Exercising Away the Pain from Cancer Meds

Breast cancer survivors taking aromatase inhibitors reduced joint pain with exercise

(RxWiki News) Aromatase inhibitors (AI) are medications that block production of estrogen, the hormone that feeds most breast cancers.

While wonderful at reducing the risk of breast cancer recurrence, about half of the women taking AIs experience joint pain. And for some of these women, the pain is so bad they stop taking their medicines.

A new study found that breast cancer survivors who consistently participated in a year-long supervised exercise program saw a considerable reduction in AI-related joint pain.

"Exercise often."

A team of researchers led by Melinda L. Irwin, PhD, MPH, associate professor of chronic disease epidemiology at the Yale School of Public Health and co-leader of the Cancer Prevention and Control Research Program at the Yale Cancer Center, evaluated exercise as a remedy for AI-induced joint pain and stiffness.

Aromatase inhibitors are given to postmenopausal women following primary breast cancer treatment. AIs include Arimidex (anastrozole), Aromasin (exemestane) and Femara (letrozole). Breast cancer survivors are supposed to take AIs for five years to cut the likelihood of the cancer returning.

This study looked at the impact of exercise on joint pain in 121 postmenopausal breast cancer survivors taking AIs. The women were randomly assigned to participate in a supervised exercise program or to usual care.

Exercisers were asked to engage in 150 minutes of moderate aerobic exercise such as walking and attend two sessions of resistance exercise sessions every week.

The researchers used a brief survey to measure joint pain at the beginning of the study. This survey was repeated at six and 12 months. The researchers also assessed the cardiovascular fitness of participants at the same intervals.

Women who attended 80 percent of the supervised sessions reported a 25 percent reduction in “worst pain” scores, while those who participated in less than 80 percent of the classes reported a 14 percent reduction in pain.

Among all the women, those who exercised saw a 20 percent decrease in pain after 12 months, compared to a 3 percent decrease in joint pain reported by women who were assigned to usual care.

Women who had a 5 percent improvement in cardiovascular fitness experienced a 29 percent decrease in worst pain scores, compared to a 7 percent decrease in worst pain scores seen in women whose cardiovascular fitness improved less than 5 percent.

According to the researchers, exercisers enjoyed these benefits regardless of age, cancer stage, treatment regimens and length of time they’d been taking AIs.

“This is one of the first studies to identify an approach — particularly a non-medical approach — that can effectively lower joint pain for these patients,” senior author Jennifer Ligibel, MD, of the Susan F. Smith Center for Women’s Cancers at Dana-Farber, said in a statement. “Exercise offers an attractive option for patients who want to continue taking these drugs but who are burdened by their side effects.”

These results did not surprise James Crowell, owner and head trainer of Integrated Fitness in Pittsburgh. "Exercise has so many positive effects on your body. It helps with blood flow, it helps your cardiovascular system, it helps your flexibility level, and it helps your strength level,” Crowell said.

“I have seen countless people add exercise to their daily activity and have major health improvements as well as a lessening in pain severity. I recommend that people begin with a program of exercise based around light strength training and flexibility training and couple in aerobic activity on top. When my clients do that without overdoing it they have wonderful results!" Crowell told dailyRx News.

Findings from this study were presented at 2013 San Antonio Breast Cancer Symposium.

This study was funded by the National Cancer Institute. No conflicts of interest were declared.

Research is considered preliminary before being published in a peer-reviewed journal.

Review Date: 
December 11, 2013