Bone Pain Among Breast Cancer Survivors: Role for Exercise?

hand joint ache pain arthralgia

A new study included patients who were taking aromatase inhibitor drugs, such as Arimidex (anastrozole), Femara (letrozole) and Aromasin (exemestane). A year-long exercise program contributed to alleviation of pain among breast cancer survivors taking these “anti-estrogen” medicines.

“Our findings of exercise improving a common side effect may in turn improve compliance with the medicine, quality of life, and lower breast cancer recurrence and mortality chances,” offered Melinda L. Irwin, PhD, MPH of the Yale School of Public Health. “Arthralgia (bone pain) is the most common reason for drug discontinuation.”

The Study: The HOPE study evaluated 121 women (median age, 60 years) who scored 3 or higher on the Brief Pain Inventory, and were not exercising more than 90 minutes per week. They were randomly assigned to:

  • usual care or
  • an exercise program (twice weekly, supervised strength training sessions or 2.5 house per week of moderate intensity aerobic exercise.

At the end of the year-long study, women in the exercise group were exercising 159 minutes per week on average. The time women in the usual care group spent exercising increased slightly. Of the women in the exercise group, 70% attended the twice-weekly strength sessions, leading to a 7% increase in cardio-respiratory fitness, and a 3% change in body weight. There were no changes in the usual care group.

Results: Over 12 months, women in the control group reported slight decreases in their pain scores. However, women in the exercise group had a 30% decrease in worst pain, and a 20% decrease in pain severity (worst pain, least pain, pain now, and average pain), as well as the level they determined pain interfered with 8 standard activities. More adherent patients had greater decreases in pain. Those who lost weight did not see a decrease in joint pain.

My Take: We still don’t know if it is primarily aerobic exercise or resistance training (or both), but the improvement in pain linked to exercise appears to be better than that associated with other therapies (glucosamine; vitamin D; acupuncture). Unfortunately, studies suggest that 70% of more of cancer survivors are inactive. I’m Dr. Michael Hunter.

The small print: The material presented herein is informational only, and is not designed to provide specific guidance for an individual. Please check with a valued health care provider with any questions or concerns. As for me, I am a Harvard- , Yale- and UPenn-educated radiation oncologist, and I practice in the Seattle, WA (USA) area. I feel genuinely privileged to be able to share with you. If you enjoyed today’s offering, please consider clicking the follow button at the bottom of this page.

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Reference: Irwin MI, Cartmel B, Gross C, et al. Randomized trial of exercise vs. usual care on aromatase inhibitor-associated arthralgias in women with breast cancer. The hormones and physical exercise (HOPE) study. Presented at: the 36th Annual San Antonio Breast Cancer Symposium held December 10-14, 2013, San Antonio, TX. Abstract S3-03. – See more at: http://www.onclive.com/conference-coverage/sabcs-2013/Exercise-Reduces-Joint-Pain-in-Breast-Cancer-Patients-Treated-With-Aromatase-Inhibitors#sthash.icmtiElq.dpuf

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understandcancerin60minutes

Harvard AB Yale MD UPenn Radiation Oncology Radiation Oncologist, Seattle area

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