Regarding the side effects of aromatase inhibitors, there was a new study published this week. It concludes that electroacupuncture provides significant relief of fatigue, anxiety, and depression in patients currently taking this medication. You can read the abstract or full article here.
Research involved 67 post-menopausal breast cancer patients. Electroacupuncture treatment and placebo treatment were conducted alongside a control group for a period of 8 weeks. Self report on symptoms was collected throughout the study and a follow up period totaling 12 weeks.
The most common side effect of aromatase inhibitor usage is joint pain. Pain combined with alterations in hormone levels can lead to psychological distress.
Like tamoxifen, aromatase inhibitors are generally taken continuously for a five year period. Yet many patients discotninue use due to side effects, possibly leading to recurrence. Currently there are no Western medical treatment options for dealing with this issue.
Electroacupuncture and traditional acupuncture can both achieve these results. What is most important is that the patient be treated by an experienced acupuncturist who can needle accurately and maximize stimulation of the acupoints. Electroacupuncture simply reduces the need for accurate placement of needles, thus only improving results for less experienced practitioners.
Aromatase inhibitors induce joint pain through a sudden and persistent decrease in estrogen levels. Declining estrogen levels may directly cause pain through diminishing anti-nociceptive function or indirectly through an increase in systemic inflammatory factors(2). A good review article on aromatase inhibitors can be found here. In Chinese medical theory this can be classified as patterns of heat, yin deficiency, qi stagnation, or a combination pattern. It is important to remember that hormone receptor positive breast cancer is always classified as a heat pattern, thus treatments should use heat-clearing toxin removing methods.
When treating cancer we must attack the tumor while simultaneously keeping the patient as healthy and strong as possible. Both aspects of this balance are critical to treatment success and patient quality of life. Just as in the research mentioned above, if we are able to eliminate some of the discomfort associated with cancer treatments, we will increase patient compliance and further improve success rates.
Jun J. Mao, John T. Farrar, Deborah Bruner, Jarcy Zee, Marjorie Bowman, Christina Seluzicki, Angela DeMichele, Sharon X. Xie. Electroacupuncture for fatigue, sleep, and psychological distress in breast cancer patients with aromatase inhibitor-related arthralgia: A randomized trial. Cancer, 2014; DOI:10.1002/cncr.28917
Niravath, P. Aromatase inhibitor-induced arthralgia: a review. Ann Oncol, 2013); doi: 10.1093/annonc/mdt037