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

Abstract

a b s t r a c tBackground: Patients with breast cancer (BC) show strong interest in complementary and alternative medicine (CAM), particularly for adverse effects of adjuvant endocrine treatment d 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 receptorepositive 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.

Systematic Review on the Search and Effectiveness of Integrative and Complementary Medicine Practices in Different Areas of Conventional Medicine

“…With regard to other medical specialties that make use of integrative medicine, a great search for complementary techniques occurs on the part of obese patients. These data corroborate other studies, which report findings on the limitations of conventional (CARLSON, et al, 2017); (LOPEZ, et al, 2018); (MILBURY, et al, 2020); (DENG, et al, 2018); (YOON, et al, 2019); (GARCIA, et al, 2021); (LU, et al, 2016); (SUN, MAO, LIU, YANG, & HE, 2020); (SHAO, et al, 2021); (WANG, YANG, FAN, & PEI, 2021); (McQUADE, et al, 2017); (LIMA, et al, 2021); (HACK, et al, 2020).…”

Transiently Expressed Mistletoe Lectin II in Nicotiana benthamiana Demonstrates Anticancer Activity In Vitro

“…Cancer treatment typically includes surgery, chemotherapy and/or radiotherapy, and more recently immunotherapy [5][6][7]. Despite major improvements over the years in cancer therapy and early diagnosis, cancer patients still opt for complementary treatment to reduce the pain associated with conventional therapies and to increase their quality of life [8,9]. It has been reported that more than 50% of cancer patients use complementary treatment [10].…”

Current and future advances in practice: aromatase inhibitor–induced arthralgia

“…One study reported significant improvement in pain with massaging topical oil onto affected joints [ 62 ]. However, a study that looked at the effect of all CAM treatments, not a particular treatment, did not find any difference in pain between the control and CAM groups [ 65 ].…”