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Kim S, Chen N, Reid P. Current and future advances in practice: aromatase inhibitor-induced arthralgia. Rheumatol Adv Pract 2024; 8:rkae024. [PMID: 38601139 PMCID: PMC11003819 DOI: 10.1093/rap/rkae024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Accepted: 01/19/2024] [Indexed: 04/12/2024] Open
Abstract
Aromatase inhibitors (AIs) have shown great success as adjuvant therapy for post-menopausal women with hormone receptor-positive breast cancers. AI-induced arthralgia (AIA) is a frequent AI toxicity contributing to non-adherence and discontinuation. This review aims to understand current knowledge of AIA. The mean incidence of AIA was 39.1% and the mean discontinuation of AI therapy due to AIA was 9.3%. Most of the AIAs were non-inflammatory. A shorter time since the last menstrual period and pre-existing joint pain were risk factors. Vitamin D3 supplementation may be a preventative measure and treatment with duloxetine, acupuncture and/or exercise is supported by large randomized controlled trials. There was consistent improvement in AIAs with switching to an alternate AI, and this could additionally allow continuation of cancer treatment with AI. Further research is needed to identify predictive biomarkers, better characterize AIA subcategories and study more reliable therapeutic options.
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Affiliation(s)
- Sara Kim
- Department of Medicine, University of Chicago, Chicago, IL, USA
| | - Nan Chen
- Division of Hematology and Oncology, Department of Medicine, University of Chicago, Chicago, IL, USA
| | - Pankti Reid
- Division of Rheumatology, Department of Medicine, University of Chicago, Chicago, IL, USA
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Giridharan S, Kumar NV. Bibliometric Analysis of Randomized Controlled Trials on Yoga Interventions for Cancer Patients: A Decade in Review. Cureus 2024; 16:e58993. [PMID: 38800314 PMCID: PMC11127709 DOI: 10.7759/cureus.58993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/25/2024] [Indexed: 05/29/2024] Open
Abstract
This literature review presents a bibliometric analysis of the randomized controlled trials conducted between 2014 and 2023 on the potential benefits of yoga as a complementary therapy for cancer patients. To conduct this analysis, we searched medical and scientific databases, such as Scopus, Cochrane, and PubMed, using relevant keywords. Our search yielded 58 clinical trials involving 4,762 patients, which indicates a growing trend in this field of research. The studies we reviewed mainly focused on breast cancer patients and demonstrated the adaptability and versatility of yoga, offering a ray of hope and optimism. Among the various styles of yoga, Hatha yoga was the most frequently practiced style in these clinical trials. The analysis we conducted reveals that yoga interventions have a promising role in cancer care and can be a valuable complementary therapy for cancer patients. However, significant gaps and limitations still need to be addressed in this area of research. For instance, more rigorous and diverse investigations are needed to further establish the potential benefits of yoga interventions for cancer patients. Additionally, the standardization of yoga interventions is crucial to optimize therapeutic benefits. By addressing these gaps and limitations, we can further enhance the potential of yoga as a complementary therapy for cancer patients.
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Giridharan S, Ansari J. Efficacy and Safety of Laughter Yoga in Cancer Patients: A Scoping Review of Randomized Controlled Trials. Cureus 2024; 16:e59163. [PMID: 38803758 PMCID: PMC11129871 DOI: 10.7759/cureus.59163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2024] [Accepted: 04/26/2024] [Indexed: 05/29/2024] Open
Abstract
The use of laughter yoga as a complementary and alternative medicine (CAM) strategy has recently gained interest as a potential supportive intervention for cancer patients. In this review, we aimed to assess the impact of laughter yoga on the quality of life of cancer patients, with a focus on evidence from randomized controlled trials (RCTs). Our analysis indicates that laughter yoga can significantly improve the quality of life of cancer patients by improving emotional and physical functioning and reducing symptoms of depression and stress. These findings suggest that laughter yoga is a promising CAM practice for enhancing cancer patients' psychological and physical health. Future research should aim to extend these studies to more extensive and more diverse populations to validate and expand upon these findings.
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Li H, Schlaeger JM, Patil CL, Danciu O, Chen Z, Lif N, Gao S, Doorenbos AZ. Feasibility of implementing acupuncture in medically underserved breast cancer survivors (FAB): A protocol. Contemp Clin Trials 2024; 136:107387. [PMID: 37972754 PMCID: PMC10922295 DOI: 10.1016/j.cct.2023.107387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 10/24/2023] [Accepted: 11/04/2023] [Indexed: 11/19/2023]
Abstract
Nearly 94% of breast cancer survivors experience one or more symptoms or side effects during or after endocrine therapy. Joint pain, hot flashes, sleep disturbance, fatigue, depression, and anxiety are the most common concurrent symptoms, some of which can persist for 5 to 10 years. Acupuncture is a holistic modality that addresses multiple symptoms and side effects in a single therapy. Acupuncture has not yet been investigated for its effectiveness in treating the multiple symptoms experienced by breast cancer survivors receiving endocrine therapy. Medically underserved breast cancer survivors typically have limited access to acupuncture. The barriers limiting access to acupuncture need to be removed to enable equal access to breast cancer survivors for this evidence-based treatment. Thus, we developed a randomized controlled trial with a 5-week acupuncture intervention versus usual care for medically underserved breast cancer survivors. Mixed methods (semi-structured interviews, surveys, study notes) will be used to obtain in-depth understanding of barriers and facilitators for eventual implementation of the acupuncture intervention. This study will facilitate the widespread implementation, dissemination, and sustained utilization of acupuncture for symptom management among medically underserved breast cancer survivors receiving endocrine therapy.
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Affiliation(s)
- Hongjin Li
- University of Illinois, Chicago College of Nursing, Department of Human Development Nursing Science, 845 S. Damen Avenue (M/C 802), Chicago, IL 60612, USA; University of Illinois Cancer Center, 818 South Wolcott Ave, Chicago, IL 60612, USA.
| | - Judith M Schlaeger
- University of Illinois, Chicago College of Nursing, Department of Human Development Nursing Science, 845 S. Damen Avenue (M/C 802), Chicago, IL 60612, USA
| | - Crystal L Patil
- University of Illinois, Chicago College of Nursing, Department of Human Development Nursing Science, 845 S. Damen Avenue (M/C 802), Chicago, IL 60612, USA
| | - Oana Danciu
- University of Illinois, Chicago College of Medicine, Department of Hematology/Oncology, 820 S. Wood Street Suite 172 CSN (M/C 712), Chicago, IL 60612, USA
| | - Zhengjia Chen
- University of Illinois Cancer Center, 818 South Wolcott Ave, Chicago, IL 60612, USA
| | - Natalie Lif
- University of Illinois, Chicago College of Nursing, Department of Human Development Nursing Science, 845 S. Damen Avenue (M/C 802), Chicago, IL 60612, USA
| | - Shuang Gao
- University of Illinois, Chicago College of Medicine, 1853 W Polk St, Chicago, IL 60612, USA
| | - Ardith Z Doorenbos
- University of Illinois Cancer Center, 818 South Wolcott Ave, Chicago, IL 60612, USA; University of Illinois, Chicago College of Nursing, Department of Biobehavioral Nursing Science, 845 S. Damen Avenue (M/C 802), Chicago, IL 60612, USA
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Li C, Zhao C, Zhao J, Wang M, Luo F, Zhou J. Global research trends of acupuncture therapy on cancer pain: A bibliometric and visualized study. Front Oncol 2023; 13:1077961. [PMID: 36950556 PMCID: PMC10026736 DOI: 10.3389/fonc.2023.1077961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Accepted: 02/10/2023] [Indexed: 03/08/2023] Open
Abstract
Background The number of publications on acupuncture for cancer pain is increasing rapidly with an upward tendency. Considering that no bibliometric articles related to this topic have been published yet. It is necessary to evaluate the global scientific output of research in this field, and shed light on the direction of clinical cancer pain management in the future. Methods Research publications regarding acupuncture on cancer pain from inception to 2022 were downloaded from the Web of Science Core Collection. Bibliometric analyses were performed using CiteSpace software, the bibliometrix R package, and VOSviewer software. Network maps were generated to assess the collaborations between different countries, institutions, authors, and keywords. And clusters map was generated to evaluate reference. Results A total of 790 articles related to acupuncture therapy for cancer pain were identified. We observe that the number of publications is gradually increasing over time. China and the United States were the main contributors. Mem Sloan Kettering Canc Ctr (38 papers) and Beijing Univ Chinese Med (28 papers) contributed the most publications, becoming the leading contributors in this field. Although J Clin Oncol (28 articles) ranked ninth in terms of publication volume, it was the journal with the most citations and the highest number of IF (50.717) and H-index (494) at the same time. MAO J from Mem Sloan Kettering Canc Ctr was the most prolific author (23 articles). The main hot topics included matters related to acupuncture (239 times), pain (199 times), management (139 times), quality of life (107 times), electroacupuncture (100 times), and breast cancer (82 times). Conclusion Our bibliometric analysis provides a comprehensive overview of the development of acupuncture for cancer pain, enabling relevant authors and research teams to identify the current research status in this field. At the same time, acupuncture for breast cancer (BC) pain, aromatase inhibitor-induced arthralgia (AIA), and chemotherapy-induced peripheral neuropathy (CIPN) may soon become prospective focus.
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Affiliation(s)
- Chunyu Li
- Acupuncture and Tuina School/The 3rd Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Can Zhao
- College of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Jingjing Zhao
- Department of Acupuncture, Sichuan Second Hospital of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Min Wang
- Department of Acupuncture, Sichuan Second Hospital of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Furong Luo
- Department of Traditional Chinese Medicine, Xi’an No. 3 Hospital, the Affiliated Hospital of Northwest University, Xi’an, Shanxi, China
| | - Jianwei Zhou
- Sichuan Academy of Chinese Medicine Sciences, Chengdu, Sichuan, China
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Ling F, Qi W, Li X, Zhou J, Xiong J, Zhao Y, Zheng Q, Liang F. Bibliometric Analysis of Acupuncture Therapy for Cancer Pain Over the Past 10 Years. J Pain Res 2023; 16:985-1003. [PMID: 36968762 PMCID: PMC10038162 DOI: 10.2147/jpr.s395421] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 02/28/2023] [Indexed: 03/21/2023] Open
Abstract
Purpose Cancer pain is a common symptom of cancer patients and greatly affects quality of life. Acupuncture has certain curative effects on cancer pain. The aim of this study was to analyze and visualize the current status and research trend of acupuncture treatment for cancer pain over the last 10 years and provide directions for future development. Methods A search of the Web of Science Core Collection from 2012-01-01 to 2022-08-20 was performed to collect studies related to acupuncture therapy for cancer pain. CiteSpace was used to conduct bibliometric analysis and visualization from the perspective of the volume of annual publications, journals, nations, institutions, authors, keywords, and references. Results A total of 302 studies were included in the analysis. The number of publications increased steadily with some fluctuations over the past decade. Integrative Cancer Therapies was the journal with the most relevant publications, and the Journal of Clinical Oncology was the most frequently cited journal. China had the highest volume of publications, and the USA contributed most to international collaboration. The most prolific institution was Memorial Sloan Kettering Cancer Center. The most productive author was Mao JJ, and the most influential author was Lu WD. "Acupuncture" was the top keyword in frequency and centrality. The references with the highest frequency and centrality were published by HE, Y, and Ting Bao, respectively. Conclusion A stable development trend has formed in this field. The overall collaborative network needs to be strengthened. Breast cancer and multiple myeloma, electroacupuncture and bee venom acupuncture, postoperative pain, peripheral neuropathic pain syndrome, and aromatase inhibitors-associated arthralgia syndrome are research hotspots in this field. Randomized controlled trials (RCTs), evidence-based evaluations and mechanisms (cancer-induced bone pain) are research trends and frontiers.
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Affiliation(s)
- Fayang Ling
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, People’s Republic of China
| | - Wenchuan Qi
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, People’s Republic of China
| | - Xiao Li
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, People’s Republic of China
| | - Jun Zhou
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, People’s Republic of China
| | - Jian Xiong
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, People’s Republic of China
| | - Yi Zhao
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, People’s Republic of China
| | - Qianhua Zheng
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, People’s Republic of China
- Qianhua Zheng, Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, People’s Republic of China, Tel +86 189 0870 5127, Fax +86-028-87683962, Email
| | - Fanrong Liang
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine/Clinical Research Center for Acupuncture and Moxibustion in Sichuan Province, Chengdu, People’s Republic of China
- Correspondence: Fanrong Liang, Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine/Clinical Research Center for Acupuncture and Moxibustion in Sichuan Province, Chengdu, People’s Republic of China, Tel +86 136 0805 8216, Fax +86-028-87683962, Email
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Bae K, Lamoury G, Carroll S, Morgia M, Lim S, Baron-Hay S, Shin IS, Park SJ, Oh B. Comparison of the clinical effectiveness of treatments for aromatase inhibitor-induced arthralgia in breast cancer patients: A systematic review with network meta-analysis. Crit Rev Oncol Hematol 2023; 181:103898. [PMID: 36535489 DOI: 10.1016/j.critrevonc.2022.103898] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 12/08/2022] [Accepted: 12/14/2022] [Indexed: 12/23/2022] Open
Abstract
Aromatase inhibitor-induced arthralgia (AIA) contributes to poor adherence of aromatase inhibitor therapies in patients with breast cancer. A systematic review using network meta-analysis (NMA) was conducted to examine the clinical effectiveness of multiple therapies and rank probabilities for the management of AIA. Randomized controlled trials (RCTs) assessing treatments for AIA in postmenopausal women with stage 0-III hormone receptor-positive breast cancer were searched from inception to October 2021. The main NMA involved 1516 participants from 17 RCTs. Acupuncture was the highest ranked intervention to improve pain intensity followed by sham acupuncture, multicomponent herbal medicine, exercise, duloxetine, vitamin D, omega-3 fatty acids, physical therapy, testosterone, and inactive controls. Single natural products were inferior to controls. The current review provides new insights into the management of AIA in breast cancer survivors for increased survival and can be utilized to make evidence-based decisions regarding treatment.
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Affiliation(s)
- Kyeore Bae
- Integrative Cancer Center, Doban Hospital, Seoul, 03170, Republic of Korea; Northern Sydney Cancer Centre, Royal North Shore Hospital, St Leonards, Sydney, New South Wales, 2065, Australia.
| | - Gillian Lamoury
- Northern Sydney Cancer Centre, Royal North Shore Hospital, St Leonards, Sydney, New South Wales, 2065, Australia; Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, 2006, Australia.
| | - Susan Carroll
- Northern Sydney Cancer Centre, Royal North Shore Hospital, St Leonards, Sydney, New South Wales, 2065, Australia; Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, 2006, Australia.
| | - Marita Morgia
- Northern Sydney Cancer Centre, Royal North Shore Hospital, St Leonards, Sydney, New South Wales, 2065, Australia.
| | - Stephanie Lim
- Medical Oncology Department, Macarthur Cancer Therapy Centre, Campbelltown, New South Wales, 2560, Australia; Western Sydney University, Campbelltown, New South Wales, 2560, Australia.
| | - Sally Baron-Hay
- Northern Sydney Cancer Centre, Royal North Shore Hospital, St Leonards, Sydney, New South Wales, 2065, Australia; Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, 2006, Australia.
| | - In-Soo Shin
- Department of Graduate School of Education, Dongguk University, Seoul, 04620, Republic of Korea.
| | - So-Jung Park
- Department of Internal Medicine, Korean Medicine Hospital of Pusan National University, Yangsan, Gyeongnam, 50612, Republic of Korea.
| | - Byeongsang Oh
- Northern Sydney Cancer Centre, Royal North Shore Hospital, St Leonards, Sydney, New South Wales, 2065, Australia; Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, 2006, Australia.
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Mao JJ, Ismaila N, Bao T, Barton D, Ben-Arye E, Garland EL, Greenlee H, Leblanc T, Lee RT, Lopez AM, Loprinzi C, Lyman GH, MacLeod J, Master VA, Ramchandran K, Wagner LI, Walker EM, Bruner DW, Witt CM, Bruera E. Integrative Medicine for Pain Management in Oncology: Society for Integrative Oncology-ASCO Guideline. J Clin Oncol 2022; 40:3998-4024. [PMID: 36122322 DOI: 10.1200/jco.22.01357] [Citation(s) in RCA: 87] [Impact Index Per Article: 43.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
PURPOSE The aim of this joint guideline is to provide evidence-based recommendations to practicing physicians and other health care providers on integrative approaches to managing pain in patients with cancer. METHODS The Society for Integrative Oncology and ASCO convened an expert panel of integrative oncology, medical oncology, radiation oncology, surgical oncology, palliative oncology, social sciences, mind-body medicine, nursing, and patient advocacy representatives. The literature search included systematic reviews, meta-analyses, and randomized controlled trials published from 1990 through 2021. Outcomes of interest included pain intensity, symptom relief, and adverse events. Expert panel members used this evidence and informal consensus to develop evidence-based guideline recommendations. RESULTS The literature search identified 227 relevant studies to inform the evidence base for this guideline. RECOMMENDATIONS Among adult patients, acupuncture should be recommended for aromatase inhibitor-related joint pain. Acupuncture or reflexology or acupressure may be recommended for general cancer pain or musculoskeletal pain. Hypnosis may be recommended to patients who experience procedural pain. Massage may be recommended to patients experiencing pain during palliative or hospice care. These recommendations are based on an intermediate level of evidence, benefit outweighing risk, and with moderate strength of recommendation. The quality of evidence for other mind-body interventions or natural products for pain is either low or inconclusive. There is insufficient or inconclusive evidence to make recommendations for pediatric patients. More research is needed to better characterize the role of integrative medicine interventions in the care of patients with cancer.Additional information is available at https://integrativeonc.org/practice-guidelines/guidelines and www.asco.org/survivorship-guidelines.
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Affiliation(s)
- Jun J Mao
- Memorial Sloan Kettering Cancer Center, New York, NY
| | | | - Ting Bao
- Memorial Sloan Kettering Cancer Center, New York, NY
| | - Debra Barton
- University of Michigan School of Nursing, Ann Arbor, MI
| | - Eran Ben-Arye
- Lin & Carmel Medical Centers, Clalit Health Services; Technion Faculty of Medicine, Haifa, Israel
| | - Eric L Garland
- College of Social Work, University of Utah, Salt Lake City, UT
| | | | | | - Richard T Lee
- City of Hope Comprehensive Cancer Center, Duarte, CA
| | - Ana Maria Lopez
- Thomas Jefferson. Sidney Kimmel Cancer Center, Philadelphia, PA
| | | | - Gary H Lyman
- Fred Hutchinson Cancer Research Center, Seattle, WA
| | - Jodi MacLeod
- Patient Representative, Memorial Sloan Kettering Integrative Medicine Service, New York, NY
| | - Viraj A Master
- Winship Cancer Institute of Emory University, Atlanta, GA
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Hershman DL, Unger JM, Greenlee H, Capodice J, Lew DL, Darke A, Minasian LM, Fisch MJ, Henry NL, Crew KD. Comparison of Acupuncture vs Sham Acupuncture or Waiting List Control in the Treatment of Aromatase Inhibitor-Related Joint Pain: A Randomized Clinical Trial. JAMA Netw Open 2022; 5:e2241720. [PMID: 36367721 PMCID: PMC9652759 DOI: 10.1001/jamanetworkopen.2022.41720] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
IMPORTANCE Aromatase inhibitors (AIs) have proven efficacy for the treatment of hormone-sensitive breast cancer; however, arthralgias (pain and stiffness) contribute to nonadherence with therapy for more than 50% of patients. OBJECTIVE To examine the effect of acupuncture in reducing AI-related joint pain through 52 weeks. DESIGN, SETTING, AND PARTICIPANTS A randomized clinical trial was conducted at 11 sites in the US from May 1, 2012, to February 29, 2016, with a scheduled final date of follow-up of September 5, 2017, to compare true acupuncture (TA) with sham acupuncture (SA) or waiting list control (WC). Women with early-stage breast cancer were eligible if they were taking an AI and scored 3 or higher on the Brief Pain Inventory Worst Pain (BPI-WP) item (score range, 0-10; higher scores indicate greater pain). Analysis was conducted for data received through May 3, 2021. INTERVENTIONS Participants were randomized 2:1:1 to the TA (n = 110), SA (n = 59), or WC (n = 57) group. The TA and SA protocols were composed of 6 weeks of intervention at 2 sessions per week (12 sessions overall), followed by 6 additional weeks of intervention with 1 session per week. Participants randomized to WC received no intervention. All participants were offered 10 acupuncture sessions to be used between weeks 24 and 52. MAIN OUTCOMES AND MEASURES In this long-term evaluation, the primary end point was the 52-week BPI-WP score, compared by study group using linear regression, adjusted for baseline pain and stratification factors. RESULTS Among 226 randomized women (mean [SD] age, 60.7 [8.6] years; 87.7% White; mean [SD] baseline BPI-WP score, 6.7 [1.5]), 191 (84.5%) completed the trial. In a linear regression, 52-week mean BPI-WP scores were 1.08 (95% CI, 0.24-1.91) points lower in the TA compared with the SA group (P = .01) and were 0.99 (95% CI, 0.12-1.86) points lower in the TA compared with the WC group (P = .03). In addition, 52-week BPI pain interference scores were statistically significantly lower in the TA compared with the SA group (difference, 0.58; 95% CI, 0.00-1.16; P = .05). Between 24 and 52 weeks, 12 (13.2%) of TA, 6 (11.3%) of SA, and 5 (10.6%) of WC patients reported receipt of acupuncture. CONCLUSIONS AND RELEVANCE In this randomized clinical trial, women with AI-related joint pain receiving 12 weeks of TA had reduced pain at 52 weeks compared with controls, suggesting long-term benefits of this therapy. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT01535066.
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Affiliation(s)
| | - Joseph M. Unger
- Fred Hutchinson Cancer Center, Seattle, Washington
- SWOG Statistics and Data Management Center, Seattle, Washington
| | | | | | - Danika L. Lew
- Fred Hutchinson Cancer Center, Seattle, Washington
- SWOG Statistics and Data Management Center, Seattle, Washington
| | - Amy Darke
- Fred Hutchinson Cancer Center, Seattle, Washington
- SWOG Statistics and Data Management Center, Seattle, Washington
| | - Lori M. Minasian
- Division of Cancer Prevention, National Cancer Institute, Bethesda, Maryland
| | | | - N. Lynn Henry
- Department of Medicine, University of Michigan, Ann Arbor
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Symptom Management and Quality of Life of Breast Cancer Patients Using Acupuncture-Related Therapies and Herbal Medicine: A Scoping Review. Cancers (Basel) 2022; 14:cancers14194683. [PMID: 36230606 PMCID: PMC9564317 DOI: 10.3390/cancers14194683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 09/14/2022] [Accepted: 09/21/2022] [Indexed: 12/03/2022] Open
Abstract
Simple Summary This is a scoping review of published literature on the usefulness of acupuncture-related therapies and herbal medicine in alleviating the side effects associated with breast cancer treatments. It is an important study given that the various treatment interventions for breast cancer, such as surgery, chemotherapy, radiotherapy, and hormone therapy, have unpleasant side effects that compromise the patient’s quality of life. The study revealed positive impact of some acupuncture-related therapies and herbal medicines in improving the symptoms and quality of life of patients with breast cancer. These findings will inform further studies on the economic impact of acupuncture and herbal medicines in the management of adverse events in patients on breast cancer treatment. Abstract The side effects associated with breast cancer treatments often reduce the patients’ quality of life. The effectiveness of acupuncture-related therapies and herbal medicine in managing the side effect is not fully understood. The study included clinical studies published in the 10 years since 2011 and analyzed the effectiveness of the therapies for managing side effects of anticancer treatment. The databases of MEDLINE via PubMed, CENTRAL, EMBASE, OASIS, and NSDL were searched. Thirty studies, including 13 (43.3%) randomized controlled trials (RCTs), 12 (40.0%) before-and-after studies, three (10.0%) case series, one (3.3%) case report, and one (3.3%) non-RCT, were included in this review. The main symptoms identified were aromatase inhibitors-induced arthralgia (AIA), lymphedema, and chemotherapy-induced peripheral neuropathy (CIPN). The types of acupuncture-related therapies applied included manual acupuncture, electro-acupuncture, moxibustion, and electro-moxibustion. In ten studies, eight herbal medications were administered. The Brief Pain Inventory-Short Form (BPI-SF) and Functional Assessment of Cancer Therapy-General (FACT-G) and -Breast (FACT-B) were frequently used to evaluate pain and QoL, respectively. Most studies suggested beneficial effects of acupuncture and herbal medicine on managing pain, daily function, and quality of life in patients going through AIA, CIPN, and/or lymphedema, with mild side effects. The scoping review implies the potential of CAM therapies as promising interventions for managing symptoms which otherwise lack alternative management options, and for improving the quality of life of breast cancer patients.
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Desideri I, Lucidi S, Francolini G, Meattini I, Ciccone LP, Salvestrini V, Valzano M, Morelli I, Angelini L, Scotti V, Bonomo P, Greto D, Terziani F, Becherini C, Visani L, Livi L. Use of an alfa-lipoic, Methylsulfonylmethane, Boswellia serrata and Bromelain dietary supplement (OPERA®) for aromatase inhibitors-related arthralgia management (AIA): a prospective phase II trial (NCT04161833). Med Oncol 2022; 39:113. [PMID: 35666314 DOI: 10.1007/s12032-022-01723-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Accepted: 03/29/2022] [Indexed: 10/18/2022]
Abstract
Aromatase Inhibitors (AIs) are recommended for the adjuvant treatment of hormone receptor positive breast cancer in both high-risk pre-menopausal and post-menopausal population; arthralgia is the main cause of discontinuation of therapy and affects up to 25% of population on AI treatment. The objective of the study was to prospectively evaluate OPERA® (GAMFARMA srl, Milan, Italy), a new dietary supplement where α-Lipoic acid, Boswellia serrata, Methylsulfonylmethane and Bromelain are combined in a single hard-gelatin capsule to be taken once a day. Fifty-three patients with arthralgia (NCI-CTCAE v4.0 grade ≥ 1) occurring during AI therapy were enrolled. All patients received OPERA® from enrollment (T0) up to sixth months (T3). Patients' AI-related arthralgia was evaluated every two months with VAS Scale, PRAI questionnaire, and CTCAE scale. Primary endpoint was the number of patients with symptom resolution (G0) at T3 if compared to T0, according to CTCAE and VAS scale. Secondary endpoints were decrease in arthralgia intensity measured with PRAI score at T3 compared to baseline, safety of OPERA® and rate of AI interruption. Treatment with OPERA® supplement was overall well tolerated; no relevant toxicities related to OPERA® intake were reported. Seven subjects (13.2%) were not included in the final analysis because of consent withdrawal. 46 participants were eligible for final analysis. According to CTCAE scale, 10 out of 46 patients reported symptoms resolution at 6-month follow-up from the time of enrollment T0 (p = 0.0009). According to VAS score, 5 patients reported complete resolution of symptoms at T3 if compared to baseline starting situation T0 (p = 0.0222). Analysis of PRAI score showed a significant reduction in arthralgia-related pain perceived (p = 0.0001). OPERA® was able to reduce the intensity of arthralgia related to AI therapy. Randomized, double-blind studies are warranted to confirm the effectiveness of this dietary supplement.
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Affiliation(s)
- Isacco Desideri
- Radiation Oncology Unit, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy.,Department of Experimental and Clinical Biomedical Sciences "Mario Serio", University of Florence, Florence, Italy
| | - Sara Lucidi
- Department of Experimental and Clinical Biomedical Sciences "Mario Serio", University of Florence, Florence, Italy
| | - Giulio Francolini
- Radiation Oncology Unit, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
| | - Icro Meattini
- Radiation Oncology Unit, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy.,Department of Experimental and Clinical Biomedical Sciences "Mario Serio", University of Florence, Florence, Italy
| | - Lucia Pia Ciccone
- Department of Experimental and Clinical Biomedical Sciences "Mario Serio", University of Florence, Florence, Italy
| | - Viola Salvestrini
- Department of Experimental and Clinical Biomedical Sciences "Mario Serio", University of Florence, Florence, Italy
| | - Marianna Valzano
- Department of Experimental and Clinical Biomedical Sciences "Mario Serio", University of Florence, Florence, Italy
| | - Ilaria Morelli
- Department of Experimental and Clinical Biomedical Sciences "Mario Serio", University of Florence, Florence, Italy. .,Radiation Oncology Unit, Department of Experimental and Clinical Biomedical Sciences, University of Florence - Azienda Ospedaliero-Universitaria Careggi, Largo Brambilla 3, 50134, Florence, Italy.
| | - Lucia Angelini
- Department of Experimental and Clinical Biomedical Sciences "Mario Serio", University of Florence, Florence, Italy
| | - Vieri Scotti
- Radiation Oncology Unit, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
| | - Pierluigi Bonomo
- Radiation Oncology Unit, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
| | - Daniela Greto
- Radiation Oncology Unit, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
| | - Francesca Terziani
- Radiotherapy Unit- Ospedale S. Donato e Santa Maria alla Gruccia, Azienda USL Toscana Sud, Arezzo, Italy
| | - Carlotta Becherini
- Radiation Oncology Unit, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
| | - Luca Visani
- Radiotherapy Department, IFCA, Florence, Italy
| | - Lorenzo Livi
- Department of Experimental and Clinical Biomedical Sciences "Mario Serio", University of Florence, Florence, Italy
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12
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Höxtermann MD, Haller H, Aboudamaah S, Bachemir A, Dobos G, Cramer H, Voiss P. Safety of acupuncture in oncology: A systematic review and meta-analysis of randomized controlled trials. Cancer 2022; 128:2159-2173. [PMID: 35262912 DOI: 10.1002/cncr.34165] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 01/06/2022] [Accepted: 02/09/2022] [Indexed: 12/26/2022]
Abstract
BACKGROUND Acupuncture is frequently used to treat the side effects of cancer treatment, but the safety of this intervention remains uncertain. The current meta-analysis was conducted to assess the safety of acupuncture in oncological patients. METHODS The PubMed, Cochrane Central Register of Controlled Trials, and Scopus databases were searched from their inception to August 7, 2020. Randomized controlled trials in oncological patients comparing invasive acupuncture with sham acupuncture, treatment as usual (TAU), or any other active control were eligible. Two reviewers independently extracted data on study characteristics and adverse events (AEs). Risk of bias was assessed using the Cochrane Risk of Bias Tool. RESULTS Of 4590 screened articles, 65 were included in the analyses. The authors observed that acupuncture was not associated an with increased risk of intervention-related AEs, nonserious AEs, serious AEs, or dropout because of AEs compared with sham acupuncture and an active control. Compared with TAU, acupuncture was not associated with an increased risk of intervention-related AEs, serious AEs, or drop out because of AEs but was associated with an increased risk for nonserious AEs (odds ratio, 3.94; 95% confidence interval, 1.16-13.35; P = .03). However, the increased risk of nonserious AEs compared with TAU was not robust against selection bias. The meta-analyses may have been biased because of the insufficient reporting of AEs in the original randomized controlled trials. CONCLUSIONS The current review indicates that acupuncture is as safe as sham acupuncture and active controls in oncological patients. The authors recommend researchers heed the CONSORT (Consolidated Standards of Reporting Trials) safety and harm extension for reporting to capture the side effects and better investigate the risk profile of acupuncture in oncology. LAY SUMMARY According to this analysis, acupuncture is a safe therapy for the treatment of patients with cancer. Acupuncture seems to be safe compared with sham acupuncture and active controls.
