One of the most common side effects to cancer drugs, especially for those on aromatase inhibitors (Aromasin, Arimidex), is joint and muscle pain (arthralgias and myalgias). These drugs are commonly prescribed to women with breast cancer. While aromatase inhibitors are effective in reducing the risk of breast cancer recurrence, the side effects can be debilitating and have a significant impact on quality of life.
At the Annual San Antonio Breast Cancer Symposium, researchers presented an abstract on a randomized controlled trial assessing the impact of a year-long exercise program on pain in those on aromatase inhibitor therapy. Compared to the control group, the exercise group experienced a 20-30% reduction in pain scores.
Studies have also found vitamin D supplementation – when optimal serum levels are achieved prior to initiation of aromatase inhibitor therapy – significantly reduces bone pain, joint pain and overall pain. Another bonus: optimal vitamin D status (pre-treatment) reduces the risk of cancer recurrence and metastasis (spread of the disease).
In addition, acupuncture is a well-established complementary therapy for reducing many side effects of cancer drugs, including: joint and muscle pain, cancer-related fatigue, sleep disturbances and chemo-brain.
As I read the study on exercise impact on reducing the aromatase inhibitor induced pain, I thought “Great news, but what about those who can’t exercise because the pain becomes so severe?” In my clinical experience, when patients come to me on aromatase inhibitors or other cancer drugs causing pain, some are so debilitated by the pain that it prohibits any possibility of physical activity. Based on the research over the past 5-10 years, we can draw on the synergy of some complementary therapies – such as acupuncture, vitamin D and exercise. But if exercise isn’t a possibility, I recommend the following:
- Water movement – being suspended in water can help take the pressure off the feet, which are commonly affected
- Interventions that can simulate physical activity – such as infrared sauna therapy and acupuncture
Curcumin is a promising complementary therapy with its potent anti-cancer and anti-inflammatory properties. A liposomal form of curcumin (or turmeric) is the most bioavailable form of curcumin. There are some drug therapies that can interact with curcumin, therefore do not take this unless you are under the guidance of an integrative or naturopathic cancer physician.
Many women stop taking the aromatase inhibitors due to the debilitating pain and pain-induced depression. Any intervention that improves the side effect profile of cancer drugs and reduces the negative impact on quality of life – without interfering with the efficacy of standard therapy – improves compliance to drug therapy, thereby improving outcomes.
If you wish to learn more about Cancer Prevention and Integrative Cancer Care, please contact our care coordinators @604-949-0077 to book an appointment with Dr. Gurm.