Acupuncture for treatment of joint pain secondary to aromatase inhibitor therapy in women with early breast cancer
Feasibility of use of acupuncture for treatment of arthralgia secondary to aromatase inhibitor therapy in women with early breast cancer
Royal Prince Alfred Hospital
30 participants
Jul 20, 2009
Interventional
Conditions
Summary
Breast cancer is most common cancer in women. Aproximately 75% of patients diagosed will have hormone receptor positive breast cancer. Tamoxifen has long been considered the gold standard for adjuvant therapy for postmenopausal women with endocrine sensitive early breast cancer. Aromatase inhibitors (AIs) are commonly used and are in fact superior in improving disease free survival. As a result, it is expected that in coming years the use of AIs in the current setting will increase dramatically. However, trials of AIs for breast cancer treatment have indicated that more than 40% of women taking AIs experience joint pain and stiffness which doesn't respond to conventional pain medication and may cause discontinuation of AI treatment. Acupuncture is one such alternative technique currentlyused for treating a variety of conditions including musculoskeletal pain. The analgesic mechanism of acupuncture is uncertain but it is speculated that analgesia may be mediated by release of opiod peptides and serotonin.
Eligibility
Inclusion Criteria3
- Early breast cancer patients taking thrid generaion aromatase inhibitor.
- Women with ongoing pain and/or stiffness in one or more joints which worsened after starting aromatase inhibitor.
- Baseline worst pain score on BPI-SF of 3 or greater (scale 0-10)
Exclusion Criteria6
- Previous use of acupuncture for Aromatase Inhibitor induced joint paint
- Severe concomitant illness or metastatic breast cancer
- Severe coagulopathy or bleeding disorder or dermatological disease within the acupuncture area (including patients on warfarin or low molecular weight heparin).
- Patients with cardiac pacemakers, defibrilator or any other implanted or topical electrical device.
- Needle phobia rendering a patient unable to receive acupuncture.
- Patients with intellectual or mental impairment
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Interventions
Acupuncture twice weekly for 6 weeks. The sites which will be used are L14, LI11, GB34, ST40, Du20, Shishencong and Baxie on Day 1(First Session) and GB21, ST36, TH5, SP6 and LIV3 on Day 2 (Second Session). In the treatment group the needles will be inserted with bilateral rotation until "de Qi" sensation is elicited. Electrical frequency will then be delivered over 2 to 10 Hz (as tolerated by the participant, 0.5 to 0.7 milliseconds duration pulse width for twenty minutes. Each session will take 30-60 minutes.
Locations(1)
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ACTRN12611000149965