Treatments for AI Arthralgia in Breast Cancer Patients

Dawn Hershman, MD, MS, offers some potential treatments for aromatase inhibitor-caused arthralgia in breast cancer patients. This video was filmed at the 2019 San Antonio Breast Cancer Symposium.

Dawn Hershman, MD, MS: I mean, the number one reason why people stop taking their medication really is because of side effects, and the most common side effect associated with aromatase inhibitors is arthralgias, or joint pain. People say, “I can’t get up from a seated position,” “I can’t open a jar,” you know, “I feel achy all the time,” “I can’t get down the stairs.” And depending on somebody’s job, it can have a big impact on their activities of daily living and, you know, how functional they are. And so, you know, it’s really important for people to ask what kinds of side effects they’re having, if they’re having joint pain, has their joint pain worsened since they started taking their medication, and if so to think of the kinds of things that have been shown to be beneficial. Exercise can be extremely helpful to patients and it’s also got other health benefits. There are studies that have looked at duloxetine as an intervention to improve the symptoms that come from AI arthralgias. We’ve looked at omega-3 fatty acids, which can be beneficial in some patient populations. Especially some patients with higher BMIs seem to get much more benefit from that type of intervention. We’ve also shown that acupuncture can be effective and is not toxic. So, you know, there are different things that you can offer. And ultimately, the best intervention is the one that the patients like the best, so everybody’s different that way. So we usually like to try to offer a variety of different things, and say if one thing doesn’t work you can always try something else.