Exercise improves joint pain caused by AI breast cancer drugs

Breast cancer patients suffering from joint pain caused by certain medications may improve with regular, long-term physical exercise, according to a new Yale-led study. The findings are being presented at the 2013 CTRC-AACR San Antonio Breast Cancer Symposium.

The Yale team studied 121 post-menopausal women diagnosed with hormone receptor-positive breast cancer who were undergoing treatment with aromatase inhibitor (AI) drugs, which block estrogen production and activity. All reported experiencing at least mild joint pain, and many described their pain as the “worst” they had experienced. As many as half of all patients taking AIs experience joint pain and stiffness, known as arthralgia, and this is the most common reason they stop taking the drugs.

In the Yale-led study, 61 of the women engaged in twice-a-week supervised resistance training and were advised to increase their moderate intensity aerobic exercise to 2.5 hours a week, either at the gym or on their own. Their “worst pain” scores decreased by as much as 30%, and overall joint pain severity also decreased significantly. The exercise also favorably impacted body weight and cardiorespiratory fitness.

“AIs are incredibly effective in lowering breast cancer recurrence and mortality risk,” said lead author Melinda Irwin, associate professor of public health and co-leader of the cancer prevention and control research program of Yale Cancer Center. “But too many women are choosing not to take these medications or are stopping them early because of the joint pain,” Irwin added. “Our study showed that exercise can improve this joint pain, and in turn, may improve adherence to the medication. Exercise also improves quality of life and is associated with lower risk of recurrence and mortality.”

The researchers write that further research may help determine whether exercise leads to increased adherence to AI therapy and potentially better outcomes in women with breast cancer.

Other authors are Brenda Cartmel, Dr. Cary Gross, Elizabeth Ercolano, Martha Fiellin, Scott Capozza, Marianna Rothbard, Yang Zhou, Maura Harrigan, and Dr. Tara Sanft of Yale; Kathryn Schmitz of the University of Pennsylvania; Dr. Tuhina Neogi of Boston University; Dr. Dawn Hershman of Columbia University; and senior author Dr. Jennifer Ligibel of the Dana-Farber Cancer Institute.

The study was funded by the National Cancer Institute.

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