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Affiliation(s)
- Melanie D Höxtermann
- Evangelical Clinics Essen-Mitte, Department of Internal and Integrative Medicine, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany
| | - Heidemarie Haller
- Evangelical Clinics Essen-Mitte, Department of Internal and Integrative Medicine, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany
| | - Shaimaa Aboudamaah
- Evangelical Clinics Essen-Mitte, Department of Internal and Integrative Medicine, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany
| | - Armin Bachemir
- Evangelical Clinics Essen-Mitte, Department of Internal and Integrative Medicine, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany
| | - Gustav Dobos
- Evangelical Clinics Essen-Mitte, Department of Internal and Integrative Medicine, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany
| | - Holger Cramer
- Evangelical Clinics Essen-Mitte, Department of Internal and Integrative Medicine, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany
| | - Petra Voiss
- Evangelical Clinics Essen-Mitte, Department of Internal and Integrative Medicine, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany
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13
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de Sire A, Lippi L, Ammendolia A, Cisari C, Venetis K, Sajjadi E, Fusco N, Invernizzi M. Physical Exercise with or without Whole-Body Vibration in Breast Cancer Patients Suffering from Aromatase Inhibitor—Induced Musculoskeletal Symptoms: A Pilot Randomized Clinical Study. J Pers Med 2021; 11:jpm11121369. [PMID: 34945841 PMCID: PMC8707128 DOI: 10.3390/jpm11121369] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 11/28/2021] [Accepted: 12/10/2021] [Indexed: 12/29/2022] Open
Abstract
In this study, we aimed to assess the safety and efficacy of physical exercise, with or without whole-body vibration (WBV), in patients with aromatase inhibitor-induced musculoskeletal symptoms (AIMSS). Eligible patients were adults (≥18 years) with a history of breast cancer and current AIMSS. Enrolled patients (n = 22) were randomly assigned 1:1 to receive physical exercise combined with WBV or sham WBV for 4 weeks. The primary endpoint was pain intensity measured by numerical pain rating scale (NPRS). The secondary endpoints were muscle strength, physical function, physical performance, and quality of life. The WBV group (mean age: 51.73 ± 10.73 years; body mass index (BMI): 25.56 ± 5.17 kg/m2) showed a statistically significant pain reduction (NPRS: 6.82 ± 1.17 vs. 5.73 ± 1.01; p = 0.031), whereas patients in the sham WBV group (mean age: 58.55 ± 9.71 years; BMI: 27.31 ± 3.84 kg/m2), did not reach statistical significance (NPRS: 6.91 ± 2.02 vs. 5.91 ± 2.51; p = 0.07). Concurrently, muscle strength, physical performance, and quality of life significantly improved in both groups, without significant differences between groups. No dropouts and no side effects were recorded. Both patients and the physical therapist reported a high level of satisfaction with the intervention. Our findings suggest that physical exercise and WBV combination might be a safe therapeutic option for improving the rehabilitative management of patients with AIMSS.
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Affiliation(s)
- Alessandro de Sire
- Physical and Rehabilitative Medicine Unit, Department of Medical and Surgical Sciences, University of Catanzaro “Magna Graecia”, 88100 Catanzaro, Italy;
- Correspondence: (A.d.S.); (L.L.); Tel.: +39-096-171-2819 (A.d.S.); +39-032-1373-4800 (L.L.)
| | - Lorenzo Lippi
- Physical and Rehabilitative Medicine, Department of Health Sciences, University of Eastern Piedmont, 28100 Novara, Italy; (C.C.); (M.I.)
- Correspondence: (A.d.S.); (L.L.); Tel.: +39-096-171-2819 (A.d.S.); +39-032-1373-4800 (L.L.)
| | - Antonio Ammendolia
- Physical and Rehabilitative Medicine Unit, Department of Medical and Surgical Sciences, University of Catanzaro “Magna Graecia”, 88100 Catanzaro, Italy;
| | - Carlo Cisari
- Physical and Rehabilitative Medicine, Department of Health Sciences, University of Eastern Piedmont, 28100 Novara, Italy; (C.C.); (M.I.)
| | - Konstantinos Venetis
- Department of Oncology and Hemato-Oncology, University of Milan, 20122 Milan, Italy; (K.V.); (E.S.); (N.F.)
- Division of Pathology, IEO, European Institute of Oncology IRCCS, 20144 Milan, Italy
| | - Elham Sajjadi
- Department of Oncology and Hemato-Oncology, University of Milan, 20122 Milan, Italy; (K.V.); (E.S.); (N.F.)
- Division of Pathology, IEO, European Institute of Oncology IRCCS, 20144 Milan, Italy
| | - Nicola Fusco
- Department of Oncology and Hemato-Oncology, University of Milan, 20122 Milan, Italy; (K.V.); (E.S.); (N.F.)
- Division of Pathology, IEO, European Institute of Oncology IRCCS, 20144 Milan, Italy
| | - Marco Invernizzi
- Physical and Rehabilitative Medicine, Department of Health Sciences, University of Eastern Piedmont, 28100 Novara, Italy; (C.C.); (M.I.)
- Translational Medicine, Dipartimento Attività Integrate Ricerca e Innovazione (DAIRI), Azienda Ospedaliera SS, Antonio e Biagio e Cesare Arrigo, 15121 Alessandria, Italy
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14
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Zhu XY, Li Z, Chen C, Feng RL, Cheng BR, Liu RY, Wang RT, Xu L, Wang Y, Tao X, Zhao P. Physical Therapies for Psychosomatic Symptoms and Quality of Life Induced by Aromatase Inhibitors in Breast Cancer Patients: A Systematic Review and Meta-Analysis. Front Oncol 2021; 11:745280. [PMID: 34868943 PMCID: PMC8632958 DOI: 10.3389/fonc.2021.745280] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Accepted: 10/22/2021] [Indexed: 01/19/2023] Open
Abstract
Objective To evaluate the effects of Physical Therapies (PTs) on improvement in psychosomatic symptoms and quality of life (QOL) in breast cancer patients. Data Sources Seven databases (MEDLINE, EMBASE, Cochrane CENTRAL, China National Knowledge Infrastructure, Wangfang, VIP, and China Biology Medicine disc databases) were systematically searched from the database inception through May 18, 2021. Study Selection Randomized controlled trials (RCTs) which compared acupuncture or exercise with a sham control or usual care for the treatment of aromatase inhibitors (AIs)-related psychosomatic symptoms and QOL. Data Extraction and Synthesis Data were screened and extracted independently using predesigned forms. The quality of RCTs was assessed with the Cochrane Handbook for Systematic Reviews of Interventions. The effect size was calculated via random-effects modeling. The quality of evidence was evaluated with the Grading of Recommendations Assessment, Development and Evaluation approach. Main Outcomes and Measures The score of pain was measured with BPI scale and Western Ontario and the McMaster Universities Index (WOMAC) scale. Emotional state was measured with Pittsburgh Sleep Quality Index (PSQI), Hospital Anxiety and Depression Scale (HADS-A), and Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-Fatigue). The QOL score was measured by self-reported measurements, including the Functional Assessment of Cancer Therapy-General (FACT-G) scale and 36-Item Short Form Survey (SF-36) scale. Results Eleven RCTs (with 830 patients) were included in the systematic review, and data from 10 RCTs (with 798 patients) were used in the meta-analysis. Results showed acupuncture significantly reduced worst pain scores (P < 0.00001, I2 = 83.5%) [SMD = −0.81, 95% CI (−1.51, −0.11)], but the effect of exercise therapies was not significant in overall change in worst pain scores (P =0.006, I2 = 72.3%) [SMD = −0.30, 95% CI (−0.76, 0.16)]. Both acupuncture and exercise resulted in little to no difference in overall change in HADS-A subscale (P = 0.026<0.05, I2 = 79.8%) [WMD = −0.21, 95% CI (−3.44, 3.03)], PSQI subscale (P = 0.488, I2 = 0%) [WMD = 0.98, 95% CI (−0.57, 2.53)], and FACIT-Fatigue subscale (P = 0.022<0.05, I2 = 81.0%) [WMD = 1.6, 95% CI (−5.75, 8.94)]. Exercise (compared with usual care) was associated with improving overall change in health-related QOL (subscales of SF-36 tool) (P = 0, I2 = 72.1%) [WMD = 7.97, 95% CI (5.68, 10.25)] and cancer-specific QOL (subscales of FACT-G tool) (P = 0.304, I2 = 16%) [WMD = 1.16, 95% CI (0.34, 1.97)]. Conclusions and Relevance This systematic review and meta-analysis suggested that based on moderate-level evidence, acupuncture was associated with significant reductions in pain intensity, and exercise might improve QOL in breast cancer patients treated with AIs. However, in psychosomatic symptoms such as anxiety, sleep disturbance, and fatigue, acupuncture and exercise training did not result in significant improvements.
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Affiliation(s)
- Xue-Ying Zhu
- Department of Oncology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Zhong Li
- Department of Oncology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Cong Chen
- Department of Cardiology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Ru-Li Feng
- Department of Cardiology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Bai-Ru Cheng
- Department of Cardiology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Ruo-Yi Liu
- Department of Encephalopathy, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Rui-Ting Wang
- Department of Cardiology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Li Xu
- Department of Gynecology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Yue Wang
- Graduate School of Beijing University of Chinese Medicine, Beijing, China
| | - Xin Tao
- School of Medical Humanities, Capital Medical University, Beijing, China
| | - Peng Zhao
- Department of Cardiology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
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15
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Li H, Schlaeger JM, Jang MK, Lin Y, Park C, Liu T, Sun M, Doorenbos AZ. Acupuncture Improves Multiple Treatment-Related Symptoms in Breast Cancer Survivors: A Systematic Review and Meta-Analysis. J Altern Complement Med 2021; 27:1084-1097. [PMID: 34449251 DOI: 10.1089/acm.2021.0133] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Introduction: Acupuncture has demonstrated effectiveness for symptom management among breast cancer survivors. This meta-analysis aims to evaluate the effect of acupuncture on treatment-related symptoms among breast cancer survivors. Methods: The authors searched PubMed, CINAHL, and EMBASE for relevant randomized clinical trials (RCTs) of acupuncture for managing treatment-related symptoms published in English through June 2021. They appraised the quality of each article using the Cochrane Collaboration Risk of Bias Criteria. The primary outcomes were pain, hot flashes, sleep disturbance, fatigue, depression, lymphedema, and neuropathy as individual symptoms. They also evaluated adverse events reported in acupuncture studies. Results: Of 26 selected trials (2055 patients), 20 (1709 patients) were included in the meta-analysis. Acupuncture was more effective than control groups in improving pain intensity [standardized mean difference (SMD) = -0.60, 95% confidence intervals (CI) -1.06 to -0.15], fatigue [SMD = -0.62, 95% CI -1.03 to -0.20], and hot flash severity [SMD = -0.52, 95% CI -0.82 to -0.22]. The subgroup analysis indicated that acupuncture showed trends but not significant effects on all the treatment-related symptoms compared with the sham acupuncture groups. Compared with waitlist control and usual care groups, the acupuncture groups showed significant reductions in pain intensity, fatigue, depression, hot flash severity, and neuropathy. No serious adverse events were reported related to acupuncture intervention. Mild adverse events (i.e., bruising, pain, swelling, skin infection, hematoma, headache, menstrual bleeding) were reported in 11 studies. Conclusion: This systematic review and meta-analysis suggest that acupuncture significantly reduces multiple treatment-related symptoms compared with the usual care or waitlist control group among breast cancer survivors. The safety of acupuncture was inadequately reported in the included studies. Based on the available data, acupuncture seems to be generally a safe treatment with some mild adverse events. These findings provide evidence-based recommendations for incorporating acupuncture into clinical breast cancer symptom management. Due to the high risk of bias and blinding issues in some RCTs, more rigorous trials are needed to confirm the efficacy of acupuncture in reducing multiple treatment-related symptoms among breast cancer survivors.
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Affiliation(s)
- Hongjin Li
- Department of Human Development Nursing Science, College of Nursing, University of Illinois Chicago, Chicago, IL, USA.,Department of Cancer Prevention and Control, University of Illinois Cancer Center, Chicago, IL, USA
| | - Judith M Schlaeger
- Department of Human Development Nursing Science, College of Nursing, University of Illinois Chicago, Chicago, IL, USA
| | - Min Kyeong Jang
- Department of Cancer Prevention and Control, University of Illinois Cancer Center, Chicago, IL, USA.,Department of Biobehavioral Nursing Science, College of Nursing, University of Illinois Chicago, Chicago, IL, USA
| | - Yufen Lin
- School of Nursing, Emory University, Atlanta, GA, USA
| | - Chang Park
- Department of Population Health Nursing Science, College of Nursing, University of Illinois Chicago, Chicago, IL, USA
| | - Tingting Liu
- Eleanor Mann School of Nursing, University of Arkansas, Little Rock, AR, USA
| | - Min Sun
- Department of Hematology and Oncology, Hillman Cancer Center, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Ardith Z Doorenbos
- Department of Cancer Prevention and Control, University of Illinois Cancer Center, Chicago, IL, USA.,Department of Biobehavioral Nursing Science, College of Nursing, University of Illinois Chicago, Chicago, IL, USA
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16
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Zhang Y, Sun Y, Li D, Liu X, Fang C, Yang C, Luo T, Lu H, Li H, Zhang H, Liang Q, Wu J, Huang L, Xu R, Ren L, Chen Q. Acupuncture for Breast Cancer: A Systematic Review and Meta-Analysis of Patient-Reported Outcomes. Front Oncol 2021; 11:646315. [PMID: 34178633 PMCID: PMC8222976 DOI: 10.3389/fonc.2021.646315] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2020] [Accepted: 05/17/2021] [Indexed: 12/29/2022] Open
Abstract
Abstract The present systematic review and meta-analysis was undertaken to evaluate the effects of acupuncture in women with breast cancer (BC), focusing on patient-reported outcomes (PROs). Methods A comprehensive literature search was carried out for randomized controlled trials (RCTs) reporting PROs in BC patients with treatment-related symptoms after undergoing acupuncture for at least four weeks. Literature screening, data extraction, and risk bias assessment were independently carried out by two researchers. Results Out of the 2, 524 identified studies, 29 studies representing 33 articles were included in this meta-analysis. At the end of treatment (EOT), the acupuncture patients’ quality of life (QoL) was measured by the QLQ-C30 QoL subscale, the Functional Assessment of Cancer Therapy-Endocrine Symptoms (FACT-ES), the Functional Assessment of Cancer Therapy–General/Breast (FACT-G/B), and the Menopause-Specific Quality of Life Questionnaire (MENQOL), which depicted a significant improvement. The use of acupuncture in BC patients lead to a considerable reduction in the scores of all subscales of the Brief Pain Inventory-Short Form (BPI-SF) and Visual Analog Scale (VAS) measuring pain. Moreover, patients treated with acupuncture were more likely to experience improvements in hot flashes scores, fatigue, sleep disturbance, and anxiety compared to those in the control group, while the improvements in depression were comparable across both groups. Long-term follow-up results were similar to the EOT results. Conclusions Current evidence suggests that acupuncture might improve BC treatment-related symptoms measured with PROs including QoL, pain, fatigue, hot flashes, sleep disturbance and anxiety. However, a number of included studies report limited amounts of certain subgroup settings, thus more rigorous, well-designed and larger RCTs are needed to confirm our results.
