Acupuncture in the management of aromatase inhibitor-induced arthralgia in women with breast cancer

Abstract

Overview of the topic: Breast cancer develops when breast cells begin to grow in an abnormal manner. It is much more prevalent in females (Sun et al, 2017). When the breast cancer has a considerable number of receptors for either oestrogen or progesterone, it results in hormone receptor-positive breast cancer (Dai, Xiang, Li & Bai, 2016). As a result, a particular class of drugs called Aromatase Inhibitors (AIs) are prescribed for women with this particular breast cancer. Arthralgia is reported to be a common side effect of these drugs (Younus & Kligman, 2010). In this dissertation, the effectiveness of acupuncture in the management of AI-induced arthralgia was studied. The research question: In women with breast cancer treated with aromatase inhibitors, is acupuncture effective in the management of aromatase inhibitor-induced arthralgia? PICO elements: Population - Women with breast cancer with AI-induced arthralgia. Intervention - Acupuncture. Comparison - No acupuncture. Outcome - Management of AIinduced arthralgia. Method: The keywords and their synonyms were combined together using different search tools. HyDi and EBSCO were utilised to search for different databases. Afterwards, the search was run using the combined terms through the chosen databases. The inclusion/exclusion criteria were applied in order to assess the eligibility of the articles. The Critical Appraisal Skills Programme tool was used to critically appraise the literature. Results: A total of five key studies were identified; four randomised controlled trials (RCTs) and one systematic review and meta-analysis. The majority of the studies reported that there was no statistically significant difference between the experimental and control groups. However, these results were not achieved in all of the studies and thus, the results were inconsistent. Conclusion: The evidence gathered suggests that acupuncture may lead to reduced AIinduced joint pain. Nevertheless, this evidence is not sufficient and further research in this area is required in order to provide a definite answer to the PICO question. Implications and recommendations: Educating breast cancer patients and healthcare professionals about acupuncture and AI-induced arthralgia is significant. Thus, providing information through courses and different types of media is essential.