Abstract P3-08-10: Feasibility and promise of a self-directed walking program to reduce joint pain among older breast cancer patients on adjuvant aromatase inhibitors

Abstract

Background: Most breast cancer cases diagnosed among postmenopausal women are hormone receptor positive (HR+); standard adjuvant endocrine treatment usually includes an aromatase inhibitor (AI). Joint pain/stiffness/achiness (arthralgia) is a common AI side-effect, and AI discontinuation due to this side-effect is an estimated 20-32%. There is a need for effective alternative or adjunctive approaches to arthralgia management that enable survivors to remain on AI therapy while optimizing as pain-free a life as possible. This pilot study investigates the feasibility of a highly scalable 6-week self-directed physical activity (PA) program – Walk With Ease (WWE) – among elderly female breast cancer survivors on AIs who report joint pain. WWE goal: minimum of 30 minutes of walking 5 days a week (150 minutes/week). Methods: Recruitment: BC survivors age 65+ were recruited through the oncology clinic of a university-affiliated hospital. Eligibility: age 65+; Stage I-III breast cancer; currently on AI therapy; self-reported joint pain/stiffness; physician permission to engage in PA; English speaking. Measures: (1) walking – number of days per week and number of minutes per walk, (2) visual analog scales (VAS) for joint pain, fatigue and stiffness, and (3) arthritis self-efficacy (ASE) to manage joint pain and fatigue. Statistics: t-test evaluation of changes in mean values. Results: Sample (N = 20) – mean age 71 (65-87), 85% Caucasian, 35% < high school, mean BMI 29. 63% chemotherapy, 61% radiation therapy. 90% completed the 6-week intervention. Compared to baseline, total minutes of walking per week increased from 95 (0-450) to 172 (45-700) (p<.001) and mean joint pain decreased 10% (p = 0.63), fatigue decreased 19% (p = 0.31), and joint stiffness decreased 32% (p = 0.07). Post-intervention, 71% of participants were “fairly” or “extremely” confident they would continue walking; 100% would recommend WWE to other breast cancer survivors experiencing joint pain or stiffness; 100% thought they had learned how joint pain or stiffness could be lessened by physical activity, and how to safely engage in moderate-intensity physical activity; 90% thought WWE had motivated them to become more physically active, and how to overcome physical and mental barriers to walking; and 90% were fairly to extremely confident they would continue walking. Conclusions: A moderate-intensity self-directed walking program is feasible for older breast cancer patients on AI therapy and almost doubled the total time of walking per week over a 6 week period. Joint pain, stiffness, and fatigue decreased, and the walking program was perceived as informative and motivational. These data are promising and the WWE intervention warrants testing in a larger randomized trial of breast cancer survivors on AI therapy. Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P3-08-10.