From Oncology 2022 Nov 11: "Acupuncture Reduces Aromatase Inhibitor-Related Joint Pain"

[Hazelgreen]

Although this study used early breast cancer patients, I assume the findings would also apply to MBC patients...

Importance : "Aromatase inhibitors (AIs) have proven efficacy for the treatment of hormone-sensitive breast cancer; however, arthralgias (pain and stiffness) contribute to nonadherence with therapy for more than 50% of patients."

Objective : "To examine the effect of acupuncture in reducing AI-related joint pain through 52 weeks."

Design, Setting, and Participants : "A randomized clinical trial was conducted at 11 sites in the US from May 1, 2012, to February 29, 2016, with a scheduled final date of follow-up of September 5, 2017, to compare true acupuncture (TA) with sham acupuncture (SA) or waiting list control (WC). Women with early-stage breast cancer were eligible if they were taking an AI and scored 3 or higher on the Brief Pain Inventory Worst Pain (BPI-WP) item (score range, 0-10; higher scores indicate greater pain). Analysis was conducted for data received through May 3, 2021.

Interventions : "Participants were randomized 2:1:1 to the TA (n = 110), SA (n = 59), or WC (n = 57) group. The TA and SA protocols were composed of 6 weeks of intervention at 2 sessions per week (12 sessions overall), followed by 6 additional weeks of intervention with 1 session per week. Participants randomized to WC received no intervention. All participants were offered 10 acupuncture sessions to be used between weeks 24 and 52."

Main Outcomes and Measures : "In this long-term evaluation, the primary end point was the 52-week BPI-WP score, compared by study group using linear regression, adjusted for baseline pain and stratification factors."

Results : "Among 226 randomized women (mean [SD] age, 60.7 [8.6] years; 87.7% White; mean [SD] baseline BPI-WP score, 6.7 [1.5]), 191 (84.5%) completed the trial. In a linear regression, 52-week mean BPI-WP scores were 1.08 (95% CI, 0.24-1.91) points lower in the TA compared with the SA group (P = .01) and were 0.99 (95% CI, 0.12-1.86) points lower in the TA compared with the WC group (P = .03). In addition, 52-week BPI pain interference scores were statistically significantly lower in the TA compared with the SA group (difference, 0.58; 95% CI, 0.00-1.16; P = .05). Between 24 and 52 weeks, 12 (13.2%) of TA, 6 (11.3%) of SA, and 5 (10.6%) of WC patients reported receipt of acupuncture.

Conclusions and Relevance : "In this randomized clinical trial, women with AI-related joint pain receiving 12 weeks of TA had reduced pain at 52 weeks compared with controls, suggesting long-term benefits of this therapy."

[bikebabe]

very interesting - thank you for highlighting

[Contrarielle]

Thanks for sharing- I certainly had lots of joint aches/ stiffness on aromatase inhibitors. Good to hear of something helpful

[love2golfwell]

Thank you again for sharing the information you found. I have not done acupuncture but would definitely consider it if I was having too much stiffness or joint pain. I have been having a little more stiffness in the mornings than I used to have but find that getting some exercise and using an essential oil blend for pain seem to help for now.

[mariootsi]

My cancer center won't institute acupuncture! I have been working on getting it as part of treatment for years. They tell me they can't do it financially! I can't afford it on my own. Medicare doesn't cover it!

[Hazelgreen in reply to mariootsi]

I've yet to mention it at my cancer clinic in Canada. Since we have socialized medicine with everyone needing to be treated similarly, I doubt whether it can be made available. My guess is that I'll only be offered pain medication since I was already given a prescription for that when I was first seen. However, I do intend to ask about it. It is possible that it may be less expensive here in any case as we have a fairly large Chinese community who may use it.

[mariootsi in reply to Hazelgreen]

I really don't think it is a question of finance here. I think there may be other reasons. They would rather keep their pain docs working giving out pills! I can't take them!

[Hazelgreen in reply to mariootsi]

I prefer to avoid pain meds if I can manage without them. It seems to me that there may come a day when I have no other choice.

I appreciate your being a bit cynical about the reasoning behind the choices we are offered. It is a sad reflection on modern societies when money drives decisions.

[mariootsi in reply to Hazelgreen]

Yes it is

[Sparky95]

I have used acupuncture for years to combat the impact of the AI joint pain. So glad to hear that this has been proven. I continue to use acupuncture to treat my pain and don’t think I would do as well as I do without it.

[MaryCos]

There is also research that says that tart cherry extract helps. I've been doing capsules of it every day for about 6 months or so. Helps ME!

[Hazelgreen in reply to MaryCos]

Healthline has an article titled, "10 Health Benefits of Tart Cherry Juice". It concludes, "Tart cherry juice may also provide the benefits listed above. However, more studies are needed before strong conclusions can be made."

If it works for you, it seems an easy way to get the benefits. However, Healthline also noted, "Safety, dosage and timing instructions : "If you’re interested in the benefits of tart cherry juice, you may want to follow dosage instructions similar to those used in the studies above. Specifically, most of the studies that observed benefits gave participants two daily 8-ounce (240-ml) doses of the juice. This is believed to be the equivalent of consuming around 200 tart cherries each day (24Trusted Source).

Regarding tart cherry juice powder, studies using powdered supplements typically used around 480 mg per day. Benefits were mostly observed following 7–10 days of supplementing. Additionally, this juice is safe for most people, though it contains high amounts of sorbitol — a type of sugar alcohol that can cause stomach pain and diarrhea for some. Tart cherry juice also contains quercetin, a plant compound that may interact with certain medications, particularly blood thinners. Individuals on medications should consult a doctor before adding large amounts of tart cherry juice to their diet."

[MaryCos in reply to Hazelgreen]

At the last LBBC conference, it was recommended by Dr. Dizon -- in response to questions about side effects of meds. That is when I started using it. I have nothing more to say on the matter, other than I cleared it with my oncologist... and I use it daily.

[mariootsi]

Yes. Many of these natural remedies interact with meds or interfere with absorption.

[PJBinMI]

I've been on Celebrex for arthritis in an injured wrist and it helps with this joint pain from AIs. I found that out when I had to skip the Celebrex for several days early in my MBC journey.