Breast (Apr 2020)
Complementary and alternative medicine and musculoskeletal pain in the first year of adjuvant aromatase inhibitor treatment in early breast cancer patients
- C.C. Hack,
- L. Häberle,
- S.Y. Brucker,
- W. Janni,
- B. Volz,
- C.R. Loehberg,
- A.D. Hartkopf,
- C.-B. Walter,
- G. Baake,
- A. Fridman,
- W. Malter,
- R. Wuerstlein,
- N. Harbeck,
- O. Hoffmann,
- S. Kuemmel,
- B. Martin,
- C. Thomssen,
- H. Graf,
- C. Wolf,
- M.P. Lux,
- C.M. Bayer,
- C. Rauh,
- K. Almstedt,
- P. Gass,
- F. Heindl,
- T. Brodkorb,
- L. Willer,
- C. Lindner,
- H.-C. Kolberg,
- P. Krabisch,
- M. Weigel,
- D. Steinfeld-Birg,
- A. Kohls,
- C. Brucker,
- V. Schulz,
- G. Fischer,
- V. Pelzer,
- B. Rack,
- M.W. Beckmann,
- T. Fehm,
- A. Rody,
- N. Maass,
- A. Hein,
- P.A. Fasching,
- N. Nabieva
Affiliations
- C.C. Hack
- Department of Gynecology, Erlangen University Hospital, Friedrich Alexander University of Erlangen–Nuremberg, Comprehensive Cancer Center Erlangen-EMN, Erlangen, Germany
- L. Häberle
- Department of Gynecology, Erlangen University Hospital, Friedrich Alexander University of Erlangen–Nuremberg, Comprehensive Cancer Center Erlangen-EMN, Erlangen, Germany; Biostatistics Unit, Department of Gynecology, Erlangen University Hospital, Erlangen, Germany
- S.Y. Brucker
- Department of Gynecology, University of Tübingen, Tübingen, Germany
- W. Janni
- Department of Gynecology, Ulm University Hospital, Ulm, Germany
- B. Volz
- Department of Gynecology, Erlangen University Hospital, Friedrich Alexander University of Erlangen–Nuremberg, Comprehensive Cancer Center Erlangen-EMN, Erlangen, Germany
- C.R. Loehberg
- Department of Gynecology, Erlangen University Hospital, Friedrich Alexander University of Erlangen–Nuremberg, Comprehensive Cancer Center Erlangen-EMN, Erlangen, Germany; St. Theresien Hospital, Nuremberg, Germany
- A.D. Hartkopf
- Department of Gynecology, University of Tübingen, Tübingen, Germany
- C.-B. Walter
- Department of Gynecology, University of Tübingen, Tübingen, Germany
- G. Baake
- Oncological Medical Practice Pinneberg, Pinneberg, Germany
- A. Fridman
- Breast Center, Department of Obstetrics and Gynecology, University of Cologne Hospital, Cologne, Germany; Evangelisches Krankenhaus Kalk, Cologne, Germany
- W. Malter
- Breast Center, Department of Obstetrics and Gynecology, University of Cologne Hospital, Cologne, Germany
- R. Wuerstlein
- Breast Center, Department of Obstetrics and Gynecology, University of Cologne Hospital, Cologne, Germany; Breast Center, Department of Gynecology and Obstetrics and CCC Munich, University of Munich (LMU), Munich, Germany
- N. Harbeck
- Breast Center, Department of Obstetrics and Gynecology, University of Cologne Hospital, Cologne, Germany; Breast Center, Department of Gynecology and Obstetrics and CCC Munich, University of Munich (LMU), Munich, Germany
- O. Hoffmann
- Department of Gynecology, Essen University Hospital, Essen, Germany
- S. Kuemmel
- Breast Unit, Essen Mitte Clinics, Evang. Huyssens-Stiftung/Knappschaft GmbH, Essen, Germany
- B. Martin
- Tuttlingen Clinic, Tuttlingen, Germany
- C. Thomssen
- Department of Gynecology, Martin Luther University of Halle-Wittenberg, Halle (Saale), Germany
- H. Graf
- Helios Clinics Meiningen, Meiningen, Germany
- C. Wolf
- Ulm Medical Center, Ulm, Germany
- M.P. Lux
- Department of Gynecology, Erlangen University Hospital, Friedrich Alexander University of Erlangen–Nuremberg, Comprehensive Cancer Center Erlangen-EMN, Erlangen, Germany
- C.M. Bayer
- Department of Gynecology, Erlangen University Hospital, Friedrich Alexander University of Erlangen–Nuremberg, Comprehensive Cancer Center Erlangen-EMN, Erlangen, Germany
- C. Rauh
- Department of Gynecology, Erlangen University Hospital, Friedrich Alexander University of Erlangen–Nuremberg, Comprehensive Cancer Center Erlangen-EMN, Erlangen, Germany
- K. Almstedt
- Department of Gynecology, Erlangen University Hospital, Friedrich Alexander University of Erlangen–Nuremberg, Comprehensive Cancer Center Erlangen-EMN, Erlangen, Germany; Department of Gynecology, Mainz University Hospital, Mainz, Germany
- P. Gass
- Department of Gynecology, Erlangen University Hospital, Friedrich Alexander University of Erlangen–Nuremberg, Comprehensive Cancer Center Erlangen-EMN, Erlangen, Germany
- F. Heindl
- Department of Gynecology, Erlangen University Hospital, Friedrich Alexander University of Erlangen–Nuremberg, Comprehensive Cancer Center Erlangen-EMN, Erlangen, Germany
- T. Brodkorb
