Complementary and alternative medicine and musculoskeletal pain in the first year of adjuvant aromatase inhibitor treatment in early breast cancer patients

Hack C, Häberle L, Brucker SY, Janni W, Volz B, Löhberg C, Hartkopf AD, Walter CB, Baake G, Fridman A, Malter W, Wuerstlein R, Harbeck N, Hoffmann O, Kuemmel S, Martin B, Thomssen C, Graf H, Wolf C, Lux MP, Bayer CM, Rauh C, Almstedt K, Gaß P, Heindl F, Brodkorb T, Willer L, Lindner C, Kolberg HC, Krabisch P, Weigel M, Steinfeld-Birg D, Kohls A, Brucker C, Schulz V, Fischer G, Pelzer V, Rack B, Beckmann M, Fehm T, Rody A, Maass N, Hein A, Fasching P, Nabieva N (2020)

Publication Type: Journal article

Publication year: 2020

Journal

Book Volume: 50

Pages Range: 11-18

DOI: 10.1016/j.breast.2019.12.017

Abstract

Background: Patients with breast cancer (BC) show strong interest in complementary and alternative medicine (CAM), particularly for adverse effects of adjuvant endocrine treatment — e.g., with letrozole. Letrozole often induces myalgia/limb pain and arthralgia, with potential noncompliance and treatment termination. This analysis investigated whether CAM before aromatase inhibitor (AI) therapy is associated with pain development and the intensity of AI-induced musculoskeletal syndrome (AIMSS) during the first year of treatment. Patients and methods: The multicenter phase IV PreFace study evaluated letrozole therapy in postmenopausal, hormone receptor–positive patients with early BC. Patients were asked about CAM use before, 6 months after, and 12 months after treatment started. They recorded pain every month for 1 year in a diary including questions about pain and numeric pain rating scales. Data were analyzed for patients who provided pain information for all time points. Results: Of 1396 patients included, 901 (64.5%) had used CAM before AI treatment. Throughout the observation period, patients with CAM before AI treatment had higher pain values, for both myalgia/limb pain and arthralgia, than non-users. Pain increased significantly in both groups over time, with the largest increase during the first 6 months. No significant difference of pain increase was noted regarding CAM use. Conclusions: CAM use does not prevent or improve the development of AIMSS. Pain intensity was generally greater in the CAM group. Therefore, because of the risk of non-compliance and treatment discontinuation due to the development of higher pain levels, special attention must be paid to patient education and aftercare in these patients.

Authors with CRIS profile

Involved external institutions

HELIOS Kliniken Germany (DE) Universität zu Köln Germany (DE) Eberhard Karls Universität Tübingen Germany (DE) Kliniken Essen-Mitte Germany (DE) Klinikum Landkreis Tuttlingen Germany (DE) Martin-Luther-Universität Halle-Wittenberg (MLU) Germany (DE) Universitätsklinikum Essen Germany (DE) Universitätsklinikum Ulm Germany (DE) Universitätsklinikum Schleswig-Holstein (UKSH) Germany (DE) Klinikum Chemnitz Germany (DE) Marienhospital Bottrop Germany (DE) Evangelisches Krankenhaus Ludwigsfelde-Teltow Germany (DE) Paracelsus Medizinische Privatuniversität, Nürnberg Germany (DE) Leopoldina Krankenhaus Schweinfurt Germany (DE) Landkreis Mittweida Krankenhaus Germany (DE) GFO Kliniken Bonn Germany (DE) Agaplesion Diakonieklinikum Hamburg Germany (DE)

How to cite

APA:

Hack, C., Häberle, L., Brucker, S.Y., Janni, W., Volz, B., Löhberg, C.,... Nabieva, N. (2020). Complementary and alternative medicine and musculoskeletal pain in the first year of adjuvant aromatase inhibitor treatment in early breast cancer patients. BREAST , 50, 11-18. https://doi.org/10.1016/j.breast.2019.12.017

MLA:

Hack, Caroline, et al. "Complementary and alternative medicine and musculoskeletal pain in the first year of adjuvant aromatase inhibitor treatment in early breast cancer patients." BREAST 50 (2020): 11-18.

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