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Electroacupuncture Helps Ease Fatigue, Anxiety, and Depression in Women Taking 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. In many cases, the joint pain caused by an aromatase inhibitor leads to fatigue, anxiety, depression, and sleeping problems.

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 has found that electroacupuncture – a type of acupuncture where a small electric current passes between pairs of acupuncture needles – eases fatigue, anxiety, and depression in women diagnosed with early-stage breast cancer who are taking an aromatase inhibitor and having joint pain.

The research was published online on July 30, 2014 by the journal Cancer. Read the abstract of “Electroacpuncture for fatigue, sleep, and psychological distress in breast cancer patients with aromastase inhibitor-related arthralgia: A randomized trial.”

The study involved 67 postmenopausal women diagnosed with early-stage breast cancer who were taking an aromatase inhibitor. All the women were having joint pain. Before the study started, all the women reported their levels of:

  • fatigue
  • sleeping problems
  • anxiety and depression

The women were randomly assigned to one of three treatment groups:

  • Electroacupuncture: Women in this group had 14 electroacupuncture sessions that lasted 20 minutes for the 12 weeks of the study (twice weekly for 2 weeks and once weekly for 10 weeks).
  • Sham electroacupuncture: Women in this group had the exact same treatment schedule as the women getting real electroacupuncture. The sham acupuncture was non-electric and the needles retracted and didn’t penetrate the skin. The retracting needles were placed on non-acupuncture points on the body. The retracting needles produce a pricking sensation, so the women couldn’t tell if they were getting real electroacupuncture or sham acupuncture.
  • No intervention: the women in this group received no special care for their joint pain

All the women in the study were contacted by phone during weeks 1, 4, 8, and 12 so the researchers could ask them about their levels of fatigue, sleeping problems, and anxiety and depression.

The results by side effect were:

  • Fatigue: By week 8, women who received electroacupuncture had less fatigue than women in the no intervention group. This difference continued until week 12.
  • Anxiety: Women who received electroacupuncture had less anxiety at the end of the study than they did at the beginning. This difference in anxiety was statistically significant, which means it was likely because of the electroacupuncture and not just due to chance.
  • Depression: Women who received electroacupuncture and women who received sham electroacupuncture had less depression than women in the no intervention group. This difference also was statistically significant.

While it might seem strange that both real and sham electroacupuncture helped ease depression, 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 feeling anxious, depressed, fatigued, or having sleeping problems because of aromatase inhibitor joint pain, you might want to talk to your doctor about this study. Electroacupuncture is one of several complementary and holistic medicine techniques that have been shown to help women deal with breast cancer treatment side effects such as fatigue and depression. Other techniques include yoga, massage, journaling, and meditation.

You can learn more about acupuncture in the Complementary & Holistic Medicine section.

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