Improving Health of Women on Aromatase Inhibitors
Creators: name: University Of California Office Of The President
Publisher: name: University of California Office of the President
publisherIdentifier: https://ror.org/00dmfq477
publisherIdentifierScheme: ROR
Year: 2024

description: Non-technical overview of the research topic and relevance to breast cancer: Women over the age of 50 account for the majority of breast cancers that occur during adulthood. The most common breast cancer tumors in women over age 50 have markers on tumor cells that are uniquely shaped to exactly fit the hormone, estrogen. When estrogen makes contact with these breast tumor cells, estrogen causes the cancer cells to divide. Aromatase inhibitor treatments block the production of estrogen, and the chances of the breast cancer cells dividing or breast cancer returning after surgery are greatly reduced. Women who take aromatase inhibitors also have prolonged survival compared to women who do not take aromatase inhibitors. However even though aromatase inhibitors increase women’s chances of living longer, many women discontinue their medication because of painful side effects such as joint and muscle pain. Women who take aromatase inhibitors also suffer bone loss, and sometimes have increased chances of developing heart problems. Our research is proposing to implement dietary and exercise interventions that will alleviate these side effects and increase the likelihood that women will stay on their medication. If women can stay on their medication for the entire duration of five years when the drugs are most effective, their chances of dying from breast cancer or their breast cancer returning are reduced.
 
 
 
 
 
 
 
 The question(s) or central hypotheses of the research: The central question of our research is whether our dietary and exercise intervention approaches will successfully alleviate side effects from aromatase inhibitors. We propose to implement two different interventions and each will last for three months: One intervention is an anti-inflammatory dietary intervention designed to decrease inflammation and alleviate joint and muscle pain. The other intervention is an exercise program that will strengthen and reduce bone loss. Both interventions may improve heart health.
 
 
 
 
 
 
 
 The general methodology: Our first aim is to recruit a sample of 20 ethnically, racially and culturally diverse postmenopausal women from UCLA Oncology Centers diagnosed with early stage breast cancer at least 6 months ago who are currently taking aromatase inhibitors and who are experiencing joint and muscle pain. Each woman will be randomly assigned to the dietary intervention or to the exercise intervention, with an equal number of 10 in each group. Our second and fourth aims are to take measurements before and after the interventions; of reported joint and muscle pain; bone mineral density (measure of bone strength); markers found in the blood for inflammation, bone loss, and heart function; and cardiovascular measures of exercise capacity, responsiveness of blood vessels, and determination of blood flow in the heart. We will evaluate measurement changes resulting from the interventions. Our third aim is to conduct the dietary and exercise interventions. The UCLA Center for Human Nutrition will provide all anti-inflammatory Mediterranean meals to participants who will only consume meals provided to them by the study. The exercise intervention will consist of participants visiting the exercise training Wooden Center at UCLA at least three times a week for one-hour sessions with a dedicated trainer. Participants will undergo exercise training designed to improve and strengthen bone, such as impact exercises, weight-bearing endurance exercise, and training with weights. If our interventions successfully reduce side effects, for our fifth aim, we will propose a much larger clinical trial that will evaluate the independent influences of the anti-inflammatory diet and bone health promoting exercise, and combined influence of diet and exercise, on the measured outcome changes.
 
 
 
 
 
 
 
 Innovative elements of the project and potential impact: Our study is innovative because we are the first to implement a dietary intervention, our echocardiography measures have only been tried on one other small study, we are the first to implement a dietary and exercise intervention together in the same study, and we are the first to include serum cardiovascular markers, galectin and st-2. The potential impact of our results, if successful, would enable women who suffer from painful side effects, through consuming an anti-inflammatory diet or engaging in a weight bearing and resistance training exercise program, be able to experience the full benefit of aromatase inhibitor treatment.