Acupuncture Helps Ease Side Effects From Aromatase Inhibitors

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After surgery, women diagnosed with hormone-receptor-positive breast cancer usually take hormonal therapy medicine to reduce the risk of the cancer coming back (recurrence). Hormonal therapy medicines work in two ways:

  • by lowering the amount of estrogen in the body
  • by blocking the action of estrogen on breast cancer cells

There are several types of hormonal therapy medicines. Tamoxifen, a selective estrogen receptor modulator (SERM), is one of the most well-known. Tamoxifen can be used to treat both premenopausal and postmenopausal women. In the early 2000s, the aromatase inhibitors:

  • Arimidex (chemical name: anastrozole)
  • Aromasin (chemical name: exemestane)
  • Femara (chemical name: letrozole)

were shown to be more effective at reducing recurrence risk in postmenopausal women and are now used more often than tamoxifen to treat women who’ve gone through menopause. Aromatase inhibitors aren’t used to reduce recurrence risk in premenopausal women.

Both tamoxifen and aromatase inhibitors can cause side effects. Tamoxifen may cause hot flashes and increase the risk of blood clots and stroke. Aromatase inhibitors may cause muscle and joint aches and pains, as well as hot flashes. Less common but more severe side effects of aromatase inhibitors are heart problems, osteoporosis, and broken bones. Research has shown that about 25% of women who are prescribed hormonal therapy to reduce the risk of recurrence after surgery either don’t start taking the medicine or stop taking it early.

If doctors can find a way to ease these side effects, more women might stick to their treatment plans.

A small study suggests that both real and placebo acupuncture can help relieve hot flashes that may be side effects of aromatase inhibitors in postmenopausal women diagnosed with hormone-receptor-positive breast cancer.

The research was published in the Feb. 1, 2014 issue of Cancer. Read the abstract of “Patient-reported outcomes in women with breast cancer enrolled in a dual-center, double-blind, randomized controlled trial assessing the effect of acupuncture in reducing aromatase inhibitor-induced musculoskeletal symptoms.”

The study involved 47 postmenopausal women diagnosed with stage 0 to stage III hormone-receptor-positive breast cancer who had been taking an aromatase inhibitor for at least 1 month and who had reported side effects.

The research randomly assigned the women to receive one of two treatments for 8 weeks:

  • one acupuncture treatment per week (23 women)
  • one placebo/sham acupuncture treatment per week (24 women)

The placebo acupuncture procedure was done with needles that retracted and didn’t penetrate the skin. These retracting needles were placed on 14 non-acupuncture points on the body. The retracting needles produced a pricking sensation, so the women couldn’t tell if they were getting real acupuncture or placebo acupuncture.

Before the women received either type of acupuncture treatment, they answered questions about their:

  • moods
  • depression
  • anxiety
  • sleep quality
  • hot flashes
  • quality of life

The women answered the same questions 4 weeks, 8 weeks, and 12 weeks after the study started.

The women also kept weekly hot flash diaries while they were getting either real or placebo acupuncture.

Women who got real acupuncture had improvements in:

  • depression
  • number and severity of hot flashes
  • the amount hot flashes interfered with daily life

These improvements were statistically significant, which means they were due to the acupuncture and didn’t just happen by chance.

Women who got placebo acupuncture had improvements in:

  • quality of life
  • the amount hot flashes interfered with daily life
  • severity of hot flashes

These improvements also were statistically significant.

There were no side effects from either type of acupuncture procedure.

While it might seem strange that both real and placebo acupuncture helped ease aromatase inhibitor side effects, it does make some sense. Placebo acupuncture involves pricking the skin, which may cause effects similar to real acupuncture. Still, because this study was so small, it may have been hard to see any differences between the two groups.

If you're having hot flashes or other aromatase inhibitor side effects, you might want to talk to your doctor about this study. Acupuncture is one of several complementary and holistic medicine techniques that have been shown to help women deal with menopausal or treatment-related hot flashes. Other techniques include yoga, massage, and meditation.

You can read more about treatments to help ease hot flashes on the Menopause Symptoms: Hot Flashes page, and you can learn more about acupuncture in the Complementary & Holistic Medicine section.

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