Feasibility of a defined exercise program for aromatase inhibitor–related arthralgia (AIRA) in breast cancer survivors.

Abstract

e19725 Background: Aromatase Inhibitors (AIs) are standard adjuvant therapy for post-menopausal women (PMW) with hormone sensitive breast cancer. Up to 40% of women taking AIs develop AIRA. While most women have mild/moderate symptoms, up to 25% have severe symptoms, which results in drug discontinuation. The etiology of AIRA is not known. While conventional therapies are beneficial, the effect is not universal. We hypothesized that a structured exercise program may attenuate AIRA. A feasibility study in 14 women being treated in a community oncology practice was performed. Methods: The primary objective was retention to a structured exercise program. The secondary objective was to assess the effect on AIRA. PMW with breast cancer being treated with an AI were eligible. Each woman had medical clearance for exercise. Exclusion criteria were significant co-morbidities, disease progression, participation in another exercise program, inability to attend the program, or uncontrolled lymphedema. Once enrolled they started a reproducible program 2-3 times/week for 8 weeks; each 45 minute session was supervised by a trainer who emphasized strength and aerobic training. The participants completed a 5-point Likert item questionnaire at 0, 4 and 8 weeks. The data were analyzed using ANOVA with repeated measurements and analyzed for correlation of results. Results: 11 of 14 women completed 8 weeks. The following were found to be significantly decreased compared to baseline (p<0.05): pain involving the feet, ankles, knees, hands, wrists and elbows; joint pain throughout the day; generalized joint pain; morning and daytime stiffness; pain with activity. In addition, the patients felt overall improvement in symptoms. The changes occurred within the first 4 weeks and persisted. There was no effect on fatigue, mood changes, or hot flashes. There were no adverse events. Overall satisfaction was high. Conclusions: This study shows that a supervised exercise program is feasible and has a benefit on AIRA. The program was well tolerated and resulted in significant improvement in clinically relevant end-points. A randomized trial is warranted.