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High-dose vitamin d relieves pain for many patients of breast cancer with estrogen-lowering drugs, a new study shows. Credit: Michael c. Purdyhigh-dose vitamin d relieves pain for many breast cancer patients estrogen-lowering drugs, according to a new study from Washington University School of medicine in St. Louis.Drugs, known as aromatase inhibitors, commonly referred to shrink breast tumors that are powered by the hormone estrogen and help prevent recurrence of cancer. It is less toxic than chemotherapy, but for many patients, the drug can cause serious musculoskeletal discomfort, including pain and stiffness in the hands, wrists, knees, hips, lower back, shoulders and legs.
"Approximately half of patients may experience these symptoms," says Antonella Rastelli l., MD, Assistant Professor of medicine and first author of the study, published online in the Journal for research on breast cancer and treatment. "We do not know exactly why pain occurs, but can be very debilitating — the point that patients decide to block the aromatase inhibitors."
This video is not supported by your browser at this time.Washington University physicians found that high doses of vitamin d helps to relieve pain in breast cancer patients estrogen-lowering drugs. Known as aromatase inhibitors, drugs to treat breast tumors being supplied by the hormone estrogen. It is less toxic than chemotherapy, but many patients experience severe musculoskeletal discomfort, including pain and stiffness in the hands, knees, hips, lower back, shoulders and legs. Credit: Clark BowenBecause drugs reduce recurrence of cancer, found a way to help patients remain on is important for long-term survival without relapse, according to Rastelli. Aromatase inhibitors are prescribed to post-menopausal women for at least five years and more frequently after the diagnosis of breast cancer. There is some evidence that patients have the experience of drug side effects are less likely to see the cancer returned, providing even more incentive to help these patients still.Rastelli was by Marie e. Taylor, MD, Assistant Professor of Radiation Oncology, who first noticed that patients with aromatase inhibitors that experienced this pain found some relief from high doses of vitamin d.
Both the Group recruited Rastelli 60 patients reported pain and distress associated with anastrozole, one of the three FDA-approved aromatase inhibitors. Patients examined also had low vitamin d levels. Half of the Group were randomized to receive the recommended daily intake of vitamin d (400 IU) plus a capsule unit-50,000 vitamin d once a week. The other half received the daily intake of 400 units of vitamin d plus weekly placebo. All subjects received 1,000 milligrams of calcium daily throughout the study.
Patients in the study reported no pain suffered through three different questionnaires. They were asked to quantify the intensity of pain, as well as the report how the pain changed the climate, influenced their work and in relationships and everyday activities. The results show that patients with high-dose vitamin d each week reported significantly less musculoskeletal pain and also were less likely to experience the pain that interfered with daily life.
"High-dose vitamin d seems to be really effective at reducing musculoskeletal pain caused by aromatase inhibitors," says Rastelli. "Patients the impression weekly vitamin d better because their pain and sometimes strays completely reduced. This makes the drug much more tolerable. Millions of women worldwide to aromatase inhibitor therapy, and can we have another ' tool ' to remain in this anymore. "
Anastrozole as used in this study, two other aromatase inhibitors approved by FDA, letrozole and exemestane, should also give rise to musculoskeletal pain. Taking into account the similar reactions, Rastelli says patients about these drugs may benefit from high doses of vitamin d.
Vitamin used in this study is of a type derived from a plant called Vitamin D2. Rastelli says that achieves the best results when given weekly, because this body metabolizes within seven to 10 days. Rastelli and her colleagues used high-dose Vitamin D3, which remains in the body longer.
"This was a very carefully conducted study, and the control of the standard makes the findings very impressive," says Matthew j. Ellis, MD, Ph.d., senior author of the study and Director of the breast cancer program at the Center, Alvin j. Siteman cancer at Barnes-Jewish Hospital and Washington University School of medicine in St. Louis. "We have to take up these findings further to determine the most effective and safe approach for additional vitamin d in our patients with breast cancer."
Since vitamin d helps the body absorb calcium, too much of it can cause high levels of calcium in the urine, which may increase the risk of kidney stones. Possible reactions to stress the importance of patient monitoring urine calcium levels taking high doses of vitamin d.
"It is important to monitor patients, but overall it seems to be very safe," says Rastelli. Because Vitamin D2 is removed from the body so quickly, it is very difficult to overdose. "
In addition to the relief of pain, the Group wanted to examine whether it could protect vitamin d in the loss of bone that is often regarded as aromatase inhibitors in patients. The researchers measured each patient bone density at the beginning of the study again after six months.
Perhaps because of its role in calcium absorption, high-dose vitamin d appear to contribute to the maintenance of bone density in the neck of the femur, at the top of the thighbone near hip hinge. Although the result did not reach statistical significance, Rastelli calls the promising and worth further study.
"Great to have something simple as vitamin d to help patients to alleviate some of this pain," says Rastelli. "It is not toxic — does not cause significant side effects. And if that is actually to protect against bone loss, which is even better. "
More info: Rastelli AL, Taylor, Gao F, Armamento Villareal-R, S-Jamalabadi Majidi, Napoli n., Ellis, MJ. Vitamin d and aromatase inhibitor-induced musculoskeletal symptoms (AIMSS): a phase II, double-blind, placebo-controlled, randomized trial separated. Research on breast cancer and treatment. Online June 2011.
Provided by Washington University School of Medicine (news: web)