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Affiliation(s)
- Yuzhu Zhang
- Breast Clinic Center, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China.,Breast Clinic Center, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China.,National Resource Center for Chinese Materia Medica, China Academy of Chinese Medical Sciences, Beijing, China
| | - Yang Sun
- Breast Clinic Center, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China.,Breast Clinic Center, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Dongmei Li
- Breast Department, Zhuhai Hospital of Guangdong Province Hospital of Chinese Medicine, Zhuhai, China
| | - Xiaoyuan Liu
- Breast Clinic Center, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China.,Breast Clinic Center, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Chen Fang
- Breast Clinic Center, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China.,Breast Clinic Center, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Chunmin Yang
- Breast Clinic Center, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China.,Breast Clinic Center, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Tianyu Luo
- Breast Clinic Center, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China.,Breast Clinic Center, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Hai Lu
- Breast Clinic Center, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China.,Breast Clinic Center, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Huachao Li
- Breast Clinic Center, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China.,Breast Clinic Center, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Hongyan Zhang
- Breast Clinic Center, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China.,Breast Clinic Center, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Qianyi Liang
- Breast Clinic Center, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China.,Breast Clinic Center, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Jiahua Wu
- Breast Clinic Center, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China.,Breast Clinic Center, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Limei Huang
- Breast Clinic Center, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China.,Breast Clinic Center, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Rui Xu
- Breast Clinic Center, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China.,Breast Clinic Center, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Liping Ren
- Breast Clinic Center, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China.,Breast Clinic Center, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Qianjun Chen
- Breast Clinic Center, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China.,Breast Clinic Center, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
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17
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Lee YC, Chen YH, Huang YC, Lee YF, Tsai MY. Effectiveness of Combined Treatment with Traditional Chinese Medicine and Western Medicine on the Prognosis of Patients with Breast Cancer. J Altern Complement Med 2021; 26:833-840. [PMID: 32924556 DOI: 10.1089/acm.2019.0200] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Objective: Traditional Chinese Medicine (TCM) can be used to balance the body's immunity and tumor development during different stages of cancer treatment. Recently, TCM has been an important part of the health care system for breast cancer in Taiwan. This study was conducted as a prospective observation of the prognosis of Western medicine and combined treatment of TCM and Western medicine. Methods: Between April 2014 and March 2015, eligible participants were treated with Western medicine (n = 16) or TCM plus Western medicine (n = 29). The TCM treatment for patients followed the principles of a breast cancer protocol that had been developed in the Integrative Cancer Center. The outcome measures included quality of life, frequency of symptom distress, and clinical safety, and were measured with the Functional Assessment of Cancer Therapy-General (FACT-G), the Common Terminology Criteria for Adverse Events (CTCAE) Scale, and laboratory examinations, respectively. Data on these measures were collected at baseline and at 3 months after treatment initiation. Survival was estimated by Kaplan-Meier curves. Results: The two treatment groups did not differ significantly at baseline in terms of demographic information, FACT-G score, or frequency of symptom distress, except for fatigue, sleep disturbance, and mucositis. Most laboratory examinations did not differ significantly between the two groups, but higher red blood cell counts and lower liver function were found with the combined treatment than with Western medicine alone (p < 0.05). The mean overall survival rates were 25.5 months for the combined group and 22.7 months for the Western medicine group (p = 0.037). Conclusion: The results of this study suggest that combining Western and TCM therapy may have a favorable effect on the prognosis of breast cancer patients. Chinese herbal medicine is worth studying in a future larger cohort with a control group. It also warrants verification as a preventive intervention.
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Affiliation(s)
- Yi-Chiao Lee
- Department of Chinese Medicine, MacKay Memorial Hospital, Taipei, Taiwan
| | - Yen-Hao Chen
- Division of Oncology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Yu-Chuen Huang
- Department of Medical Research, China Medical University Hospital, School of Chinese Medicine, China Medical University, Taichung, Taiwan
| | - Yun-Fang Lee
- Department of Nursing, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Ming-Yen Tsai
- Department of Chinese Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan
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18
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Liu X, Lu J, Wang G, Chen X, Xv H, Huang J, Xue M, Tang J. Acupuncture for Arthralgia Induced by Aromatase Inhibitors in Patients with Breast Cancer: A Systematic Review and Meta-analysis. Integr Cancer Ther 2021; 20:1534735420980811. [PMID: 33586504 PMCID: PMC7883140 DOI: 10.1177/1534735420980811] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
Background: Aromatase inhibitor-induced arthralgia (AIA) is the most common side effect of aromatase inhibitors (AIs) used in breast cancer patients and is related to the rate of adherence to AIs. The clinical effects of acupuncture on AIA have been assessed by some randomized controlled trials (RCTs). However, some studies reported that acupuncture was effective, while others claimed that it was ineffective. To clarify the clinical and placebo effects of acupuncture in treating AIA, we conducted this meta-analysis. Methods: Two reviewers (XL and GW) independently searched for RCTs in 5 English databases (PubMed, Web of Science, Embase, Springer, Cochrane Library) and 4 Chinese databases (China National Knowledge Infrastructure Database (CNKI), SinoMed, VIP and Wanfang Database) from their inception to 30 November 2019. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, this meta-analysis was performed by fixed or random-effects models, and data were pooled with mean differences (MDs). Results: Seven trials involving 603 patients were reviewed. The primary outcome, the Brief Pain Inventory (BPI) score, significantly differed between the acupuncture and control groups [pain-related interference: MD = −1.89, 95% confidence interval (CI) [−2.99, −0.79], Z = 3.36 (P = .008 < .05), pain severity: MD = −1.57, 95% CI [−2.46, −0.68], Z = 3.45 (P = .0006 < .05), worst pain: MD = −2.31, 95% CI [−3.15, −1.48], Z = 5.47 (P < .0001 < .05)]. No severe adverse events were reported in any study. Conclusion: This meta-analysis showed that acupuncture is a safe and effective treatment for breast cancer patients with AIA. Additional research with improved blinding methods is warranted to further explore the nature of non-specific and placebo effects in true and sham acupuncture.
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Affiliation(s)
- Xiaomeng Liu
- Nanjing University of Chinese Medicine, Nanjing, People's Republic of China.,The First Affiliated Hospital of Nanjing Medical University, Nanjing, People's Republic of China
| | - Jing Lu
- The First Affiliated Hospital of Nanjing Medical University, Nanjing, People's Republic of China
| | - Guoxin Wang
- Nanjing University of Chinese Medicine, Nanjing, People's Republic of China
| | - Xiu Chen
- The First Affiliated Hospital of Nanjing Medical University, Nanjing, People's Republic of China
| | - Haiping Xv
- The First Affiliated Hospital of Nanjing Medical University, Nanjing, People's Republic of China
| | - Jing Huang
- Third Affiliated Hospital of Kunming Medical University, Kunming, People's Republic of China
| | - Mingxin Xue
- Nanjing University of Chinese Medicine, Nanjing, People's Republic of China.,The First Affiliated Hospital of Nanjing Medical University, Nanjing, People's Republic of China
| | - Jinhai Tang
- The First Affiliated Hospital of Nanjing Medical University, Nanjing, People's Republic of China
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19
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Huang L, Zhao Y, Xiang M. Knowledge Mapping of Acupuncture for Cancer Pain: A Scientometric Analysis (2000-2019). J Pain Res 2021; 14:343-358. [PMID: 33574698 PMCID: PMC7872910 DOI: 10.2147/jpr.s292657] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2020] [Accepted: 12/23/2020] [Indexed: 12/13/2022] Open
Abstract
Objective This study aimed to demonstrate the state of the present situation and trends concerning the global use of acupuncture for cancer pain in the past 20 years. Methods Searched the Web of Science database from 2000 to 2019 related to acupuncture for cancer pain, and then used CiteSpace to conduct scientometric analysis to acquire the knowledge mapping. Results Yearly output has increased year by year, and the growth rate has become faster after 2012. According to the cluster analysis of institutions, authors, cited references, and keywords, 4, 4, 15, and 14 categories were obtained, respectively. The most productive countries, institutions, and authors are the USA, Mem Sloan Kettering Cancer Center, and Mao JJ, whose frequencies are 196, 24, and 17, respectively. However, the most important of them are Australia, Univ. Maryland, and Bao T, owing to their highest centrality, they are 0.90, 0.21, and 0.09 separately. Moreover, cited references that contributed to the most co-citations are Crew KD (2010), however, the most key cited reference is Roscoe JA (2003). Keywords such as acupuncture, pain, breast cancer, palliative care, and quality of life are the most frequently used. But auricular acupuncture is the crucial keyword. In the cluster analysis of institutions, authors, cited references, and keywords, the more convincing research categories are multiple myeloma, placebo effect, neck malignancies, and early breast cancer, with S values of 0.990, 0.991, 0.990, and 0.923, respectively. Therefore, they can be regarded as research hotspots in this field. Conclusion Based on the scientometric analysis in the past 20 years, the knowledge mapping of the country, institution, author, cited reference, and the keyword is gained, which has an important guiding significance for quickly and accurately positioning the trend in this field.
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Affiliation(s)
- Li Huang
- Putuo Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, People's Republic of China
| | - Yanqing Zhao
- Putuo Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, People's Republic of China
| | - Minhong Xiang
- Putuo Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, People's Republic of China
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20
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He Y, Guo X, May BH, Zhang AL, Liu Y, Lu C, Mao JJ, Xue CC, Zhang H. Clinical Evidence for Association of Acupuncture and Acupressure With Improved Cancer Pain: A Systematic Review and Meta-Analysis. JAMA Oncol 2020; 6:271-278. [PMID: 31855257 PMCID: PMC6990758 DOI: 10.1001/jamaoncol.2019.5233] [Citation(s) in RCA: 200] [Impact Index Per Article: 50.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Question Is the use of acupuncture and acupressure associated with improved cancer pain management compared with sham intervention and/or analgesic therapy alone? Findings In this systematic review of 17 randomized clinical trials and meta-analysis of 14 trials in the current English-language and Chinese-language literature, a significant association was found between real (compared with sham) acupuncture and reduced pain, and acupuncture combined with analgesic therapy was associated with decreased analgesic use. However, heterogeneity lowered the level of certainty of the evidence. Meaning This study found a moderate level of evidence that acupuncture and/or acupressure was significantly associated with lower pain intensity in patients with cancer compared with a sham control, which suggests a potential for a combination of acupuncture and acupressure to help reduce opioid doses in patients with cancer. Importance Research into acupuncture and acupressure and their application for cancer pain has been growing, but the findings have been inconsistent. Objective To evaluate the existing randomized clinical trials (RCTs) for evidence of the association of acupuncture and acupressure with reduction in cancer pain. Data Sources Three English-language databases (PubMed, Embase, and CINAHL) and 4 Chinese-language biomedical databases (Chinese Biomedical Literature Database, VIP Database for Chinese Technical Periodicals, China National Knowledge Infrastructure, and Wanfang) were searched for RCTs published from database inception through March 31, 2019. Study Selection Randomized clinical trials that compared acupuncture and acupressure with a sham control, analgesic therapy, or usual care for managing cancer pain were included. Data Extraction and Synthesis Data were screened and extracted independently using predesigned forms. The quality of RCTs was appraised with the Cochrane Collaboration risk of bias tool. Random-effects modeling was used to calculate the effect sizes of included RCTs. The quality of evidence was evaluated with the Grading of Recommendations Assessment, Development and Evaluation approach. Main Outcomes and Measures The primary outcome was pain intensity measured by the Brief Pain Inventory, Numerical Rating Scale, Visual Analog Scale, or Verbal Rating Scale. Results A total of 17 RCTs (with 1111 patients) were included in the systematic review, and data from 14 RCTs (with 920 patients) were used in the meta-analysis. Seven sham-controlled RCTs (35%) were notable for their high quality, being judged to have a low risk of bias for all of their domains, and showed that real (compared with sham) acupuncture was associated with reduced pain intensity (mean difference [MD], −1.38 points; 95% CI, −2.13 to −0.64 points; I2 = 81%). A favorable association was also seen when acupuncture and acupressure were combined with analgesic therapy in 6 RCTs for reducing pain intensity (MD, −1.44 points; 95% CI, −1.98 to −0.89; I2 = 92%) and in 2 RCTs for reducing opioid dose (MD, −30.00 mg morphine equivalent daily dose; 95% CI, −37.5 mg to −22.5 mg). The evidence grade was moderate because of the substantial heterogeneity among studies. Conclusions and Relevance This systematic review and meta-analysis found that acupuncture and/or acupressure was significantly associated with reduced cancer pain and decreased use of analgesics, although the evidence level was moderate. This finding suggests that more rigorous trials are needed to identify the association of acupuncture and acupressure with specific types of cancer pain and to integrate such evidence into clinical care to reduce opioid use.
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Affiliation(s)
- Yihan He
- Guangdong Provincial Hospital of Chinese Medicine, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangdong Provincial Academy of Chinese Medical Sciences, Guangzhou, Guangdong Province, China.,China-Australia International Research Centre for Chinese Medicine, School of Health and Biomedical Sciences, RMIT University, Melbourne, Victoria, Australia
| | - Xinfeng Guo
- Guangdong Provincial Hospital of Chinese Medicine, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangdong Provincial Academy of Chinese Medical Sciences, Guangzhou, Guangdong Province, China
| | - Brian H May
- China-Australia International Research Centre for Chinese Medicine, School of Health and Biomedical Sciences, RMIT University, Melbourne, Victoria, Australia
| | - Anthony Lin Zhang
- China-Australia International Research Centre for Chinese Medicine, School of Health and Biomedical Sciences, RMIT University, Melbourne, Victoria, Australia
| | - Yihong Liu
- Guangdong Provincial Hospital of Chinese Medicine, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangdong Provincial Academy of Chinese Medical Sciences, Guangzhou, Guangdong Province, China
| | - Chuanjian Lu
- Guangdong Provincial Hospital of Chinese Medicine, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangdong Provincial Academy of Chinese Medical Sciences, Guangzhou, Guangdong Province, China
| | - Jun J Mao
- Integrative Medicine Department, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Charlie Changli Xue
- Guangdong Provincial Hospital of Chinese Medicine, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangdong Provincial Academy of Chinese Medical Sciences, Guangzhou, Guangdong Province, China.,China-Australia International Research Centre for Chinese Medicine, School of Health and Biomedical Sciences, RMIT University, Melbourne, Victoria, Australia
| | - Haibo Zhang
- Guangdong Provincial Hospital of Chinese Medicine, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangdong Provincial Academy of Chinese Medical Sciences, Guangzhou, Guangdong Province, China
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21
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Jang S, Ko Y, Sasaki Y, Park S, Jo J, Kang NH, Yoo ES, Park NC, Cho SH, Jang H, Jang BH, Hwang DS, Ko SG. Acupuncture as an adjuvant therapy for management of treatment-related symptoms in breast cancer patients: Systematic review and meta-analysis (PRISMA-compliant). Medicine (Baltimore) 2020; 99:e21820. [PMID: 33327222 PMCID: PMC7738093 DOI: 10.1097/md.0000000000021820] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Although randomized controlled trials have revealed the considerable effectiveness of acupuncture in breast cancer patients, there have been no studies exploring current acupuncture research trends for treatment induced various symptoms in breast cancer patients. This review evaluated the effectiveness of acupuncture for treatment-induced symptoms in breast cancer patients. METHODS We performed a systematic review and meta-analysis of the literature regarding acupuncture to treat symptoms associated with breast cancer therapies. The following databases were searched for relevant RCTs published before June 2018: MEDLINE, EMBASE, the Cochrane Library, AMED, CINAHL, OASIS, CNKI, and CiNii. RESULTS Among the 19,483 records identified, 835 articles remained after screening titles and abstracts. A total of 19 RCTs were included in this qualitative synthesis. Among the studies, 8 explored climacteric symptoms, 4 explored pain, 2 explored lymphedemas, 2 explored nausea and vomiting and 3 investigated miscellaneous symptoms.explored miscellaneous symptoms due to cancer treatments. Most of the studies reported that acupuncture can alleviate various symptoms of breast cancer treatment. However, there is a lack of evidence as to whether accupuncture can alleviate chemotherapy associated side effects CONCLUSIONS:: Acupuncture may alleviate the treatment-related symptoms of breast cancer; however, further studies are necessary to obtain conclusive evidence of the effectiveness of acupuncture in treating breast cancer. REGISTRATION NUMBER CRD42018087813.