- Department of Gynecology, Erlangen University Hospital, Friedrich Alexander University of Erlangen–Nuremberg, Comprehensive Cancer Center Erlangen-EMN, Erlangen, Germany
- L. Willer
- Department of Gynecology, Erlangen University Hospital, Friedrich Alexander University of Erlangen–Nuremberg, Comprehensive Cancer Center Erlangen-EMN, Erlangen, Germany
- C. Lindner
- Agaplesion Diakonie Clinic Hamburg, Hamburg, Germany
- H.-C. Kolberg
- Department of Gynecology and Obstetrics, Marienhospital Bottrop, Bottrop, Germany
- P. Krabisch
- Department of Gynecology, Klinikum Chemnitz gGmbH, Chemnitz, Germany
- M. Weigel
- Department of Gynecology, Leopoldina Hospital Schweinfurt, Schweinfurt, Germany
- D. Steinfeld-Birg
- Gynecologic Onocologic Practice Steinfeld-Birg, Augsburg, Germany
- A. Kohls
- Protestant County Hospital of Ludwigsfelde-Teltow, Ludwigsfelde-Teltow, Germany
- C. Brucker
- Department of Gynecology and Obstetrics, Nuremberg General Hospital, Paracelsus Medical University, Nuremberg, Germany
- V. Schulz
- Gynecologic Practice Abts+partner, Kiel, Germany
- G. Fischer
- Mittweida Hospital gGmbH, Mittweida, Germany
- V. Pelzer
- Department of Gynecology, GFO Clinics Bonn, Bonn, Germany
- B. Rack
- Department of Gynecology, Ulm University Hospital, Ulm, Germany
- M.W. Beckmann
- Department of Gynecology, Erlangen University Hospital, Friedrich Alexander University of Erlangen–Nuremberg, Comprehensive Cancer Center Erlangen-EMN, Erlangen, Germany
- T. Fehm
- Department of Gynecology, University of Tübingen, Tübingen, Germany; Department of Gynecology, Heinrich Heine University of Dusseldorf, Dusseldorf, Germany
- A. Rody
- Department of Gynecology, Campus Lübeck, Schleswig-Holstein University Hospital, Schleswig-Holstein, Germany
- N. Maass
- Department of Gynecology, Campus Kiel, Schleswig-Holstein University Hospital, Schleswig-Holstein, Germany
- A. Hein
- Department of Gynecology, Erlangen University Hospital, Friedrich Alexander University of Erlangen–Nuremberg, Comprehensive Cancer Center Erlangen-EMN, Erlangen, Germany
- P.A. Fasching
- Department of Gynecology, Erlangen University Hospital, Friedrich Alexander University of Erlangen–Nuremberg, Comprehensive Cancer Center Erlangen-EMN, Erlangen, Germany; Corresponding author. Department of Gynecology, Erlangen University Hospital; University Breast Center for Franconia; Comprehensive Cancer Center Erlangen, European Metropolitan Area Nuremberg (CCC ER-EMN); Friedrich Alexander University of Erlangen-Nuremberg, Universitätsstrasse 21–23, 91054, Erlangen, Germany.
- N. Nabieva
- Department of Gynecology, Erlangen University Hospital, Friedrich Alexander University of Erlangen–Nuremberg, Comprehensive Cancer Center Erlangen-EMN, Erlangen, Germany
- Journal volume & issue
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Vol. 50
pp. 11 – 18
Abstract
Background: Patients with breast cancer (BC) show strong interest in complementary and alternative medicine (CAM), particularly for adverse effects of adjuvant endocrine treatment — e.g., with letrozole. Letrozole often induces myalgia/limb pain and arthralgia, with potential noncompliance and treatment termination. This analysis investigated whether CAM before aromatase inhibitor (AI) therapy is associated with pain development and the intensity of AI-induced musculoskeletal syndrome (AIMSS) during the first year of treatment. Patients and methods: The multicenter phase IV PreFace study evaluated letrozole therapy in postmenopausal, hormone receptor–positive patients with early BC. Patients were asked about CAM use before, 6 months after, and 12 months after treatment started. They recorded pain every month for 1 year in a diary including questions about pain and numeric pain rating scales. Data were analyzed for patients who provided pain information for all time points. Results: Of 1396 patients included, 901 (64.5%) had used CAM before AI treatment. Throughout the observation period, patients with CAM before AI treatment had higher pain values, for both myalgia/limb pain and arthralgia, than non-users. Pain increased significantly in both groups over time, with the largest increase during the first 6 months. No significant difference of pain increase was noted regarding CAM use. Conclusions: CAM use does not prevent or improve the development of AIMSS. Pain intensity was generally greater in the CAM group. Therefore, because of the risk of non-compliance and treatment discontinuation due to the development of higher pain levels, special attention must be paid to patient education and aftercare in these patients.
