Acupuncture improves quality of life for breast cancer patients taking aromatase inhibitors (AIs)

Electroacupuncture (EA) produces significant improvements in fatigue, anxiety, and depression in as little as 8 weeks for patients with early stage breast cancer experiencing joint pain related to the use of aromatase inhibitors (AIs) to treat breast cancer. EA is a form of acupuncture where a small electric current is passed between pairs of acupuncture needles. This randomized, placebo-controlled trial is the first demonstration of EA's efficacy for both joint pain relief, as well as these other common symptoms.

The results build upon earlier findings reported in November 2013 that showed that EA can decrease the joint pain reported by approximately 50% of breast cancer patients taking AIs. Aromatase inhibitors are the most-commonly prescribed medications to prevent disease recurrence among postmenopausal women with early stage, hormone-receptor positive breast cancer.

Despite their efficacy, the joint pain associated with the use of AIs often leads to fatigue, anxiety, depression, and sleep disturbances for these patients, which researchers suggest may cause premature discontinuation of the drug. Previous studies have shown that nearly half of women taking AIs do not complete their recommended course of treatment, and that those who stop taking the drugs or do not take them as prescribed have a higher chance of dying of both breast cancer and other causes.

"Since many patients experience pain, fatigue, anxiety, and depression simultaneously, our results provide an opportunity to offer patients one treatment that may target multiple symptoms," said lead author Jun Mao, MD, MSCE, associate professor of Family Medicine and Community Health in the University of Pennsylvania's Perelman School of Medicine, who directs the Integrative Oncology program in the Abramson Cancer Center in Philadelphia. "We see patients every day who are looking for ways to combat some of the side effects of their treatment. What is particularly significant about these new results is that we can now offer more evidence-based treatment and management solutions for these women."

In the 8-week trial, published in Cancer (2014; doi:10.1002/cncr.28917), researchers evaluated the short-term effects and safety of EA for AI-related joint pain and other side effects, compared with sham acupuncture (SA; a non-electric, placebo acupuncture where the needles are not actually inserted into the skin), and usual care. The study participants, who were all receiving AI therapy and experiencing joint pain, were randomly assigned to receive EA, SA, or usual care. Patient-reported experiences of fatigue and psychological distress, were measured prior to the study, and periodically throughout the duration, with additional follow-up 4 weeks after treatment.

The patients reported significant improvements in fatigue, anxiety, and depression, both during the 12-week treatment period and during the 4-week follow-up period.

"Our study provides a novel understanding of how fatigue, sleep, and psychological distress relate to pain in patients with AI-related joint pain. More importantly, we found that acupuncture helped reduce these symptoms and the effects persisted for at least 4 weeks following treatment," said Mao.

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