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Affiliation(s)
- Soobin Jang
- Clinical Research Division, Korea Institute of Oriental Medicine; 1672 Yuseong-daero, Yuseong-gu, Daejeon
| | - Youme Ko
- Department of Preventive Medicine, College of Korean Medicine, Kyung Hee University; 26, Kyungheedae-ro, Hoegi-dong, Dongdaemun-gu, Seoul
| | - Yui Sasaki
- Department of Preventive Medicine, College of Korean Medicine, Kyung Hee University; 26, Kyungheedae-ro, Hoegi-dong, Dongdaemun-gu, Seoul
| | - Sunju Park
- Department of Preventive Medicine, College of Korean Medicine, Daejeon University; 62 Daehak-ro, Dong-gu, Daejeon
| | - Junyoung Jo
- Department of Korean Obstetrics and Gynecology, Conmaul Hospital of Korean Medicine, 110 Seochojungang-ro, Seocho-dong, Seocho-gu, Seoul
| | - Na-Hoon Kang
- Department of Clinical Korean Medicine, Graduate School, Kyung-Hee University, 26, Kyungheedae-ro, Hoegi-dong, Dongdaemun-gu, Seoul
| | - Eun-Sil Yoo
- Department of Clinical Korean Medicine, Graduate School, Kyung-Hee University, 26, Kyungheedae-ro, Hoegi-dong, Dongdaemun-gu, Seoul
| | - Nam-Chun Park
- Department of Clinical Korean Medicine, Graduate School, Kyung-Hee University, 26, Kyungheedae-ro, Hoegi-dong, Dongdaemun-gu, Seoul
| | - Seong hee Cho
- Department of Obstetrics and Gynecology, College of Korean Medicine, Dong-Shin University, 185, Geonjae-ro, Naju-si, Jeollanam-do
| | - Heejea Jang
- Women Cancer Center, Soram Korean medicine Hospital, 154–11, Samsung-dong, 06154, Gangnam-gu, Seoul, Republic of Korea
| | - Bo-Hyoung Jang
- Department of Preventive Medicine, College of Korean Medicine, Kyung Hee University; 26, Kyungheedae-ro, Hoegi-dong, Dongdaemun-gu, Seoul
| | - Deok-Sang Hwang
- Department of Preventive Medicine, College of Korean Medicine, Daejeon University; 62 Daehak-ro, Dong-gu, Daejeon
| | - Seong-Gyu Ko
- Department of Preventive Medicine, College of Korean Medicine, Kyung Hee University; 26, Kyungheedae-ro, Hoegi-dong, Dongdaemun-gu, Seoul
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22
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Tenti S, Correale P, Cheleschi S, Fioravanti A, Pirtoli L. Aromatase Inhibitors-Induced Musculoskeletal Disorders: Current Knowledge on Clinical and Molecular Aspects. Int J Mol Sci 2020; 21:E5625. [PMID: 32781535 PMCID: PMC7460580 DOI: 10.3390/ijms21165625] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 07/29/2020] [Accepted: 08/04/2020] [Indexed: 02/06/2023] Open
Abstract
Aromatase inhibitors (AIs) have radically changed the prognosis of hormone receptor positive breast cancer (BC) in post-menopausal women, and are a mainstay of the adjuvant therapy for BC after surgery in place of, or following, Tamoxifen. However, AIs aren't side effect-free; frequent adverse events involve the musculoskeletal system, in the form of bone loss, AI-associated arthralgia (AIA) syndrome and autoimmune rheumatic diseases. In this narrative review, we reported the main clinical features of these three detrimental conditions, their influence on therapy adherence, the possible underlying molecular mechanisms and the available pharmacological and non-pharmacological treatments. The best-known form is the AIs-induced osteoporosis, whose molecular pathway and therapeutic possibilities were extensively investigated in the last decade. AIA syndrome is a high prevalent joint pain disorder which often determines a premature discontinuation of the therapy. Several points still need to be clarified, as a universally accepted diagnostic definition, the pathogenetic mechanisms and satisfactory management strategies. The association of AIs therapy with autoimmune diseases is of the utmost interest. The related literature has been recently expanded, but many issues remain to be explored, the first being the molecular mechanisms.
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Affiliation(s)
- Sara Tenti
- Rheumatology Unit, Department of Medicine, Surgery and Neuroscience, Azienda Ospedaliera Universitaria Senese, Policlinico Le Scotte, Viale Bracci 1, 53100 Siena, Italy; (S.T.); (A.F.)
| | - Pierpaolo Correale
- Medical Oncology Unit, Grand Metropolitan Hospital “Bianchi-Melacrino-Morelli”, 89121 Reggio Calabria, Italy;
| | - Sara Cheleschi
- Rheumatology Unit, Department of Medicine, Surgery and Neuroscience, Azienda Ospedaliera Universitaria Senese, Policlinico Le Scotte, Viale Bracci 1, 53100 Siena, Italy; (S.T.); (A.F.)
| | - Antonella Fioravanti
- Rheumatology Unit, Department of Medicine, Surgery and Neuroscience, Azienda Ospedaliera Universitaria Senese, Policlinico Le Scotte, Viale Bracci 1, 53100 Siena, Italy; (S.T.); (A.F.)
| | - Luigi Pirtoli
- Sbarro Institute for Cancer Research and Molecular Medicine-Center for Biotechnology, Department of Biology, College of Science and Technology, Temple University, Philadelphia, PA 19122, USA;
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23
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Shi K, Tang Y, He F, Xiao X, Zhang J, Jin Y, Wang Y, Zhang Q. The maintenance effect of acupuncture on the side effects of breast cancer endocrine therapy: A protocol for systematic review and meta analysis. Medicine (Baltimore) 2020; 99:e20567. [PMID: 32541483 PMCID: PMC7302662 DOI: 10.1097/md.0000000000020567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Breast cancer is common among women throughout the world and endocrine therapy is an established part of its treatment. But, unfortunately, this has also resulted in intolerable side effects affecting the quality of life. Acupuncture has been widely used to treat endocrine-related side effects in patients with breast cancer, but how long its effect can be maintained has not been published. The systematic review is designed to evaluate the maintenance efficacy of acupuncture for related side effects after breast cancer endocrine therapy. METHODS AND ANALYSIS We will search for the following databases: PubMed, Embase, Cochrane Library, Web of Science, including China National Knowledge Infrastructure (CNKI), WanFang Data, Technology Periodical Database (VIP), and China Biology Medicine (CBM) from inception to May 2020. Two reviewers will search these databases, collect all articles, and assess the quality of studies separately, and there will be no limitations on language. The primary outcomes will be assessed using acupuncture for endocrine-related hot flashes and joint pain duration (1 month, 3 months, 6 months). Measurement tools include the Kupperman index, Brief Pain Inventory Short Form (BPI-SF), the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), the Brief Pain Inventory-Short (BPI-SF). We will use RevMan V.5.3 for meta-analysis and employ the Grading of Recommendations Assessment, Development and Evaluation System to assess the quality of evidence. RESULTS This systematic review will evaluate the maintenance efficacy of acupuncture on the side effects of breast cancer endocrine therapy. CONCLUSION This study will provide high-quality current evidence of how long its effect can be maintained after acupuncture for related side effects after breast cancer endocrine therapy. ETHICS AND DISSEMINATION Ethical committee approval is not required for this systematic review as patient data will not be collected. This study will help to inform doctors and researchers on the duration of acupuncture treatment for endocrine-related hot flashes and joint pain. The results will be published in a peer-reviewed journal and will be disseminated in relevant conferences. INPLASY REGISTRATION NUMBER INPLASY202040024.
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24
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The Effects of Pharmacological and Non-Pharmacological Interventions on Symptom Management and Quality of Life among Breast Cancer Survivors Undergoing Adjuvant Endocrine Therapy: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17082950. [PMID: 32344759 PMCID: PMC7215959 DOI: 10.3390/ijerph17082950] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Revised: 04/17/2020] [Accepted: 04/18/2020] [Indexed: 02/06/2023]
Abstract
Breast cancer survivors need to undergo adjuvant endocrine therapy after completion of curative treatments to prevent disease recurrence. These individuals often experience symptoms which are detrimental to their quality of life (QOL). Implementation of interventions for effective symptom management among these survivors is warranted. This review provides an overview of studies on the effectiveness of the previously developed interventions for breast cancer survivors undergoing adjuvant endocrine therapy on symptom alleviation and enhancement of QOL or health-related QOL (HRQOL). Five electronic databases were employed in the literature search. Study selection, data extraction and critical appraisal of the included studies were conducted by three authors independently. Twenty-four studies were included. Both pharmacological and non-pharmacological interventions are effective in addressing the symptoms associated with adjuvant endocrine therapy among the breast cancer survivors, and in improving their QOL, although discrepancies were noted between the studies in terms of the significance of these effects. Pharmacological and non-pharmacological interventions can be effective for symptom management among breast cancer survivors. Their implementation is recommended for effective survivorship care for these individuals. Further research on intervention development for breast cancer survivors is recommended to provide further evidence for the utility of the explored interventions in survivorship care for these patients.
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Behzadmehr R, Dastyar N, Moghadam MP, Abavisani M, Moradi M. Effect of complementary and alternative medicine interventions on cancer related pain among breast cancer patients: A systematic review. Complement Ther Med 2020; 49:102318. [PMID: 32147038 DOI: 10.1016/j.ctim.2020.102318] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2019] [Revised: 01/13/2020] [Accepted: 01/14/2020] [Indexed: 12/25/2022] Open
Abstract
OBJECTIVE This systematic review aimed to evaluate the efficacy of CAM interventions for cancer-related pain in breast cancer patients. METHODS Databases (PubMed, Scopus, Web of Science, and EMBASE) were searched from January 1, 2000, up to April 31, 2019, using the keywords: Complementary and alternative medicine therapies and cancer related pain. Standard tools were used to evaluate the quality of the studies included. RESULTS Of the 3742 articles found, 46 articles comprising 3685 participants entered the final phase. Our results indicate that interventions including acupuncture/acupressure, tai chi/qi gong, hypnosis, meditation, music therapy, yoga, massage, reflexology, and Reiki improve cancer-related pain in breast cancer patients. However, aromatherapy had no effect on the same. CONCLUSIONS Despite the positive effect of various CAM interventions in reducing cancer-related pain, necessary precautions should be adopted to use them alongside other treatments to control cancer pain in the clinical setting.
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Affiliation(s)
- Razieh Behzadmehr
- Department of Radiology, School of Medicine, Zabol University of Medical Sciences, Zabol, Iran
| | - Neda Dastyar
- Department of Midwifery, Jiroft University of Medical Sciences, Jiroft, Iran
| | - Mahdieh Poodineh Moghadam
- Department of Nursing, Faculty of Nursing and Midwifery, Zabol University of Medical Sciences, Zabol, Iran
| | - Mahnaz Abavisani
- MSc of Medical Surgical Nursing, Department of Nursing, Neyshabur University of Medical Sciences, Neyshabur, Iran
| | - Mandana Moradi
- Clinical Pharmacy Department, School of Pharmacy, Zabol University of Medical Sciences, Zabol, Iran.
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26
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Maindet C, Burnod A, Minello C, George B, Allano G, Lemaire A. Strategies of complementary and integrative therapies in cancer-related pain-attaining exhaustive cancer pain management. Support Care Cancer 2019; 27:3119-3132. [PMID: 31076901 DOI: 10.1007/s00520-019-04829-7] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Accepted: 04/23/2019] [Indexed: 12/13/2022]
Abstract
PURPOSE Complementary integrative therapies (CITs) correspond to growing demand in patients with cancer-related pain. This demand needs to be considered alongside pharmaceutical and/or interventional therapies. CITs can be used to cover certain specific pain-related characteristics. The objective of this review is to present the options for CITs that could be used within dynamic, multidisciplinary, and personalized management, leading to an integrative oncology approach. METHODS Critical reflection based on literature analysis and clinical practice. RESULTS Most CITs only showed trends in efficacy as cancer pain was mainly a secondary endpoint, or populations were restricted. Physical therapy has demonstrated efficacy in motion and pain, in some specific cancers (head and neck or breast cancers) or in treatments sequelae (lymphedema). In cancer survivors, higher levels of physical activity decrease pain intensity. Due to the multimorphism of cancer pain, certain mind-body therapies acting on anxiety, stress, depression, or mood disturbances (such as massage, acupuncture, healing touch, hypnosis, and music therapy) are efficient on cancer pain. Other mind-body therapies have shown trends in reducing the severity of cancer pain and improving other parameters, and they include education (with coping skills training), yoga, tai chi/qigong, guided imagery, virtual reality, and cognitive-behavioral therapy alone or combined. The outcome sustainability of most CITs is still questioned. CONCLUSIONS High-quality clinical trials should be conducted with CITs, as their efficacy on pain is mainly based on efficacy trends in pain severity, professional judgment, and patient preferences. Finally, the implementation of CITs requires an interdisciplinary team approach to offer optimal, personalized, cancer pain management.
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Affiliation(s)
- Caroline Maindet
- Pain management centre, Grenoble-Alpes University Hospital, Grenoble, France
| | - Alexis Burnod
- Department of supportive care, Institut Curie, PSL Research University, Paris, France
| | - Christian Minello
- Anaesthesia-intensive care department, Cancer Centre Georges François Leclerc, Dijon, France
| | | | - Gilles Allano
- Pain management unit, Mutualist Clinic of la Porte-de-l'Orient, Lorient, France
| | - Antoine Lemaire
- Oncology and medical specialties department, Valenciennes General Hospital, Valenciennes, France.
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Anand K, Niravath P. Acupuncture and Vitamin D for the Management of Aromatase Inhibitor-Induced Arthralgia. Curr Oncol Rep 2019; 21:51. [PMID: 30997616 DOI: 10.1007/s11912-019-0795-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
PURPOSE OF REVIEW Aromatase inhibitor-induced arthralgia (AIA) is a very common syndrome which significantly affects breast cancer survivors' quality of life, and it often leads to non-compliance with aromatase inhibitor (AI) therapy. However, the treatment of AIA remains a clinical challenge. Here, we will review the current data for acupuncture and vitamin D in the management of AIA. RECENT FINDINGS Acupuncture has been shown to improve AIA symptoms, but it has not consistently been proven to offer significantly more clinical benefit than sham acupuncture. Similarly, while some vitamin D trials have shown benefit, the studies have not consistently shown improvement in AIA symptoms. Neither acupuncture nor vitamin D can be touted as standard treatments for AIA. However, many patients do experience subjective improvement of their symptoms with these therapies. When other treatments, such as exercise and duloxetine, are not feasible or not effective, it is reasonable to offer a trial of acupuncture or vitamin D to patients who are suffering from AIA, as the potential harms are very few, and they do offer possible relief from AIA symptoms.
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Affiliation(s)
- Kartik Anand
- Houston Methodist Cancer Center/Weill Cornell Medicine, Outpatient Tower, Floor 24, 6445 Main Street, Houston, TX, 77030, USA
| | - Polly Niravath
- Houston Methodist Cancer Center/Weill Cornell Medicine, Outpatient Tower, Floor 24, 6445 Main Street, Houston, TX, 77030, USA.
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28
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Wang CC, Tan JY, Williams A. Safety and side effects of acupuncture therapy in Australia: A systematic review. Eur J Integr Med 2019. [DOI: 10.1016/j.eujim.2019.03.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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Tam KW, Chen L, Lin CC, Huang TW, Kuan YC, Huang YH, Chen HC, Kao CY, Su CM. Reply to correspondence concerning "Acupuncture on aromatase inhibitor-induced arthralgia in patients with breast cancer". Breast 2019; 45:119-120. [PMID: 30857771 DOI: 10.1016/j.breast.2019.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Accepted: 02/11/2019] [Indexed: 10/27/2022] Open
Affiliation(s)
- Ka-Wai Tam
- Division of General Surgery, Department of General Surgery, Shuang Ho Hospital, Taipei Medical University, Taiwan; Center for Evidence-Based Health Care, Shuang Ho Hospital, Taipei Medical University, Taiwan.
| | - Lawrence Chen
- Center for Evidence-Based Health Care, Shuang Ho Hospital, Taipei Medical University, Taiwan
| | - Chao-Chun Lin
- Center for Evidence-Based Health Care, Shuang Ho Hospital, Taipei Medical University, Taiwan
| | - Tsai-Wei Huang
- School of Nursing, College of Nursing, Taipei Medical University, Taiwan
| | - Yi-Chun Kuan
- Center for Evidence-Based Health Care, Shuang Ho Hospital, Taipei Medical University, Taiwan; Department of Neurology, Shuang Ho Hospital, Taipei Medical University, Taiwan
| | - Yao-Hsien Huang
- Department of Neurology, Shuang Ho Hospital, Taipei Medical University, Taiwan
| | - Hung-Chou Chen
- Center for Evidence-Based Health Care, Shuang Ho Hospital, Taipei Medical University, Taiwan; Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, Taiwan
| | - Chun-Yu Kao
- Division of General Surgery, Department of General Surgery, Shuang Ho Hospital, Taipei Medical University, Taiwan
| | - Chih-Ming Su
- Division of General Surgery, Department of General Surgery, Shuang Ho Hospital, Taipei Medical University, Taiwan
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30
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Lu W, Rosenthal DS. Oncology Acupuncture for Chronic Pain in Cancer Survivors: A Reflection on the American Society of Clinical Oncology Chronic Pain Guideline. Hematol Oncol Clin North Am 2019; 32:519-533. [PMID: 29729786 DOI: 10.1016/j.hoc.2018.01.009] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Chronic pain syndromes associated with cancer treatment are common but difficult to manage. The American Society of Clinical Oncology recently published a practice guideline to address the unmet needs of cancer survivors, Management of Chronic Pain in Survivors of Adult Cancers, which stresses the importance of implementing integrative therapies including acupuncture. This review focuses on randomized clinical trials of acupuncture for chronic pain in cancer survivors, including its use in chemotherapy-induced peripheral neuropathy, aromatase inhibitor-associated arthralgia, and post neck dissection pain, and provides future directions of oncology acupuncture research in cancer survivorship. The features of oncology acupuncture are also discussed.
