Aromatase inhibitors (AIs) - those drugs we love to hate Whether you’re taking Femara, Arimidex, or Aromasin, there’s a good chance you’re experiencing a common side effect, arthralgia - joint pain. Before you consider quitting these potential life-savers, though, make sure you’ve done everything you can to mitigate the discomfort.
Fact: At least half of the approximately 233,000 women diagnosed with invasive breast cancer each year are good candidates for an aromatase inhibitor, a hormone therapy drug used to help prevent recurrence.
Fact: About half of women taking an AI experience joint and/or muscle pain ranging from mild to severe.
Fact: Up to 40% of women taking an AI either discontinue the drug, or don’t take it as prescribed - chiefly due to its painful side effects. (Goodman, 2014)
If you’re one of the women described above, and are considering giving up on your AI - despite its proven benefit at reducing your risk of cancer - read on. There may be something you can do to reduce (if not eliminate) the pain you’re enduring.
If your pain is constant but fairly mild, acetaminophen (e.g., Tylenol) or ibuprofen (e.g., Motrin) might provide sufficient relief.
For more severe pain, your doctor might prescribe either of the two drugs above paired with something stronger, like codeine.
For short-term pain, or for new pain that doesn’t respond to milder drugs, ask your doctor about a corticosteroid (e.g., prednisone).
Surprisingly, certain antidepressants (Effexor, Cymbalta) have also been shown effective in combating AI-induced joint pain. While these drugs can come with their own side effects, they might be worth a try.
A study presented at the 2013 San Antonio Breast Cancer Symposium revealed that survivors taking an AI who followed a regular course of exercise for one year experienced a 30% decrease in worst pain; a 20% decrease in pain severity, and a 20% decrease in the amount of interference pain caused in their daily activities. In comparison, women in the study who didn’t exercise showed a 5% increase in each of those three areas. (Goodman, 2014)
While this was a relatively small study and bears repeating, we all know exercise is good for us; maintaining a healthy weight is one of the proven ways to reduce breast cancer risk. So if you’re experiencing AI pain, exercise can both help reduce that pain, and lower your risk of cancer recurrence. Win-win!
Omega-3 fatty acids are a natural inflammation reducer; thus, it follows that they might be effective in combating joint pain caused by an AI.
One study released last fall showed that 60% of women experiencing pain from an AI reported relief after taking an omega-3 supplement. Surprisingly, the study showed the same benefit in women NOT taking the supplement; which led the study authors to conclude that either there was a large placebo effect, or the placebo itself (soybean/corn oil) provided relief. Either way, though, taking an omega-3 supplement - think fish oil caplets - might just cut back on your pain.
This complementary therapy continues to gain acceptance in the medical community. A 2014 National Institutes of Health study showed women receiving acupuncture for 8 weeks reported noticeable reduction in their joint pain. Noted the study, "Compared to usual care, [acupuncture] produced clinically important and durable improvement in arthralgia related to AIs in breast cancer patients."
Goodman, Alice. “Exercise Program Reduces Aromatase Inhibitor-Associated Joint Pain.” The ASCO Post. March 1, 2014. Accessed February 28, 2015. http://www.ascopost.com/issues/march-1,-2014/exercise-program-reduces-aromatase-inhibitor-associated-joint-pain.aspx.
Marlow, Lacey. “Joint Resolution.” Cure, vol. 3, no. 3, October 1, 2014, p. 58.
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Breast cancer survivor and award-winning author PJ Hamel, a long-time contributor to the HealthCentral community, counsels women with breast cancer through the volunteer program at her local hospital. She founded and manages a large and active online survivor support network.
PJ Hamel is senior digital content editor and food writer at King Arthur Flour, and a James Beard award-winning author. A 16-year breast cancer survivor, her passion is helping women through this devastating disease. She manages a large and active online survivor support network based at her local hospital and shares her wisdom and experience with the greater community via HealthCentral.com.