Find A Physician

Return to For Breast Cancer Patients, Acupuncture Relieves Pain Overview

More on For Breast Cancer Patients, Acupuncture Relieves Pain

Research and Clinical Trials

Return to For Breast Cancer Patients, Acupuncture Relieves Pain Overview

More on For Breast Cancer Patients, Acupuncture Relieves Pain

For Breast Cancer Patients, Acupuncture Relieves Pain

Study Finds Ancient Remedy Relieves Joint Pain Brought On By Modern Cancer Medicines

New York (Aug 23, 2010)

practitioner's hands insert acupuncture needle in woman's ear

Aromastase inhibitors (AIs) are effective treatments for breast cancer, however, nearly half of women taking these medications experience joint pain and stiffness. These side effects can have a major impact on a woman's quality of life and compliance with these life-saving medications. New research from NewYork-Presbyterian Hospital suggests that acupuncture may help alleviate these joint symptoms and allow more women to complete their treatment course.

Treatment with acupuncture (twice weekly for 6 weeks) was linked to an approximately 50% reduction in joint pain and stiffness scores while sham acupuncture was linked to no change in this study, explained senior author Dawn L. Hershman, M.D., the Co-Director of the Breast Cancer Program of the Herbert Irving Comprehensive Cancer Center at NewYork-Presbyterian/Columbia University Medical Center. The study is the first randomized, controlled trial of any intervention for the management of AI-induced joint symptoms. The findings were published in the March issue of the Journal of Clinical Oncology (vol 28; no 20: 1154-1160).

graphic of quote from article

Long-term treatment with AIs is the standard of care for post-menopausal women with breast cancer. "We know that these treatments are very effective for curing breast cancer and preventing a recurrence," said first author of the study Katherine Crew, M.D., an Assistant Attending Physician at NewYork-Presbyterian/Columbia University Medical Center. However, "adherence to these hormonal therapies is quite poor in the general population," she explained. A previous study by Dr. Hershman and colleagues showed that up to 50% of women do not complete their full 5 years of AI therapy – a rate that is significantly higher than that was reported in previous studies.

Dawn L. Hershman, M.D.
Dawn L. Hershman, M.D.

In addition, the researchers previously found that the prevalence of joint symptoms in women taking AIs is much higher than previously thought, with rates of 44% in a survey of 200 consecutive women taking AIs at their clinic. The pain is severe in approximately 30%, said Dr. Crew.

How the Study Worked

The current study involved 38 women who were randomized to true acupuncture or sham acupuncture. True acupuncture was designed specifically for women with joint symptoms related to arthritis and included ear acupuncture points that have been shown to decrease stress. Sham treatment consisted of insertion of acupuncture needles in non-acupuncture points on the body.

Katherine Crew, M.D.
Katherine Crew, M.D.

Worst pain scores at 6 weeks (on a scale of 0-10 with 10 being most severe) were significantly lower in the true acupuncture group than in the sham group (3.0 vs. 5.5; P<.001). Pain severity scores also were significantly lower in the acupuncture group (2.6 vs. 4.5; P<.003) as was the impact of pain-related interference on activities of daily living (2.5 vs. 4.5; P=.002) at six weeks. Acupuncture was well tolerated with approximately two thirds of women reporting that the treatment was at least moderately relaxing and enjoyable, 74% wanting to continue treatments, and 59% willing to pay for acupuncture.

Doctors Optimistic

"This is a very exciting study and is the first randomized trial of an intervention for AI-associated joint pain," commented Tessa Cigler, M.D., a Medical Oncologist and Clinical Investigator at the Weill Cornell Breast Center at NewYork-Presbyterian/Weill Cornell Medical Center. "The results from the study are promising and I hope they will prompt further and larger studies," she said, adding that a strength of the study is the use of a placebo treatment (sham acupuncture). "This placebo arm is sometimes lacking in trials of complementary and alternative medicine," she said.

Tessa Cigler, M.D., M.P.H.
Tessa Cigler, M.D.,
M.P.H.

While the study was not designed to measure the treatment efficacy after 6 weeks, Dr. Hershman said that many women chose to continue acupuncture on their own. The center has an acupuncturist on staff with whom women can schedule appointments.

Other Complementary and Alternative Therapies

"We have a lot of interest in doing research in wellness in this area. Studies have shown that 80% of women with breast cancer use some form of complementary and alternative medicine, but there is very little research to show that these treatments are effective. A major interest of ours is looking at various different supplements and modalities to see if they reduce adverse symptoms from cancer treatment," said Dr. Hershman. The researchers have several ongoing studies examining the effects of glucosamine chondroitin and omega-3 fatty acids in the treatment of AI-induced joint symptoms.

graphic of quote from article

Researchers at NewYork-Presbyterian/Columbia also are involved in studying the effects of acetyl-L-carnitine (ALCAR) in the treatment of chemotherapy-induced neuropathy, green tea extract for the secondary prevention of breast cancer, and high-dose vitamin D in women at high risk for breast cancer. Patients who are interested in enrolling in these trials or seeking treatment at the Herbert Irving Comprehensive Cancer Center can call (212) 305-8615.

At NewYork-Presbyterian/Weill Cornell, Dr. Cigler and colleagues conducted a study in collaboration with the rheumatology department at the Hospital for Special Surgery designed to better characterize these AI-associated joint pain and musculoskeletal symptoms. "Although these symptoms are very common, their etiology is not understood," she said. "Our group attempted to characterize these symptoms clinically and radiographically through physical examination findings by a rheumatologist, grip strength measurement, blood test and magnetic resonance imaging (MRI). "I think the results of our study complement ongoing studies such as the one by Drs. Crew and Hershman in that our findings might offer objective endpoints to look at when assessing improvement in terms of AI-induced musculoskeletal symptoms," she said.

Dr. Cigler and colleagues also are investigating use of the amino acid glutamine as a treatment for neuropathy associated with use of taxane chemotherapy. This placebo-controlled trial is ongoing and patients can enroll in it by contacting the Weill Cornell Breast Center at (212) 821-0644.

Contributing faculty for this article:

Tessa Cigler, M.D., M.P.H., is a Medical Oncologist and Clinical Investigator at the Weill Cornell Breast Center at NewYork-Presbyterian Hospital/Weill Cornell Medical Center and an Assistant Professor of Medicine at Weill Cornell Medical College.

Katherine Crew, M.D., is an Assistant Attending Physician at NewYork-Presbyterian Hospital/Columbia University Medical Center and an Assistant Professor of Medicine and Epidemiology at Columbia University College of Physicians and Surgeons.

Dawn L. Hershman, M.D., is the Co-Director of the Breast Cancer Program of the Herbert Irving Comprehensive Cancer Center at NewYork-Presbyterian Hospital/Columbia University Medical Center and an Associate Professor of Medicine and Epidemiology at Columbia University College of Physicians and Surgeons.

  • Bookmark
  • Print

    Find a Doctor

Click the button above or call
1 877 NYP WELL


eNewsletters

Newsroom



Top of page