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Affiliation(s)
- Weidong Lu
- Leonard P. Zakim Center for Integrative Therapies and Healthy Living, Dana-Farber Cancer Institute, Harvard Medical School, 450 Brookline Avenue, Boston, MA 02215, USA.
| | - David S Rosenthal
- Leonard P. Zakim Center for Integrative Therapies and Healthy Living, Dana-Farber Cancer Institute, Harvard Medical School, 450 Brookline Avenue, Boston, MA 02215, USA
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Hershman DL, Unger JM, Greenlee H, Capodice JL, Lew DL, Darke AK, Kengla AT, Melnik MK, Jorgensen CW, Kreisle WH, Minasian LM, Fisch MJ, Henry NL, Crew KD. Effect of Acupuncture vs Sham Acupuncture or Waitlist Control on Joint Pain Related to Aromatase Inhibitors Among Women With Early-Stage Breast Cancer: A Randomized Clinical Trial. JAMA 2018; 320:167-176. [PMID: 29998338 PMCID: PMC6583520 DOI: 10.1001/jama.2018.8907] [Citation(s) in RCA: 185] [Impact Index Per Article: 30.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
IMPORTANCE Musculoskeletal symptoms are the most common adverse effects of aromatase inhibitors and often result in therapy discontinuation. Small studies suggest that acupuncture may decrease aromatase inhibitor-related joint symptoms. OBJECTIVE To determine the effect of acupuncture in reducing aromatase inhibitor-related joint pain. DESIGN, SETTING, AND PATIENTS Randomized clinical trial conducted at 11 academic centers and clinical sites in the United States from March 2012 to February 2017 (final date of follow-up, September 5, 2017). Eligible patients were postmenopausal women with early-stage breast cancer who were taking an aromatase inhibitor and scored at least 3 on the Brief Pain Inventory Worst Pain (BPI-WP) item (score range, 0-10; higher scores indicate greater pain). INTERVENTIONS Patients were randomized 2:1:1 to the true acupuncture (n = 110), sham acupuncture (n = 59), or waitlist control (n = 57) group. True acupuncture and sham acupuncture protocols consisted of 12 acupuncture sessions over 6 weeks (2 sessions per week), followed by 1 session per week for 6 weeks. The waitlist control group did not receive any intervention. All participants were offered 10 acupuncture sessions to be used between weeks 24 and 52. MAIN OUTCOMES AND MEASURES The primary end point was the 6-week BPI-WP score. Mean 6-week BPI-WP scores were compared by study group using linear regression, adjusted for baseline pain and stratification factors (clinically meaningful difference specified as 2 points). RESULTS Among 226 randomized patients (mean [SD] age, 60.7 [8.6] years; 88% white; mean [SD] baseline BPI-WP score, 6.6 [1.5]), 206 (91.1%) completed the trial. From baseline to 6 weeks, the mean observed BPI-WP score decreased by 2.05 points (reduced pain) in the true acupuncture group, by 1.07 points in the sham acupuncture group, and by 0.99 points in the waitlist control group. The adjusted difference for true acupuncture vs sham acupuncture was 0.92 points (95% CI, 0.20-1.65; P = .01) and for true acupuncture vs waitlist control was 0.96 points (95% CI, 0.24-1.67; P = .01). Patients in the true acupuncture group experienced more grade 1 bruising compared with patients in the sham acupuncture group (47% vs 25%; P = .01). CONCLUSIONS AND RELEVANCE Among postmenopausal women with early-stage breast cancer and aromatase inhibitor-related arthralgias, true acupuncture compared with sham acupuncture or with waitlist control resulted in a statistically significant reduction in joint pain at 6 weeks, although the observed improvement was of uncertain clinical importance. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT01535066.
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Affiliation(s)
| | - Joseph M. Unger
- Fred Hutchinson Cancer Research Center, Seattle, Washington
- SWOG Statistics and Data Management Center, Seattle, Washington
| | | | | | - Danika L. Lew
- Fred Hutchinson Cancer Research Center, Seattle, Washington
- SWOG Statistics and Data Management Center, Seattle, Washington
| | - Amy K. Darke
- Fred Hutchinson Cancer Research Center, Seattle, Washington
- SWOG Statistics and Data Management Center, Seattle, Washington
| | | | | | - Carla W. Jorgensen
- NCORP of the Carolinas (Greenville Health System), Greenville, South Carolina
| | | | - Lori M. Minasian
- Division of Cancer Prevention, National Cancer Institute, Bethesda, Maryland
| | | | - N. Lynn Henry
- University of Utah Huntsman Cancer Institute, Salt Lake City
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Conejo I, Pajares B, Alba E, Cuesta-Vargas AI. Effect of neuromuscular taping on musculoskeletal disorders secondary to the use of aromatase inhibitors in breast cancer survivors: a pragmatic randomised clinical trial. Altern Ther Health Med 2018; 18:180. [PMID: 29890985 PMCID: PMC5996544 DOI: 10.1186/s12906-018-2236-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2017] [Accepted: 05/21/2018] [Indexed: 12/27/2022]
Abstract
Background Aromatase inhibitors reduce breast cancer recurrence rates in postmenopausal women by about 30% compared with tamoxifen while treatments differ. Unfortunately, nearly half of women taking AIs report AI-associated arthralgia (AIA), leading to therapy abandon in on third of patients, which could lead to cancer recurrence. The purpose of the current study was to evaluate the effectiveness of Neuromuscular Taping (NMT) in the treatment of AIA in women who have been treated of BC. Methods This study included 40 BC survivors receiving endocrine therapy (either AIs or TMX) from Hospital Universitario Virgen de la Victoria (Málaga, Spain) suffered from AIA. Patients were randomized to one of the two groups that made this pilot study: A. Placebo intervention B. Real NMT. Clinical data were collected from medical history, grip strength, algometry measured, questionnaires and VAS scale. There have been three interventions prior to the completion of the study, 5 weeks later. The primary objective of this pilot study was to achieve an improvement of pain by 20% decrease of VAS. Results Significant differences in measures of VAS (p = 0.009), global health status/QoL (p = 0.005), fatigue (p = 0.01) and pain (p = 0.04) were observed post intervention with NMT. Conclusions An intervention by NMT to MSCM under treatment with AIs improves their subjective sensation of pain. In addition, this taping had an impact on variables related to the quality of life. This pilot study may be the basis for others to support the use of NMT for the treatment of AIAs, thereby improving their well-being and reducing the dropout rate. Trial registration ClinicalTrials.gov Identifier: NCT02406794. Registered on 2 April 2015 Retrospectively registered.
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Bao T, Peppone LJ, Robinson P. Addressing the Unintentional Consequences of Cancer Therapy With Novel Integrative Therapeutics. Am Soc Clin Oncol Educ Book 2018; 38:822-828. [PMID: 30231327 DOI: 10.1200/edbk_201411] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
There are 15.5 million cancer survivors in the United States because of, in part, improvements in therapy. As a result, there will be an increased burden of long- and late-term complications of cancer care, such as metabolic alterations. These metabolic changes will include alterations in bone resorption, obesity, hypercholesterolemia, and diabetes mellitus. The majority of cancer treatment-related toxicities have focused on endocrine therapy; however, chemotherapy and supportive medications, such as steroids, contribute to the development of these disorders. Because of the chronicity of these metabolic changes and their impact on morbidity, cancer risk, and outcomes as well other negative effects, including musculoskeletal pain and vasomotor symptoms, alternative strategies must be developed. These strategies should include nonpharmacologic approaches. Here, we summarize metabolic changes secondary to cancer care and integrative approaches to help alleviate therapy-associated toxicities.
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Affiliation(s)
- Ting Bao
- From the Memorial Sloan Kettering Cancer Center, New York, NY; University of Rochester Medical Center, Rochester, NY; Loyola University Medical Center, Maywood, IL
| | - Luke J Peppone
- From the Memorial Sloan Kettering Cancer Center, New York, NY; University of Rochester Medical Center, Rochester, NY; Loyola University Medical Center, Maywood, IL
| | - Patricia Robinson
- From the Memorial Sloan Kettering Cancer Center, New York, NY; University of Rochester Medical Center, Rochester, NY; Loyola University Medical Center, Maywood, IL
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Nahm N, Mee S, Marx G. Efficacy of management strategies for aromatase inhibitor-induced arthralgia in breast cancer patients: a systematic review. Asia Pac J Clin Oncol 2018; 14:374-382. [PMID: 29380528 DOI: 10.1111/ajco.12845] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2017] [Accepted: 12/12/2017] [Indexed: 01/22/2023]
Abstract
Aromatase inhibitors are the gold standard in the treatment of hormone receptor-positive breast cancer, but lead to an arthralgia syndrome which is implicated in 13-22% of noncompliance. This is the first systematic review of the efficacy of existing management strategies for this side effect. Eligible studies were retrieved from computer searches of Medline, Cochrane and Embase and the significant intervention groups were identified. The risk of bias of selected studies was evaluated and the relevant data items were extracted, summarized and analyzed. A total of 21 studies were discussed in this review representing 12 different interventions. While several trials had positive findings, the major methodological limitations of the studies meant that no definitive evidence could be found supporting any of the interventions. Future trials are needed which address the methodological problems identified in this review. Exercise holds promise for future research based on its proven benefit in breast cancer.
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Affiliation(s)
- Nicole Nahm
- University of Sydney, Sydney Adventist Hospital, SAN Integrated Cancer Centre, Wahroonga, New South Wales, Australia
| | - Susie Mee
- University of Sydney, Sydney Adventist Hospital, SAN Integrated Cancer Centre, Wahroonga, New South Wales, Australia
| | - Gavin Marx
- University of Sydney, Sydney Adventist Hospital, SAN Integrated Cancer Centre, Wahroonga, New South Wales, Australia
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River J, McKenzie H, Levy D, Pavlakis N, Back M, Oh B. Convergent priorities and tensions: a qualitative study of the integration of complementary and alternative therapies with conventional cancer treatment. Support Care Cancer 2017; 26:1791-1797. [DOI: 10.1007/s00520-017-4021-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2017] [Accepted: 12/10/2017] [Indexed: 10/18/2022]
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Van der Weijden-Van Doornik EM, Slot DE, Burtin C, van der Weijden GA. Grip Strength in Women Being Treated for Breast Cancer and Receiving Adjuvant Endocrine Therapy: Systematic Review. Phys Ther 2017; 97:904-914. [PMID: 28969348 DOI: 10.1093/ptj/pzx069] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2016] [Accepted: 06/21/2017] [Indexed: 12/27/2022]
Abstract
BACKGROUND Adjuvant endocrine therapy in breast cancer has increased survival rates; however, it is not without musculoskeletal side effects. PURPOSE The purpose of this review was to systematically and critically appraise the available scientific evidence concerning the effect of adjuvant endocrine treatment on grip strength in women being treated for breast cancer. DATA SOURCES AND STUDY SELECTION The National Library of Medicine (MEDLINE-PubMed), Cochrane Central Register of Controlled Trials (CENTRAL), Excerpta Medical Database by Elsevier (EMBASE), Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Physiotherapy Evidence Database (PEDro) were searched from inception to February 2017 for appropriate papers that could answer the focused question. The searches were independently screened by 2 reviewers. The data from 7 papers that met the eligibility criteria were processed for further analysis. DATA EXTRACTION AND SYNTHESIS The collective data and the statistical analysis of all included studies were summarized and presented in a descriptive manner. If not provided, based on data from the individual included studies, a mean percent change in grip strength was calculated. The included studies evaluating aromatase inhibitors had inconclusive outcomes, and studies with a follow-up of 6 or 12 months showed a percent reduction in grip strength varying from 0.1% to 9.7%. None of the included studies showed a significant decrease in grip strength in tamoxifen users, with a percent reduction in grip strength varying from 1.4% to 2.2%. LIMITATIONS The 7 studies included cohort studies lacking a control group. CONCLUSIONS There is inconclusive evidence for a small decrease in grip strength in women treated for breast cancer who are also receiving aromatase inhibitors. In those that use tamoxifen, grip strength did not change significantly.
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Affiliation(s)
| | - Dagmar E Slot
- Department Periodontology, Academic Centre for Dentistry Amsterdam, University of Amsterdam and Vrije Universiteit Amsterdam
| | - Chris Burtin
- Rehabilitation Research Centre, Biomedical Research Institute, Faculty of Medicine and Life Sciences, Hasselt University, Diepenbeek, Belgium
| | - G A van der Weijden
- Department Periodontology, Academic Centre for Dentistry Amsterdam, University of Amsterdam and Vrije Universiteit Amsterdam
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Interventions for the Treatment of Aromatase Inhibitor-Associated Arthralgia in Breast Cancer Survivors: A Systematic Review and Meta-analysis. Cancer Nurs 2017; 40:E26-E41. [PMID: 27333128 DOI: 10.1097/ncc.0000000000000409] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND Aromatase inhibitors (AIs) have been established as successful adjuvant therapy for breast cancer survivors. Unfortunately, nearly half of women taking AIs report joint pain, AI-associated arthralgia (AIA). Aromatase inhibitor-associated arthralgia often results in noncompliance, which could lead to cancer recurrence. OBJECTIVE The purpose of this study was to identify current pain management of AIA and to evaluate the study quality and effects of interventions. METHODS Nineteen articles published from 2000 to August 2015 were identified using PubMed, CINAHL, PsycINFO, Web of Science, and additional records. Study quality was evaluated by the Quality Assessment Tool for Quantitative Studies. Meta-analysis was used to obtain effect sizes of interventions on pain and subgroups. RESULTS Five types of interventions emerged: pharmacological approaches, acupuncture, nutritional supplementation, relaxation techniques, and physical exercise. Six studies were strong, 8 were moderate, and 5 were weak in quality. The overall effect size of the interventions on pain was large; pharmacological approaches, acupuncture, and relaxation techniques showed moderate to large effects on pain, whereas nutritional supplementation and physical exercise had no significant effects on it. CONCLUSION The evidence was based on a body of research with moderate study quality. Although the overall effect of interventions is large, further investigation into the influence of nutrition and physical exercise is needed to better discern their potential for pain management. IMPLICATION FOR PRACTICE Oncology nurses may be able to implement such validated interventions as pain management modalities to mitigate the symptoms so that breast cancer survivors remain compliant with AIA therapy.
