Dr. Leigh Callahan and team awarded an R21 grant by the NIH, National Cancer Institute

This new funding will enable the team to explore how an evidence-based physical activity (PA) program – the Arthritis Foundation’s Walk With Ease program – can be adapted for breast cancer survivors on aromatase inhibitors therapy (AI) therapy to: (1) help them maintain or achieve recommended levels of physical activity, (2) reduce their joint pain/stiffness/achiness, and (3) thereby enable to them to remain on AI therapy as prescribed. Co-Investigators for this study are Christine Rini, PhD, Associate Professor of Health Behavior and a member of the Lineberger Comprehensive Cancer Center (LCCC) and Hyman B. Muss, MD, Director of Geriatric Oncology at the LCCC and breast cancer oncologist at the North Carolina Cancer Hospital. This study represents an important inter-disciplinary research initiative between rheumatology and oncology.

Breast cancer is the second most common cancer among women in the U.S., with an estimated 207,090 new diagnoses in 2010 and a lifetime risk among women born today of 1 in 8. Most breast cancer cases are diagnosed among postmenopausal women at an early and treatable stage, and most of their tumors (70-80%) are hormone-receptor positive. For these women, standard adjuvant endocrine treatment is aromatase inhibitor (AI) therapy to prolong disease-free survival and time-to-recurrence. Unfortunately, joint pain/stiffness/ achiness is a common side-effect of AIs, with estimates of joint complaints ranging from 46% to 74% among survivors seen in clinical practice. The precise etiology of AI-associated musculoskeletal symptoms (AIMSS) remains unclear and is complicated by the high prevalence of benign and non-specific musculoskeletal symptoms in the general population of older women, such as arthritis. AI discontinuation due to side-effect severity is an estimated 20-32%, and is of great concern among oncologists. Research is needed to identify effective, easy-to-use, sustainable, and safe alternative or adjunct approaches to AIMSS management, so that breast cancer survivors are able to remain on AI therapy and have a life that is as pain-free as possible.

The Callahan team will investigate whether moderate-intensive physical activity (PA) can provide relief from AIMSS within a sample of female breast cancer survivors on AI therapy who report moderate to severe joint symptoms. Specifically, they will adapt and test the Arthritis Foundation’s Walk With Ease (WWE) program, which is evidence-based for reducing joint pain, stiffness and fatigue among adults with arthritis and is available in a self-directed (non-group) format. All aspects of this study will be informed by Patient Advisors who are part of the Study Team as well as by oncologists who are actively engaged in the design, implementation and analysis of the program.