Featured Research

from universities, journals, and other organizations

Recent Evidence Suggests Caution In Prescribing Hormone Therapy For Breast Cancer And Sheds New Light On 'Menopausal Arthritis'

Date:
September 2, 2005
Source:
John Wiley & Sons, Inc.
Summary:
A study published in the September 2005 issue of Arthritis & Rheumatism examines the evidence linking aromatase inhibitors and, more broadly, estrogen deprivation joint pain.

One of the most effective new treatments for breast cancer is a hormonetherapy. Aromatase inhibitors work by powerfully blocking theconversion of androgen precursors into estrogens, which lowersestradiol levels in the bloodstream and estrogen levels in peripheraltissues. Because aromatase inhibitors reduce the rates of recurrence inwomen with early-stage postmenopausal breast cancer, these agents arenot only becoming widely used in breast cancer treatment, but alsobeing explored for their potential to prevent the disease in women athigh risk. While focusing on this therapy's promise, advocates havetended to downplay one of its drawbacks. Women treated with aromataseinhibitors often experience joint pain and musculoskeletalaching--severe enough, in some cases, to make them stop the treatment.

Two noted researchers, David T. Felson, M.D., of Boston UniversityClinical Epidemiology Unit, and Steven R. Cummings, M.D., of CaliforniaPacific Medical Center Research Institute and University of California,San Francisco, have thoroughly examined the evidence linking aromataseinhibitors and, more broadly, estrogen deprivation joint pain. In theSeptember 2005 issue of Arthritis & Rheumatism (http://www.interscience.wiley.com/journal/arthritis),they share their insights to alert oncologists, primary carephysicians, and other health care professionals to this widelyoverlooked, potential problem for women.

"Estrogen's effects on inflammation within the joint are not wellknown," Dr. Felson and Dr. Cummings observe. Yet, as they note,estrogen has well-established tissue-specific effects on inflammatorycytokines. Estrogen's role in joint inflammation could account for theincreased sensitivity to pain that some women suffer with estrogendepletion. Citing studies of pharmacological suppression of estrogenand studies of natural menopause, the authors offer a look atcompelling evidence associating estrogen deprivation with joint pain,including:

  • Aromatase inhibitors have been linked to higher ratesof joint and muscle pain than tamoxifen and placebo in various clinicaltrials for breast cancer treatment and prevention. One example: In aNational Cancer Institute of Canada study, 5,187 postmenopausal womenwho completed a 5-year course of tamoxifen therapy for breast cancerwere randomized to a further 5 years receiving the aromatase inhibitorletrozole or a placebo. 21 percent of women taking letrozole reportedjoint pain compared with 16 percent of the women receiving placebo.
  • In a study of leuprolide, a hormonal agent used totreat infertility and a variety of gynecological disorders, 102premenopausal women experienced symptoms of estrogen deprivation, suchas vaginal dryness, after 2 weeks of treatment, and suffered joint painbetween weeks 3 and 7 of treatment. Overall, 25 percent of the womendeveloped persistent joint pain, affecting the knees, elbows, ankles,and other areas, during the study. The pain was resolved in all womenbetween 2 and 12 weeks after stopping the leuprolide therapy.
  • In a postmenopausal estrogen/progestin interventiontrial, women who received estrogen had a significantly decrease chanceof musculoskeletal symptoms--between 32 and 38 percent--compared withwomen randomly assigned placebo. Symptoms reported in the placebo groupincluded joint pain, muscle stiffness, and skull and neck aching. Inother studies, however, estrogen replacement therapy had no beneficialeffect on musculoskeletal pain.

    Dr. Felson and Dr. Cummings also highlight recent data showing thatAsian women undergoing menopause have lower estradiol levels thanCaucasian women and seem to be more vulnerable to a syndrome commonlyknown as "menopausal arthritis." They also note the high rate of bothosteoarthritis and rheumatoid arthritis in postmenopausal women. Theyconclude by stressing the need for further research into thecontribution of estrogen deficiency to arthritis, as well as forrecognizing the risks of musculoskeletal syndrome when prescribingaromatase inhibitors and other estrogen-depleting treatments.

    ###

    Article: "AromataseInhibitors and the Syndrome of Arthralgias With Estrogen Deprivation,"David T. Felson and Steven R. Cummings, Arthritis & Rheumatism,September 2005; 52:9; pp. 2594-2598.


  • Story Source:

    The above story is based on materials provided by John Wiley & Sons, Inc.. Note: Materials may be edited for content and length.


    Cite This Page:

    John Wiley & Sons, Inc.. "Recent Evidence Suggests Caution In Prescribing Hormone Therapy For Breast Cancer And Sheds New Light On 'Menopausal Arthritis'." ScienceDaily. ScienceDaily, 2 September 2005. <www.sciencedaily.com/releases/2005/09/050902071738.htm>.
    John Wiley & Sons, Inc.. (2005, September 2). Recent Evidence Suggests Caution In Prescribing Hormone Therapy For Breast Cancer And Sheds New Light On 'Menopausal Arthritis'. ScienceDaily. Retrieved October 23, 2014 from www.sciencedaily.com/releases/2005/09/050902071738.htm
    John Wiley & Sons, Inc.. "Recent Evidence Suggests Caution In Prescribing Hormone Therapy For Breast Cancer And Sheds New Light On 'Menopausal Arthritis'." ScienceDaily. www.sciencedaily.com/releases/2005/09/050902071738.htm (accessed October 23, 2014).

    Share This



    More Health & Medicine News

    Thursday, October 23, 2014

    Featured Research

    from universities, journals, and other organizations


    Featured Videos

    from AP, Reuters, AFP, and other news services

    Orthodontist Mom Jennifer Salzer on the Best Time for Braces

    Orthodontist Mom Jennifer Salzer on the Best Time for Braces

    Working Mother (Oct. 22, 2014) Is your child ready? Video provided by Working Mother
    Powered by NewsLook.com
    U.S. Issues Ebola Travel Restrictions, Are Visa Bans Next?

    U.S. Issues Ebola Travel Restrictions, Are Visa Bans Next?

    Newsy (Oct. 22, 2014) Now that the U.S. is restricting travel from West Africa, some are dropping questions about a travel ban and instead asking about visa bans. Video provided by Newsy
    Powered by NewsLook.com
    US to Track Everyone Coming from Ebola Nations

    US to Track Everyone Coming from Ebola Nations

    AP (Oct. 22, 2014) Stepping up their vigilance against Ebola, federal authorities said Wednesday that everyone traveling into the US from Ebola-stricken nations will be monitored for symptoms for 21 days. (Oct. 22) Video provided by AP
    Powered by NewsLook.com
    Doctors Help Paralysed Man Walk Again, Patient in Disbelief

    Doctors Help Paralysed Man Walk Again, Patient in Disbelief

    AFP (Oct. 22, 2014) Polish doctors describe how they helped a paralysed man walk again, with the patient in disbelief at the return of sensation to his legs. Duration: 1:04 Video provided by AFP
    Powered by NewsLook.com

    Search ScienceDaily

    Number of stories in archives: 140,361

    Find with keyword(s):
    Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

    Save/Print:
    Share:

    Breaking News:

    Strange & Offbeat Stories


    Health & Medicine

    Mind & Brain

    Living & Well

    In Other News

    ... from NewsDaily.com

    Science News

    Health News

    Environment News

    Technology News



    Save/Print:
    Share:

    Free Subscriptions


    Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

    Get Social & Mobile


    Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

    Have Feedback?


    Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
    Mobile: iPhone Android Web
    Follow: Facebook Twitter Google+
    Subscribe: RSS Feeds Email Newsletters
    Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins