After breast cancer treatment, many women are prescribed aromatase inhibitors* to prevent recurrence of estrogen sensitive tumors. These drugs can cause joint pain that leads many women to stop using them, thus increasing their risk of a recurrence. It is surprising to find that a drug company has sponsored research on natural nutrient supplementation with glucosamine and chondroitin for the relief of aromatase inhibitor related joint pain.
Results of the study** show that combined use of glucosamine and chondroitin are of benefit to breast cancer patients experiencing joint pain and stiffness related to the use of aromatase inhibitors.
Additional common side effects of these drugs include hot flashes, sleep disruption, depression and bone loss. These side effects are not relieved by glucosamine and chondroitin therapy which targets only joint linings, cartilage and connective tissues including tendons and ligaments.
The most recent study by Dr. Heather Greenlee of Columbia University, New York focused postmenopausal breast cancer patients without metastatic disease who had been on aromatase therapy for at least three months, who reported a pain rating of 4 or higher on a 10-point scale, and whose pain worsened after initiating treatment with aromatase inhibitors if they had preexisting osteoarthritis.
Studies*** have also shown that supplementation with Vitamin D is very effective in relieving joint and bone pain associated with aromatase inhibitor side effects. In my practice I have observed patients enjoy significant pain relief with Vitamin D supplementation. Low Vitamin D levels are also linked to more aggressive breast cancers.
Acupuncture is also very effective in relieving joint pain caused by aromatase inhibitors and is also used to treat a wide array of cancer treatment side effects including hot flashes, nausea and insomnia.
Natural aromatase inhibitors include resveratrol and chrysin. Natural aromatase inhibitors are mild and do not produce the same number or intensity of side effects. Oncologists do not recommend natural aromatase inhibitors as there are no formal studies supporting their use. However, many women who cannot tolerate the side effects of drugs turn to alternatives to get both relief and protection.
Participants in Dr. Greenlee's study were a diverse group of ethnicities and on the average 3.5 years post breast cancer treatment. Each woman took 1,500 mg/day of glucosamine and 1,200 mg/day of chondroitin, and were evaluated every six weeks for 40 weeks.
According to Dr. Greenlee, "There was a drop in pain and stiffness in the hips and knees at 12 and 24 weeks, as well as improvement in function affecting about 50 percent of the women. We saw a very similar pattern looking at the hands and the wrist. We saw similar results with about 35 percent to 50 percent of women." Although the results were modest, because glucosamine and chondroitin are considered safe, women with joint pain are advised to discuss their use to manage aromatase associated pain with their physicians.
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These statements have not been evaluated by the Food and Drug Administration and are not intended to diagnose, treat, cure or prevent any disease. You should always speak with your physician or other healthcare professional before taking any medication or nutritional, herbal or homeopathic supplement or adopting any treatment for a health problem.
Aromatase inhibitors stop the production of estrogen in post-menopausal women. Aromatase inhibitors work by blocking the enzyme aromatase, which turns the hormone androgen into small amounts of estrogen in the body resulting in less estrogen is available to stimulate the growth of estrogen receptor-positive breast cancer cells. Aromatase inhibitors do not stop the ovaries from making estrogen, therefore aromatase inhibitors are used only in post-menopausal women.
**This study was presented Nov. 10, 2011 at the 8th International Conference of the Society for Integrative Oncology: Presented Nov. 10, 2011
*** EPIDEMIOLOGY Vitamin D threshold to prevent aromatase inhibitor-induced arthralgia: a prospective cohort study.
"Breast Cancer Research and Treatment." Volume 125, Number 3, 869-878, DOI: 10.1007/s10549-010-1075-9 Daniel Prieto-Alhambra, M. Kassim Javaid, Sonia Servitja, Nigel K. Arden, Maria Martinez-García, Adolfo Diez-Perez, Joan Albanell, Ignasi Tusquets and Xavier Nogues