Exercise might help women beat
breast cancer. Researchers found it can ease the achy joints and muscle pain
that lead many patients to quit taking medicines that treat the disease and
lower the risk of a recurrence.
The study is the first
major test of an exercise program for women on aromatise inhibitors. These oestrogen-blocking
pills, sold as Femara, Aromasin and other brands, are recommended for five
years after initial breast cancer treatment for hormone-driven tumours, the
most common type.
The pills also increasingly
are being used to help prevent breast cancer in women at high risk of it
because of family history, bad genes or other reasons. A separate study found
that one of these medicines – anastrosole, sold as Arimidex and in generic form – cut this risk by 53%. It's the second aromatise inhibitor shown to lower risk
Despite how effective the
drugs are, many women shun them because they can cause aches and pains, hot
flashes and other side effects. About 15% of US women have enough risk to merit
considering the pills to prevent breast cancer, yet less than 5% take
them, said Dr Powel Brown, a prevention expert at the University of Texas MD
Anderson Cancer Centre.
Pain severity declined
The exercise study involved
121 postmenopausal women taking various aromatise inhibitors to treat breast
cancer who complained of achy joints on a pain survey.
About half were assigned to
two supervised strength training sessions a week plus at least 150 minutes of
aerobic exercise per week. The rest got advice on the benefits of exercise and
did their usual activities.
After a year, joint pain
scores fell 20% among exercisers and 3% among the others. The severity
of pain and how much it interfered with daily live also declined more in
The exercise group improved
cardio respiratory fitness and lost weight – nearly 8 pounds (3.6 kilograms)
versus a slight gain in the others. 80% stuck with the program, helped by free
access to a gym and a personal trainer.
A lot of side effects
The National Cancer
Institute paid for the study, which was led by Melinda Irwin of the Yale Cancer
Centre and Dr. Jennifer Ligibel of the Dana-Farber Cancer Institute in Boston.
Dr Eric Winer, breast
cancer chief at Dana-Farber, said the results may help more women stick with
"A lot of people will
say, 'If it's going to have a lot of side effects, I'm not going to do it.' The
truth is, not everyone gets symptoms. Exercise might be a solution," he
The other study was led by
Dr. Jack Cuzick of Queen Mary University of London and tested anastrosole for
preventing first breast cancers. Nearly 4000 women were given the drug or
daily dummy pills, and 70% stuck with them for five years, just a little
less than the placebo group.
After that time, 40 women
on anastrosole had developed breast cancer versus 85 of the others, a 53% reduction in risk. That's comparable to how another aromatise inhibitor – exemestane, or Aromasin – did in an earlier study and better than tamoxifen,
the longest-used breast cancer prevention medicine.
Women on anastrosole had
more joint pain and hot flashes, but these also were very common in the placebo
group – more than half of both groups reported these problems, which often are
due to menopause and ageing, Cuzick said. Anastrosole users had more cases of a
painful wrist condition called carpal tunnel syndrome, and dry eye, but these
were relatively rare. Aromatise inhibitors are known to raise the risk of
fractures, so many women take bone-strengthening drugs to help prevent that
Besides the British cancer
research agency, London-based AstraZeneca PLC, which makes the anastrosole used
in the study, Arimidex, helped pay for the work, and some researchers are paid
speakers for the company.
Results were discussed at the San Antonio Breast Cancer Symposium and published by the
British journal Lancet. In a commentary in the journal, Dr. David A. Cameron of
Edinburgh Cancer Centre in Scotland wrote that healthy women still may resist
prevention drugs unless taking them turns out to save lives, not just avoid
The cancer conference is
sponsored by the American Association for Cancer Research, Baylor College of
Medicine and the UT Health Science Centre.