A RANDOMIZED TRIAL OF ELECTROACUPUNCTURE FOR FATIGUE,SLEEP, AND PSYCHOLOGICAL DISTRESS IN BREAST CANCER PATIENTS WITH AROMATASE INHIBITOR-RELATED ARTHRALGIA

Background: While fatigue, sleep disturbance, depression and anxiety are associated with pain in breast cancer patients, it is unknown if acupuncture can decrease these co-morbid symptoms in cancer patients with pain.This study aimed at evaluating the effects of electroacupuncture(EA) on fatigue, sleep and psychological distress in breast cancer survivors who experience joint pain related to aromatase inhibitors(AIs).Methods: We performed a randomized controlled trial of an eight-week EA as compared to waitlist control(WLC) and sham acupuncture(SA) in postmenopausal women with breast cancer who self-reported joint pain attributable to AIs.Acupuncturists performed 10 EA/SA treatments over eight weeks using a manual protocol with 2 Hz electro-stimulation delivered by a TENS unit.Acupuncturists administered SA using Streitberger(nonpenetrating) needles at non-acupuncture points without electrostimulation.Fatigue, sleep disturbance, anxiety and depression were measured by the Brief Fatigue Inventory(BFI), Pittsburgh Sleep Quality Index(PSQI), and Hospital Anxiety and Depression Scale(HADS).The effects of EA and SA vs.WLC on these outcomes were evaluated using mixed-effects models.Results: Of the 67 randomly assigned patients, baseline paininterference was associated with fatigue(Pearson correlation coefficient r=0.75, P0.001), sleep(r=0.38, P=0.002 6), and depression(r=0.58, P0.001).Compared to the WLC, EA produced significant improvement in fatigue(P=0.009 5), anxiety(P=0.044), and depression(P=0.015) and marginal improvement in sleep(P=0.058) during the 12-week intervention and followup period.In contrast, SA only produced significant improvement in depression compared with WLC(P=0.008 8).Conclusion: Among women who experienced AI-related arthralgia, EA produced significant improvement in fatigue, anxiety and depression, while SA improved only depression.These findings provide initial evidence to suggest that EA may reduce pain-related symptom clusters in breast cancer survivors.