Exercise can reduce drug-related joint pain in breast cancer patients, study shows

Women being treated with breast cancer drugs known as aromatase inhibitors can markedly ease the joint pain associated with the drugs by engaging in moderate daily exercise, Dana-Farber Cancer Institute and Yale University investigators report in a study to be presented during the San Antonio Breast Cancer Symposium.

The study, scheduled for presentation Thursday, Dec. 12, at 10:00 a.m. CT in San Antonio, Texas, involved 121 postmenopausal women who were taking aromatase inhibitors for breast cancer and who rated their joint pain as mild or greater on a standard pain-evaluation questionnaire. Sixty-one of them were randomly assigned to participate in two supervised strength training sessions a week and to engage in an average of 150 minutes of aerobic exercise a week. The others followed their normal daily activities.

After a year, joint pain scores decreased by 20 percent among the women in the exercise group and by 3 percent in the other group. The severity of joint pain also decreased significantly more in those who exercised than in those who didn't, as did the degree to which pain interfered with their lives.

"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," says the study's senior author, Jennifer Ligibel, MD, of the Susan F. Smith Center for Women's Cancers at Dana-Farber. "Exercise offers an attractive option for patients who want to continue taking these drugs but who are burdened by their side effects."

Aromatase inhibitors are recommended for all postmenopausal women with breast cancer categorized as hormone receptor-positive, meaning the cancer cells grow and divide in response to estrogen. The drugs, which prevent other hormones from being converted into estrogen, can reduce the risk of a cancer recurrence.

"Joint pain, or arthralgia, which occurs in up to half of breast cancer patients who take aromatase inhibitors, is one of the major drawbacks of these drugs," Ligibel states. "The pain leads many to discontinue the drugs, which can increase the chance that the cancer will return. Identifying a way to help women tolerate these drugs is a very important finding."

The lead author of the study is Melinda Irwin, PhD, MPH, who leads the Yale HOPE (Hormone & Physical Exercise) Study, which recruited the participants in the current study. Co-authors are Brenda Cartmel, PhD, Cary Gross, MD, Elizabeth Ercolano, RN, DNSc, Martha Fiellin, Scott Capozza, Marianna Rothbard, Yang Zhou, PhD, Maura Harrigan, MS, RD, and Tara Sanft, MD, of Yale; Kathryn Schmitz, PhD, MPH, of the University of Pennsylvania; Tuhina Neogi, MD, PhD, of Boston University; and Dawn Hershman, MD, MS, of Columbia University.

This study was funded by the National Cancer Institute.