncture points. Another 57 women were on a waiting list for acupuncture treatment and were used as a control group.
The women in the true acupuncture group and sham acupuncture group received two sessions a week for six weeks, 30 to 45 minutes per session, and one session for six additional weeks. They were then followed for an additional 12 weeks with no treatment. The study participants rated their pain on a scale of 0 for no pain to 10 for pain as bad as you can imagine.
“We went to great lengths training the acupuncturists,” Hershman says. “They had do on-site or Skype-based training. They had to do web-based training modules. They had to be observed at least once a year to make sure they were consistently sticking to the protocol. We have a manual to show exactly what we wanted people to do.”
At the conclusion of the study, researchers found a statistically significant difference between true acupuncture and sham acupuncture and a statistically significant difference between sham acupuncture and the wait-list control group.
“That was true for a whole variety of different outcomes: stiffness, severity of pain, and pain interference (the extent to which pain interferes with the activities of daily life). The results were fairly consistent,” Hershman says.
A separate analysis after the study ended showed 60 percent of patients in the true acupuncture group had a two-point reduction on a pain scale compared with 33 percent in the sham group and 31 percent in controls.
The study also indicated that the effects seem to last even after the treatment is stopped. The reduction in pain may allow more women to continue taking aromatase inhibitors for the full 10 years recommended, Hershman says, adding that acupuncture is safe.
Side effects were limited to minimal bruising.
Acupuncture May Become the Standard of Care
“I think this study will have a practice-changing impact for women with breast cancer suffering from this terrible pain,” says Jun J. Mao, MD, chief of the integrative medicine service at Memorial Sloan Kettering Cancer Center in New York City. Dr. Mao was not involved in the study. “True acupuncture reduced pain overall greater than two points. That is hard to achieve with medication and other nondrug therapies for chronic pain.”
Mao says he usually recommends exercise to alleviate chronic joint pain, but that some women have difficulty starting because of the pain. Having acupuncture first to take the edge off may allow women to resume an exercise regimen, he says.
Insurance coverage for acupuncture varies widely. The treatment may cost from to 0 per session. But many more medical centers are offering acupuncture, Hershman says.
“I think there has been a real sea change in the oncology community,” she says. “We had no trouble finding sites all over the country that had acupuncturists. We hear routinely from people that some places have it incorporated into their cancer centers.”
Women interested in trying acupuncture to alleviate the side effects of aromatase inhibitors should look for a licensed acupuncturist, Hershman says. It may be helpful to contact the nearest cancer center to ask for a referral to a credible practitioner, she says. The methodology used for the study has been published so that acupuncturists can follow the specific protocol established by the study’s authors.
More work is needed to understand how acupuncture may help alleviate joint pain, Hershman says. The study authors collected blood samples from the participants and will begin looking for molecular changes that might explain how the therapy works.
Video: Acupuncture for Relief of Bone Pain from Breast Cancer Treatment
Best Arabic Tattoo Designs – Our Top 10
This set of routers will solve your Wi-Fi problems for good
Vitamin A Reviews
How to grow taller after puberty – Tips
How to Style Shoulder Length Hair
Save the Children unveils new campaign for 2011
Apparently Your Cuddling Style Can Say A LOT About Your Relationship
Read more about Sears downfall
This Next Fitness Star Finalist Ditched Law School to Become a Pilates Pro
How to Deal With a Moody Boss
5-Minute Workout: Tone Your Butt and Thighs
8 Surprising Reasons Youre Tired