Breast cancer patients experience increased pain in joints

Joint pain is more common and more severe in women with breast cancer than women of the same age without breast cancer, according to a new study led by researchers at the University of Southampton.

Although joint and muscle aches, pains and stiffness are among the more common problems reported by breast cancer patients, this is the first study to compare the prevalence and patterns of these symptoms in different parts of the body to those in healthy women of a similar age.

The findings raise awareness of joint pain as a potentially serious and long-lasting problem for some women who have had breast cancer and pave the way for finding effective treatments, say the research team.

They analysed responses to questionnaires completed by 247 women with breast cancer following primary breast cancer treatment and 272 women without breast cancer undergoing routine breast screening.  For the women with breast cancer, the average time since diagnosis was 36 months.

The women completed three pain questionnaires, the Nordic musculoskeletal pain questionnaire, the Brief Pain Inventory (BPI) and the SF-36 general health questionnaire.  Medical and demographic details were also collected, as well as information about factors which might affect these symptoms, such as weight and menopausal status.

On the day they completed the questionnaire, 62 per cent of breast cancer patients complained of pain as opposed to 49 per cent of women without cancer.  The breast cancer group also reported a higher level of pain, with a mean score of 4.2 on the ten-point Brief Pain Inventory scale, compared to 3.4 in women without breast cancer, although pain did not significantly interfere with daily activities.

In terms of patterns of pain in the body, women with breast cancer were more likely to experience pain in their hands and upper back: 41 per cent of that group reported pain in their hands and 21 per cent reported pain in their upper back over the previous seven days, compared to 31 per cent and 11 per cent of healthy women.

Although pain in the feet was not reported as more common in breast cancer patients, they reported that it was more likely to interfere with activity in the last 12 months.  Neck pain was, however, more common in healthy women: 37 per cent compared to 28 per cent of cancer patients.

Dr Deborah Fenlon, Senior Research Fellow at the Macmillan Research Unit in the University of Southampton’s School of Health Sciences, who led the study, comments: "Although some of these symptoms will inevitably be caused by ageing, there is some evidence to suggest that they are specific to or made worse by primary breast cancer treatment.  Clinical observations also suggest that specific patterns of pain may be related to specific breast cancer treatments.

"Almost two-thirds of newly-diagnosed patients are likely to survive for at least 20 years now that cancer detection and treatment are improving and, as a result, more women are living with the long-term consequences of breast cancer treatment.  We need to understand how these consequences impact on women’s lives and develop ways of managing them," she adds.

Future studies will explore how symptoms affect quality of life and whether and how the perception of pain differs between cancer and non-cancer patients. Further research is needed to examine the effect of different medications and other interventions in managing joint pain.

The findings were presented at the 2008 San Antonio Breast Cancer Symposium (SABCS). The study was funded by a National Cancer Research Institute (NCRI) SuPaC Capacity Building Grant.

(Source: 2008 San Antonio Breast Cancer Symposium: University of Southampton: December 2008)