Joint pain management in obese breast cancer patients treated with aromatase inhibitors

This article investigated the safety and effectiveness of adding Omega-3 fatty acid (O3-FA) to the management of joint pain in patients with breast cancer treated with aromatase inhibitors. The authors concluded that the addition of O3-FA is safe and gave the greatest benefit to patients who were obese. 

Hormone (estrogen and progesterone) receptors are proteins, found in and on breast cells. They give the cells signals to grow. Aromatase inhibitors (AI) are a standard treatment for patients with hormone-receptor-positive cancer. They work by blocking a protein (aromatase) that normally turns androgen hormones (mostly male hormones) into estrogen. This results in less estrogen available to stimulate the growth of hormone-receptor-positive breast cancer cells. However, they are associated with an increased risk of joint pain, especially in obese patients. This may lead patients to stop treatment. 

Omega-3 fatty acids (O3-FA) have shown promise in improving joint pain in previous studies. O3-FAs are a type of fat naturally found mainly in fish oil. It is important to research if added to AI, O3-FA can improve joint pain in patients with breast cancer. 

This study involved 249 patients with breast cancer treated with AIs. 139 patients had a body mass index (BMI; a measurement of weight over height) of less than 30 kg/m² (not obese) and 110 had a BMI of 30 kg/m² or higher (obese). They were randomly assigned to two groups. Group 1 received treatment with O3-FA. Group 2 received treatment with a placebo (soybean-corn oil blend). Pain questionnaires were given to patients at the beginning of the study and at 12 and 24 weeks of treatment. 

Obese patients treated with O3-FA had significantly lower pain scores at 24 weeks compared with the placebo (4.36 vs. 5.70). In non-obese patients, there was no difference between those who received O3-FA compared with the placebo. In the obese patients, those who received O3-FA had reduced pain scores at 24 weeks compared to the beginning of the study. Obese patients also had an improvement in joint stiffness scores at 12 weeks compared to placebo. These improvements were not seen in non-obese patients.

The authors concluded that O3-FAs are safe and effective in reducing joint pain associated with AI treatment in obese patients with breast cancer.

This study was based on patient questionnaires, which is not the best level of evidence. Also, the study period was rather short. Further studies are needed.

If you have concerns about joint pain related to breast cancer treatment, discuss this with your doctor.