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Chen L, Lin CC, Huang TW, Kuan YC, Huang YH, Chen HC, Kao CY, Su CM, Tam KW. Effect of acupuncture on aromatase inhibitor-induced arthralgia in patients with breast cancer: A meta-analysis of randomized controlled trials. Breast 2017; 33:132-138. [DOI: 10.1016/j.breast.2017.03.015] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2017] [Revised: 03/25/2017] [Accepted: 03/29/2017] [Indexed: 01/27/2023] Open
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Greenlee H, DuPont-Reyes MJ, Balneaves LG, Carlson LE, Cohen MR, Deng G, Johnson JA, Mumber M, Seely D, Zick SM, Boyce LM, Tripathy D. Clinical practice guidelines on the evidence-based use of integrative therapies during and after breast cancer treatment. CA Cancer J Clin 2017; 67:194-232. [PMID: 28436999 PMCID: PMC5892208 DOI: 10.3322/caac.21397] [Citation(s) in RCA: 420] [Impact Index Per Article: 60.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Answer questions and earn CME/CNE Patients with breast cancer commonly use complementary and integrative therapies as supportive care during cancer treatment and to manage treatment-related side effects. However, evidence supporting the use of such therapies in the oncology setting is limited. This report provides updated clinical practice guidelines from the Society for Integrative Oncology on the use of integrative therapies for specific clinical indications during and after breast cancer treatment, including anxiety/stress, depression/mood disorders, fatigue, quality of life/physical functioning, chemotherapy-induced nausea and vomiting, lymphedema, chemotherapy-induced peripheral neuropathy, pain, and sleep disturbance. Clinical practice guidelines are based on a systematic literature review from 1990 through 2015. Music therapy, meditation, stress management, and yoga are recommended for anxiety/stress reduction. Meditation, relaxation, yoga, massage, and music therapy are recommended for depression/mood disorders. Meditation and yoga are recommended to improve quality of life. Acupressure and acupuncture are recommended for reducing chemotherapy-induced nausea and vomiting. Acetyl-L-carnitine is not recommended to prevent chemotherapy-induced peripheral neuropathy due to a possibility of harm. No strong evidence supports the use of ingested dietary supplements to manage breast cancer treatment-related side effects. In summary, there is a growing body of evidence supporting the use of integrative therapies, especially mind-body therapies, as effective supportive care strategies during breast cancer treatment. Many integrative practices, however, remain understudied, with insufficient evidence to be definitively recommended or avoided. CA Cancer J Clin 2017;67:194-232. © 2017 American Cancer Society.
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Affiliation(s)
- Heather Greenlee
- Assistant Professor, Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY
- Member, Herbert Irving Comprehensive Cancer Center, Columbia University, New York, NY
| | - Melissa J DuPont-Reyes
- Doctoral Fellow, Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY
| | - Lynda G Balneaves
- Associate Professor, College of Nursing, Rady Faculty of Health Sciences, Winnipeg, MB, Canada
| | - Linda E Carlson
- Professor, Department of Oncology, University of Calgary, Calgary, AB, Canada
| | - Misha R Cohen
- Adjunct Professor, American College of Traditional Chinese Medicine at California Institute of Integral Studies, San Francisco, CA
- Clinic Director, Chicken Soup Chinese Medicine, San Francisco, CA
| | - Gary Deng
- Medical Director, Integrative Oncology, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Jillian A Johnson
- Post-Doctoral Scholar, Department of Biobehavioral Health, The Pennsylvania State University, University Park, PA
| | | | - Dugald Seely
- Executive Director, Ottawa Integrative Cancer Center, Ottawa, ON, Canada
- Executive Director of Research, Canadian College of Naturopathic Medicine, Toronto, ON, Canada
| | - Suzanna M Zick
- Research Associate Professor, Department of Family Medicine, Michigan Medicine, University of Michigan, Ann Arbor, MI
- Research Associate Professor, Department of Nutritional Sciences, School of Public Health, University of Michigan, Ann Arbor, MI
| | - Lindsay M Boyce
- Research Informationist, Memorial Sloan Kettering Library, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Debu Tripathy
- Professor, Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
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Dowling M, McDonagh B, Meade E. Arthralgia in Breast Cancer Survivors: An Integrative Review of Endocrine Therapy. Oncol Nurs Forum 2017. [DOI: 10.1188/17.337-349] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Roberts K, Rickett K, Greer R, Woodward N. Management of aromatase inhibitor induced musculoskeletal symptoms in postmenopausal early Breast cancer: A systematic review and meta-analysis. Crit Rev Oncol Hematol 2017; 111:66-80. [DOI: 10.1016/j.critrevonc.2017.01.010] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2016] [Revised: 11/30/2016] [Accepted: 01/18/2017] [Indexed: 12/27/2022] Open
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Sham Electroacupuncture Methods in Randomized Controlled Trials. Sci Rep 2017; 7:40837. [PMID: 28106094 PMCID: PMC5247761 DOI: 10.1038/srep40837] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2016] [Accepted: 12/13/2016] [Indexed: 01/04/2023] Open
Abstract
Sham electroacupuncture (EA) control is commonly used to evaluate the specific effects of EA in randomized-controlled trials (RCTs). However, establishing an inert and concealable sham EA control remains methodologically challenging. Here, we aimed to systematically investigate the sham EA methods. Eight electronic databases were searched from their inception to April 2015. Ten out of the 17 sham EA methods were identified from 94 RCTs involving 6134 participants according to three aspects: needle location, depth of needle insertion and electrical stimulation. The top three most frequently used types were sham EA type A, type L and type O ordinally. Only 24 out of the 94 trials reported credibility tests in six types of sham EA methods and the results were mainly as follows: sham EA type A (10/24), type B (5/24) and type Q (5/24). Compared with sham EA controls, EA therapy in 56.2% trials reported the specific effects, of which the highest positive rate was observed in type N (3/4), type F (5/7), type D (4/6) and type M (2/3). In conclusion, several sham EA types were identified as a promising candidate for further application in RCTs. Nonetheless, more evidence for inert and concealable sham EA control methods is needed.
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Niravath P. Aromatase Inhibitor-Associated Arthralgia: How Big Is the Problem and What Can Be Done? CURRENT BREAST CANCER REPORTS 2016. [DOI: 10.1007/s12609-016-0217-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Acupoint stimulation, massage therapy and expressive writing for breast cancer: A systematic review and meta-analysis of randomized controlled trials. Complement Ther Med 2016; 27:87-101. [PMID: 27515882 DOI: 10.1016/j.ctim.2016.06.003] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2015] [Revised: 03/23/2016] [Accepted: 06/10/2016] [Indexed: 11/21/2022] Open
Abstract
UNLABELLED Researches have accumulated using non-pharmacologic interventions including acupoint stimulation, massage therapy and expressive writing to manage breast cancer-related symptoms. Results from randomized controlled trials (RCTs) can get contradictory. OBJECTIVE A systematic review and meta-analysis were conducted to determine the effects on the quality of life, negative emotions and disease-related symptoms among women with breast cancer. METHODS Two independent researchers performed a structured search using data sources including MEDLINE, CINAHL, Cochrane Central Register of Controlled Trials, EMBASE, PubMed and PsychINFO from the beginning of time until the first week of January 2015. A total of 23 acupoint stimulation, massage therapy and expressive writing RCTs were included in the review. RESULTS The study showed that no single intervention could be put under the spotlight exhibiting an overall effective result on all measured outcomes; however, looking into each one in detail shows different results in specific outcomes. Among the three interventions, acupoint stimulation has a treatment effect for general pain (MD=-1.46, 95% CI=-2.38 to -0.53) and fatigue (MD=-2.22, 95% CI=-3.68 to -0.77), massage therapy has a treatment effect for anxiety (MD=-0.50, 95% CI=-0.77 to -0.24), and expressive writing has a treatment effect for quality of life (MD=7.18, 95% CI=0.38 to 13.98). The measurement other outcomes showed either ineffective or equivocal results. CONCLUSION Non-pharmacologic interventions including acupoint stimulation, massage therapy and expressive writing have an effect on a middle-age woman with breast cancer. However, because of limitations, the seemingly promising results should be interpreted with caution.
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Greenlee H, Balneaves LG, Carlson LE, Cohen M, Deng G, Hershman D, Mumber M, Perlmutter J, Seely D, Sen A, Zick SM, Tripathy D. Clinical practice guidelines on the use of integrative therapies as supportive care in patients treated for breast cancer. J Natl Cancer Inst Monogr 2015; 2014:346-58. [PMID: 25749602 DOI: 10.1093/jncimonographs/lgu041] [Citation(s) in RCA: 166] [Impact Index Per Article: 18.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND The majority of breast cancer patients use complementary and/or integrative therapies during and beyond cancer treatment to manage symptoms, prevent toxicities, and improve quality of life. Practice guidelines are needed to inform clinicians and patients about safe and effective therapies. METHODS Following the Institute of Medicine's guideline development process, a systematic review identified randomized controlled trials testing the use of integrative therapies for supportive care in patients receiving breast cancer treatment. Trials were included if the majority of participants had breast cancer and/or breast cancer patient results were reported separately, and outcomes were clinically relevant. Recommendations were organized by outcome and graded based upon a modified version of the US Preventive Services Task Force grading system. RESULTS The search (January 1, 1990-December 31, 2013) identified 4900 articles, of which 203 were eligible for analysis. Meditation, yoga, and relaxation with imagery are recommended for routine use for common conditions, including anxiety and mood disorders (Grade A). Stress management, yoga, massage, music therapy, energy conservation, and meditation are recommended for stress reduction, anxiety, depression, fatigue, and quality of life (Grade B). Many interventions (n = 32) had weaker evidence of benefit (Grade C). Some interventions (n = 7) were deemed unlikely to provide any benefit (Grade D). Notably, only one intervention, acetyl-l-carnitine for the prevention of taxane-induced neuropathy, was identified as likely harmful (Grade H) as it was found to increase neuropathy. The majority of intervention/modality combinations (n = 138) did not have sufficient evidence to form specific recommendations (Grade I). CONCLUSIONS Specific integrative therapies can be recommended as evidence-based supportive care options during breast cancer treatment. Most integrative therapies require further investigation via well-designed controlled trials with meaningful outcomes.
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Affiliation(s)
- Heather Greenlee
- Department of Epidemiology, Mailman School of Public Health (HG, DH), Herbert Irving Comprehensive Cancer Center, (HG, DH), and Department of Medicine, College of Physicians and Surgeons (DH), Columbia University, New York, NY (HG, DH); School of Nursing, University of British Columbia, Vancouver, BC, Canada (LGB); Department of Oncology, University of Calgary, Calgary, AB, Canada (LEC); Institute for Health and Aging, University of California San Francisco, CA (MC); Chicken Soup Chinese Medicine, San Francisco, CA (MC); Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY (GD); Harbin Clinic, Rome, GA (MM); Gemini Group, Ann Arbor, MI (JP); Ottawa Integrative Cancer Center, Ottawa, ON, Canada (DS); Canadian College of Naturopathic Medicine, Toronto, ON, Canada (DS); Department of Family Medicine, University of Michigan Health System (AS, SMZ), Department of Environmental Health Sciences, School of Public Health (SMZ), and Department of Biostatistics (AS), University of Michigan, Ann Arbor, MI (AS, SMZ); Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX (DT).
| | - Lynda G Balneaves
- Department of Epidemiology, Mailman School of Public Health (HG, DH), Herbert Irving Comprehensive Cancer Center, (HG, DH), and Department of Medicine, College of Physicians and Surgeons (DH), Columbia University, New York, NY (HG, DH); School of Nursing, University of British Columbia, Vancouver, BC, Canada (LGB); Department of Oncology, University of Calgary, Calgary, AB, Canada (LEC); Institute for Health and Aging, University of California San Francisco, CA (MC); Chicken Soup Chinese Medicine, San Francisco, CA (MC); Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY (GD); Harbin Clinic, Rome, GA (MM); Gemini Group, Ann Arbor, MI (JP); Ottawa Integrative Cancer Center, Ottawa, ON, Canada (DS); Canadian College of Naturopathic Medicine, Toronto, ON, Canada (DS); Department of Family Medicine, University of Michigan Health System (AS, SMZ), Department of Environmental Health Sciences, School of Public Health (SMZ), and Department of Biostatistics (AS), University of Michigan, Ann Arbor, MI (AS, SMZ); Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX (DT)
| | - Linda E Carlson
- Department of Epidemiology, Mailman School of Public Health (HG, DH), Herbert Irving Comprehensive Cancer Center, (HG, DH), and Department of Medicine, College of Physicians and Surgeons (DH), Columbia University, New York, NY (HG, DH); School of Nursing, University of British Columbia, Vancouver, BC, Canada (LGB); Department of Oncology, University of Calgary, Calgary, AB, Canada (LEC); Institute for Health and Aging, University of California San Francisco, CA (MC); Chicken Soup Chinese Medicine, San Francisco, CA (MC); Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY (GD); Harbin Clinic, Rome, GA (MM); Gemini Group, Ann Arbor, MI (JP); Ottawa Integrative Cancer Center, Ottawa, ON, Canada (DS); Canadian College of Naturopathic Medicine, Toronto, ON, Canada (DS); Department of Family Medicine, University of Michigan Health System (AS, SMZ), Department of Environmental Health Sciences, School of Public Health (SMZ), and Department of Biostatistics (AS), University of Michigan, Ann Arbor, MI (AS, SMZ); Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX (DT)
| | - Misha Cohen
- Department of Epidemiology, Mailman School of Public Health (HG, DH), Herbert Irving Comprehensive Cancer Center, (HG, DH), and Department of Medicine, College of Physicians and Surgeons (DH), Columbia University, New York, NY (HG, DH); School of Nursing, University of British Columbia, Vancouver, BC, Canada (LGB); Department of Oncology, University of Calgary, Calgary, AB, Canada (LEC); Institute for Health and Aging, University of California San Francisco, CA (MC); Chicken Soup Chinese Medicine, San Francisco, CA (MC); Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY (GD); Harbin Clinic, Rome, GA (MM); Gemini Group, Ann Arbor, MI (JP); Ottawa Integrative Cancer Center, Ottawa, ON, Canada (DS); Canadian College of Naturopathic Medicine, Toronto, ON, Canada (DS); Department of Family Medicine, University of Michigan Health System (AS, SMZ), Department of Environmental Health Sciences, School of Public Health (SMZ), and Department of Biostatistics (AS), University of Michigan, Ann Arbor, MI (AS, SMZ); Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX (DT)
| | - Gary Deng
- Department of Epidemiology, Mailman School of Public Health (HG, DH), Herbert Irving Comprehensive Cancer Center, (HG, DH), and Department of Medicine, College of Physicians and Surgeons (DH), Columbia University, New York, NY (HG, DH); School of Nursing, University of British Columbia, Vancouver, BC, Canada (LGB); Department of Oncology, University of Calgary, Calgary, AB, Canada (LEC); Institute for Health and Aging, University of California San Francisco, CA (MC); Chicken Soup Chinese Medicine, San Francisco, CA (MC); Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY (GD); Harbin Clinic, Rome, GA (MM); Gemini Group, Ann Arbor, MI (JP); Ottawa Integrative Cancer Center, Ottawa, ON, Canada (DS); Canadian College of Naturopathic Medicine, Toronto, ON, Canada (DS); Department of Family Medicine, University of Michigan Health System (AS, SMZ), Department of Environmental Health Sciences, School of Public Health (SMZ), and Department of Biostatistics (AS), University of Michigan, Ann Arbor, MI (AS, SMZ); Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX (DT)
| | - Dawn Hershman
- Department of Epidemiology, Mailman School of Public Health (HG, DH), Herbert Irving Comprehensive Cancer Center, (HG, DH), and Department of Medicine, College of Physicians and Surgeons (DH), Columbia University, New York, NY (HG, DH); School of Nursing, University of British Columbia, Vancouver, BC, Canada (LGB); Department of Oncology, University of Calgary, Calgary, AB, Canada (LEC); Institute for Health and Aging, University of California San Francisco, CA (MC); Chicken Soup Chinese Medicine, San Francisco, CA (MC); Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY (GD); Harbin Clinic, Rome, GA (MM); Gemini Group, Ann Arbor, MI (JP); Ottawa Integrative Cancer Center, Ottawa, ON, Canada (DS); Canadian College of Naturopathic Medicine, Toronto, ON, Canada (DS); Department of Family Medicine, University of Michigan Health System (AS, SMZ), Department of Environmental Health Sciences, School of Public Health (SMZ), and Department of Biostatistics (AS), University of Michigan, Ann Arbor, MI (AS, SMZ); Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX (DT)
| | - Matthew Mumber
- Department of Epidemiology, Mailman School of Public Health (HG, DH), Herbert Irving Comprehensive Cancer Center, (HG, DH), and Department of Medicine, College of Physicians and Surgeons (DH), Columbia University, New York, NY (HG, DH); School of Nursing, University of British Columbia, Vancouver, BC, Canada (LGB); Department of Oncology, University of Calgary, Calgary, AB, Canada (LEC); Institute for Health and Aging, University of California San Francisco, CA (MC); Chicken Soup Chinese Medicine, San Francisco, CA (MC); Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY (GD); Harbin Clinic, Rome, GA (MM); Gemini Group, Ann Arbor, MI (JP); Ottawa Integrative Cancer Center, Ottawa, ON, Canada (DS); Canadian College of Naturopathic Medicine, Toronto, ON, Canada (DS); Department of Family Medicine, University of Michigan Health System (AS, SMZ), Department of Environmental Health Sciences, School of Public Health (SMZ), and Department of Biostatistics (AS), University of Michigan, Ann Arbor, MI (AS, SMZ); Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX (DT)
| | - Jane Perlmutter
- Department of Epidemiology, Mailman School of Public Health (HG, DH), Herbert Irving Comprehensive Cancer Center, (HG, DH), and Department of Medicine, College of Physicians and Surgeons (DH), Columbia University, New York, NY (HG, DH); School of Nursing, University of British Columbia, Vancouver, BC, Canada (LGB); Department of Oncology, University of Calgary, Calgary, AB, Canada (LEC); Institute for Health and Aging, University of California San Francisco, CA (MC); Chicken Soup Chinese Medicine, San Francisco, CA (MC); Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY (GD); Harbin Clinic, Rome, GA (MM); Gemini Group, Ann Arbor, MI (JP); Ottawa Integrative Cancer Center, Ottawa, ON, Canada (DS); Canadian College of Naturopathic Medicine, Toronto, ON, Canada (DS); Department of Family Medicine, University of Michigan Health System (AS, SMZ), Department of Environmental Health Sciences, School of Public Health (SMZ), and Department of Biostatistics (AS), University of Michigan, Ann Arbor, MI (AS, SMZ); Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX (DT)
| | - Dugald Seely
- Department of Epidemiology, Mailman School of Public Health (HG, DH), Herbert Irving Comprehensive Cancer Center, (HG, DH), and Department of Medicine, College of Physicians and Surgeons (DH), Columbia University, New York, NY (HG, DH); School of Nursing, University of British Columbia, Vancouver, BC, Canada (LGB); Department of Oncology, University of Calgary, Calgary, AB, Canada (LEC); Institute for Health and Aging, University of California San Francisco, CA (MC); Chicken Soup Chinese Medicine, San Francisco, CA (MC); Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY (GD); Harbin Clinic, Rome, GA (MM); Gemini Group, Ann Arbor, MI (JP); Ottawa Integrative Cancer Center, Ottawa, ON, Canada (DS); Canadian College of Naturopathic Medicine, Toronto, ON, Canada (DS); Department of Family Medicine, University of Michigan Health System (AS, SMZ), Department of Environmental Health Sciences, School of Public Health (SMZ), and Department of Biostatistics (AS), University of Michigan, Ann Arbor, MI (AS, SMZ); Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX (DT)
| | - Ananda Sen
- Department of Epidemiology, Mailman School of Public Health (HG, DH), Herbert Irving Comprehensive Cancer Center, (HG, DH), and Department of Medicine, College of Physicians and Surgeons (DH), Columbia University, New York, NY (HG, DH); School of Nursing, University of British Columbia, Vancouver, BC, Canada (LGB); Department of Oncology, University of Calgary, Calgary, AB, Canada (LEC); Institute for Health and Aging, University of California San Francisco, CA (MC); Chicken Soup Chinese Medicine, San Francisco, CA (MC); Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY (GD); Harbin Clinic, Rome, GA (MM); Gemini Group, Ann Arbor, MI (JP); Ottawa Integrative Cancer Center, Ottawa, ON, Canada (DS); Canadian College of Naturopathic Medicine, Toronto, ON, Canada (DS); Department of Family Medicine, University of Michigan Health System (AS, SMZ), Department of Environmental Health Sciences, School of Public Health (SMZ), and Department of Biostatistics (AS), University of Michigan, Ann Arbor, MI (AS, SMZ); Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX (DT)
| | - Suzanna M Zick
- Department of Epidemiology, Mailman School of Public Health (HG, DH), Herbert Irving Comprehensive Cancer Center, (HG, DH), and Department of Medicine, College of Physicians and Surgeons (DH), Columbia University, New York, NY (HG, DH); School of Nursing, University of British Columbia, Vancouver, BC, Canada (LGB); Department of Oncology, University of Calgary, Calgary, AB, Canada (LEC); Institute for Health and Aging, University of California San Francisco, CA (MC); Chicken Soup Chinese Medicine, San Francisco, CA (MC); Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY (GD); Harbin Clinic, Rome, GA (MM); Gemini Group, Ann Arbor, MI (JP); Ottawa Integrative Cancer Center, Ottawa, ON, Canada (DS); Canadian College of Naturopathic Medicine, Toronto, ON, Canada (DS); Department of Family Medicine, University of Michigan Health System (AS, SMZ), Department of Environmental Health Sciences, School of Public Health (SMZ), and Department of Biostatistics (AS), University of Michigan, Ann Arbor, MI (AS, SMZ); Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX (DT)
| | - Debu Tripathy
- Department of Epidemiology, Mailman School of Public Health (HG, DH), Herbert Irving Comprehensive Cancer Center, (HG, DH), and Department of Medicine, College of Physicians and Surgeons (DH), Columbia University, New York, NY (HG, DH); School of Nursing, University of British Columbia, Vancouver, BC, Canada (LGB); Department of Oncology, University of Calgary, Calgary, AB, Canada (LEC); Institute for Health and Aging, University of California San Francisco, CA (MC); Chicken Soup Chinese Medicine, San Francisco, CA (MC); Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY (GD); Harbin Clinic, Rome, GA (MM); Gemini Group, Ann Arbor, MI (JP); Ottawa Integrative Cancer Center, Ottawa, ON, Canada (DS); Canadian College of Naturopathic Medicine, Toronto, ON, Canada (DS); Department of Family Medicine, University of Michigan Health System (AS, SMZ), Department of Environmental Health Sciences, School of Public Health (SMZ), and Department of Biostatistics (AS), University of Michigan, Ann Arbor, MI (AS, SMZ); Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX (DT)
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46
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Abstract
An increasing number of breast cancer survivors have been using acupuncture to reduce side effects associated with cancer treatment, such as joint/muscle discomfort, hot flashes, lymphedema, fatigue, chemotherapy-induced peripheral neuropathy, anxiety and depression. Rigorous clinical research has begun to investigate the safety, efficacy of acupuncture in treating such conditions. Acupuncture has been shown to be a safe procedure with minimal side effects. Most studies showed that acupuncture is significantly better than no acupuncture in relieving such symptoms. The benefit of real acupuncture over sham acupuncture in treating such symptoms has not been fully established. Additional research is needed to determine the efficacy, mechanism and cost–effectiveness of acupuncture. Meanwhile, since acupuncture poses minimal risks and carries potentially significant benefits, this medical procedure remains a reasonable treatment option for breast cancer survivors to alleviate cancer treatment induced side effects.
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Affiliation(s)
- Ting Bao
- Integrative Medicine Service & Breast Service, 1429 First Avenue, Memorial Sloan–Kettering Cancer Center, NY 10021, USA
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47
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Abstract
In a previous systematic review of the worldwide literature of randomized controlled trials (RCTs) involving needle insertion into acupuncture points for symptom management in cancer patients, we identified only one high-quality RCT that was deemed to have a low risk of bias. Medline, Embase, CINAHL, Cochrane (all databases), Scopus, and PubMed were searched from inception through December 2011 with no language limits applied. A total of 41 RCTs met all inclusion criteria and were rated. In the current review, we examined 18 trials published since our last report. The purpose of this update was to emphasize important recent findings and discuss how concerns such as blinding, separating non-specific placebo effects from specific needling effects, determining biologic mechanisms and dosing parameters, evaluating determinants of response such as expectation, controlling for sources of bias, and the lack of standardization in treatment and study methods may affect the interpretation of study results.
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48
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Wang J, Lu K, Song Y, Zhao S, Ma W, Xuan Q, Tang D, Zhao H, Liu L, Zhang Q. RANKL and OPG Polymorphisms Are Associated with Aromatase Inhibitor-Related Musculoskeletal Adverse Events in Chinese Han Breast Cancer Patients. PLoS One 2015. [PMID: 26218592 PMCID: PMC4547828 DOI: 10.1371/journal.pone.0133964] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
Background Breast cancer patients treated with aromatase inhibitors (AIs) may experience musculoskeletal adverse events (MS-AEs). Several studies have confirmed that the RANKL/RANK/OPG signaling pathway plays a dominant role in bone health. Therefore, this study aimed to analyze the relationship between the serum levels of RANKL, OPG and their SNPs (single nucleotide polymorphisms) with AI-related MS-AEs. Methodology and Principal Findings Patients with early stage, hormone-sensitive breast cancer who were receiving AI therapy were enrolled. We included 208 cases with AI-related MS-AEs and 212 without (controls). The levels of estradiol, bone-turnover markers, multiple inflammatory cytokines, RANKL,OPG and lumbar spine BMD were measured, and questionnaires were completed. We analyzed 29 SNPs of RANKL, RANK and OPG using Sequenom MassARRAY assays and PCR-based TaqMan assays. The levels of bone-turnover markers and RANKL and the ratio of RANKL/OPG were higher in patients with AI-related MS-AEs than controls (all p < 0.05). A genetic assay showed that the RANKL SNP rs7984870 and OPG SNP rs2073618 were associated with AI-related MS-AEs. In patients with AI-related MS-AEs, rs7984870 CC and rs2073618 CC were risk genotypes. Carriers of the rs7984870 CC genotype were more likely to have a higher RANKL level and RANKL/OPG ratio than carriers of the GG genotype, and carriers of the rs2073618 CC genotype were more likely to have a lower OPG level and a higher RANKL/OPG ratio than carriers of the GG genotype (all p < 0.05). Moreover, risk genotypes were associated with higher levels of serum CTX and PINP and a lower lumbar spine BMD (all p < 0.05). Conclusions and Significance In conclusion, the RANKL and OPG risk genotypes synergize to negatively impact bone health and predispose breast cancer patients to AI-related MS-AEs.
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Affiliation(s)
- Jingxuan Wang
- Department of Medical Oncology, The Third Hospital of Harbin Medical University, Harbin, China
| | - Kangping Lu
- Department of Medical Oncology, The Third Hospital of Harbin Medical University, Harbin, China
| | - Ying Song
- Department of Medical Oncology, The Third Hospital of Harbin Medical University, Harbin, China
| | - Shu Zhao
- Department of Medical Oncology, The Third Hospital of Harbin Medical University, Harbin, China
| | - Wenjie Ma
- Department of Medical Oncology, The Third Hospital of Harbin Medical University, Harbin, China
| | - Qijia Xuan
- Department of Medical Oncology, The Third Hospital of Harbin Medical University, Harbin, China
| | - Dabei Tang
- Department of Medical Oncology, The Third Hospital of Harbin Medical University, Harbin, China
| | - Hong Zhao
- Department of Medical Oncology, The Third Hospital of Harbin Medical University, Harbin, China
| | - Lei Liu
- Department of Medical Oncology, The Third Hospital of Harbin Medical University, Harbin, China
| | - Qingyuan Zhang
- Department of Medical Oncology, The Third Hospital of Harbin Medical University, Harbin, China
- * E-mail:
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49
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Bae K, Yoo HS, Lamoury G, Boyle F, Rosenthal DS, Oh B. Acupuncture for Aromatase Inhibitor–Induced Arthralgia. Integr Cancer Ther 2015. [PMID: 26220605 DOI: 10.1177/1534735415596573] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Background. Aromatase inhibitors (AIs) are commonly used as adjunctive hormone treatment for early breast cancer patients. The major side effect of AIs is arthralgia, which affects adherence. Previous reviews suggested that acupuncture is effective in the management of cancer-related pain. The aim of this review is to evaluate the effects of acupuncture on arthralgia caused by AIs. Methods. This article examined randomized controlled trials (RCTs) measuring the effects of acupuncture on joint symptoms caused by AIs within 8 medical databases till May 2014. The quality of the articles was evaluated according to the Cochrane risk of bias (ROB) tool. Results. Four RCTs were identified in medical journals. Two studies were conducted with manual acupuncture and 2 studies were electroacupuncture. The range of sample size was between 32 and 67. One RCT showed significant improvement in the acupuncture group compared with the sham control group and another RCT showed a statistical difference between the electroacupuncture and waitlist group. The other 2 studies showed no statistical differences between control and acupuncture groups. Two studies conducted blood analysis to elucidate the mechanism of efficacy of acupuncture for arthralgia. The 2 positive studies had a lower ROB and 2 studies had a high ROB. Conclusions. The systematic review suggests that acupuncture has potential benefits to improve arthralgia caused by AIs. However, further trials of adequate sample size, appropriate control group, and longer follow-up are necessary to investigate the efficacy of acupuncture in AI-induced arthralgia.
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Affiliation(s)
- Kyeore Bae
- Royal North Shore Hospital, Sydney Medical School, Sydney, New South Wales, Australia
- East-West Cancer Center, Dunsan Korean Medicine Hospital of Daejeon University, Daejeon, Korea
| | - Hwa-Seung Yoo
- East-West Cancer Center, Dunsan Korean Medicine Hospital of Daejeon University, Daejeon, Korea
| | - Gillian Lamoury
- Royal North Shore Hospital, Sydney Medical School, Sydney, New South Wales, Australia
- Mater Hospital, Sydney Medical School, Sydney, New South Wales, Australia
| | - Frances Boyle
- Mater Hospital, Sydney Medical School, Sydney, New South Wales, Australia
| | | | - Byeongsang Oh
- Royal North Shore Hospital, Sydney Medical School, Sydney, New South Wales, Australia
- Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
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50
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Abstract
Background: The therapeutic mainstays of cancer remain surgery, radiotherapy, and chemotherapy. However, radiotherapy and chemotherapy are often associated with serious side-effects, such as nausea and vomiting. Acupuncture has been used widely to treat disorders in clinical practice for at least 3000 years. According to the National Institutes of Health (NIH) Consensus Statement, chemotherapy-induced nausea and vomiting are suitable for acupuncture intervention. Objectives: The goal of this review is to analyze the applications of acupuncture for treating cancer and to look ahead at the potential advantages of acupuncture for patients with cancer. Materials and Methods: The PubMed database was searched for articles on acupuncture therapy and neoplasms. The different distributions of scientific papers were analyzed preliminarily. Results: The articles found showed that acupuncture was used to address various symptoms related to different types of cancer. Conclusions: The results of clinical trials in acupuncture have provided important clues in oncologic practice. The evidence suggests that acupuncture is a safe and effective therapy for managing cancer and treatment-related symptoms, such as nausea and vomiting and fatigue caused by chemotherapy. As more evidence emerges, the potential advantages of acupuncture in tumor treatment will eventually be clear.
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Affiliation(s)
- Guangjun Wang
- Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences , Dongzhimennei, Beijing, China . ; Research Unit for Complementary and Integrative Laser Medicine, Research Unit of Biomedical Engineering in Anesthesia and Intensive Care Medicine, and TCM Research Center Graz, Medical University of Graz , Graz, Austria
| | - Gerhard Litscher
- Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences , Dongzhimennei, Beijing, China . ; Research Unit for Complementary and Integrative Laser Medicine, Research Unit of Biomedical Engineering in Anesthesia and Intensive Care Medicine, and TCM Research Center Graz, Medical University of Graz , Graz, Austria
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