1. Susman, Ed

Article Content

VIENNA-Acupuncture treatments appear to relieve the common musculoskeletal discomfort experienced by women taking aromatase inhibitors (AIs) to reduce the risk of recurrent breast cancer, researchers reported in a small, single-arm study here at the St. Gallen International Cancer Conference.

Figure. Cover of a b... - Click to enlarge in new windowFigure. Cover of a book on the specific technique, published by Thieme
Figure. No caption a... - Click to enlarge in new windowFigure. No caption available.

As shown in the poster study by Giovanni Giardina, MD, Senior Assistant in Oncology at Ospedale di Circolo e Fondazione Macchi in Italy, all women with self-reported musculoskeletal pain who were treated with acupuncture techniques reported improvement in pain and quality of life on validated assessment instruments.


He and his coauthors enrolled 17 women in the study, and reported on outcomes for 16, all of whom were experiencing musculoskeletal pain as a result of long-term therapy with aromatase inhibitors. The women ranged in age from 49 to 78, with a median of 62.


"All patients had a significant improvement of musculoskeletal aromatase inhibitor-related pain," Giardina reported, "and our study suggests that acupuncture may be a promising modality for relieving aromatase inhibitor-related musculoskeletal side effects.


"It was quite easy to recruit women for the study because musculoskeletal pain is frequent in women taking aromatase inhibitors; the reduction of quality of life is a clinical issue and the patients have to make a choice between an effective therapy and the impairment of their daily quality of life."


He said his clinic now routinely offers the procedure to women with such musculoskeletal pain, and that there have been no significant side effects.


Giardina noted that while AIs are recommended as part of the adjuvant treatment of hormone-sensitive early breast cancer, "a consistent proportion of patients may experience musculoskeletal symptoms that can lead to discontinuation of this effective therapy or to a reduction of quality of life.


"We believe that acupuncture may be offered to all patients who experience that side effect, because is a safe and effective treatment," he said.


'Yamamoto New Scalp Acupuncture'

The Italian research team used an acupuncture technique known as Yamamoto New Scalp Acupuncture, a system of acupuncture that evolved in the 1960s and 1970s through the work of Japanese physician and scientist Toshikatsu Yamamoto.


"The method proposed by Yamamoto is based on a somatotype on the scalp, in the same way as with ear or mouth acupuncture," Giardina explained. "The theory is that the entire locomotor system is at the boundary of the forehead and hair, whereas the internal organs are represented via ypsilon points on both temples."


Proof of Principle

Asked for her perspective, Valerie Jenkins, PhD, a senior research fellow at Brighton & Sussex Medical School in England, said the study represents a proof of principle. Still, there was no control group, so it is difficult to determine if the improvements patients had was a placebo effect-"However, it is encouraging that all the patients appeared to improve, which would indicate that there could be an effect with acupuncture."


Jenkins, who specializes in the impact cancer and therapies have on quality of life, added that the phenomenon of musculoskeletal pain among women taking aromatase inhibitors is not new, of course-"going back to at least as early as the ATAC [Arimidex, Tamoxifen, Alone or in Combination] trial that established the benefit of the aromatase inhibitors. But these aches and pains may be underappreciated."


She said she would like to now see a controlled trial. "The patients seemed to stick to this treatment and didn't drop out. Many women report these musculoskeletal side effects, and treatment to relieve these pains is suboptimal. It would be interesting if a treatment such as acupuncture would have an impact."


Giardina said he and his colleagues were not planning any further studies to assess the effectiveness of the use of acupuncture: "Our endpoint was a simple evaluation of the efficacy of acupuncture compared with baseline."

Table Signs of Impro... - Click to enlarge in new windowTable Signs of Improvement