ABSTRACT
Purpose@#Aromatase inhibitors (AIs) are widely prescribed for postmenopausal women with breast cancer and are known to cause musculoskeletal pain. This study aimed to identify factors associated with AI continuation intention among breast cancer survivors (BCS). @*Methods@#A cross-sectional survey was conducted on 123 BCS (stages I–III), who had been taking AIs for at least 6 weeks. Participants were recruited from a cancer center in Goyang, Korea, from September to November 2019. Descriptive statistics, Welch analysis of variance, Pearson correlation coefficients, and simple linear regression were used for the analysis. @*Results@#Belief in endocrine therapy was a significant predictor of AI continuation intention (β=.66, p<.001). The majority of participants (87.0%) reported experiencing musculoskeletal pain since taking AIs and the score for the worst pain severity within 24 hours was 5.08±2.80 out of 10. Musculoskeletal pain, however, was not associated with AI continuation intention. Fear of cancer recurrence (FCR) was clinically significant (≥13) for 74.0% of the respondents (mean, 17.62±7.14). Musculoskeletal pain severity and pain interference were significantly associated with FCR (r=.21, p<.05; r=.35, p<.01, respectively). Pain interference was significantly associated with belief in endocrine therapy (r=–.18, p<.05). @*Conclusion@#AI continuation intention can be modified by reinforcing patients’ belief in endocrine therapy. Musculoskeletal pain may have a negative effect on belief in endocrine therapy and increase FCR among BCS. Thus, awareness of musculoskeletal pain during AI therapy should be raised and further research is required to develop multidisciplinary pain management strategies and clinical guidelines to reinforce belief in endocrine therapy.
ABSTRACT
Purpose@#Aromatase inhibitors (AIs) are widely prescribed for postmenopausal women with breast cancer and are known to cause musculoskeletal pain. This study aimed to identify factors associated with AI continuation intention among breast cancer survivors (BCS). @*Methods@#A cross-sectional survey was conducted on 123 BCS (stages I–III), who had been taking AIs for at least 6 weeks. Participants were recruited from a cancer center in Goyang, Korea, from September to November 2019. Descriptive statistics, Welch analysis of variance, Pearson correlation coefficients, and simple linear regression were used for the analysis. @*Results@#Belief in endocrine therapy was a significant predictor of AI continuation intention (β=.66, p<.001). The majority of participants (87.0%) reported experiencing musculoskeletal pain since taking AIs and the score for the worst pain severity within 24 hours was 5.08±2.80 out of 10. Musculoskeletal pain, however, was not associated with AI continuation intention. Fear of cancer recurrence (FCR) was clinically significant (≥13) for 74.0% of the respondents (mean, 17.62±7.14). Musculoskeletal pain severity and pain interference were significantly associated with FCR (r=.21, p<.05; r=.35, p<.01, respectively). Pain interference was significantly associated with belief in endocrine therapy (r=–.18, p<.05). @*Conclusion@#AI continuation intention can be modified by reinforcing patients’ belief in endocrine therapy. Musculoskeletal pain may have a negative effect on belief in endocrine therapy and increase FCR among BCS. Thus, awareness of musculoskeletal pain during AI therapy should be raised and further research is required to develop multidisciplinary pain management strategies and clinical guidelines to reinforce belief in endocrine therapy.
ABSTRACT
PURPOSE: Estrogen relaxes vascular smooth muscle via genomic and non-genomic mechanisms. Most studies of the role of estrogen in the relaxation response have been conducted in females, and little information is available in males. This study investigated whether estrogen plays a role in relaxation of the rabbit cavernous smooth muscle. MATERIALS AND METHODS: Relaxation responses of rabbit cavernous smooth muscle to estrogen (30 nM, 300 nM, 3 micrometer, 30 micrometer) were observed in vitro. The responses of the muscle strips to estrogen after incubation with the transcription inhibitor dactinomycin (10 micrometer) or the nonspecific nitric oxide (NO) synthase inhibitor L-NAME (10 micrometer) also were evaluated. RESULTS: Estrogen caused dose-dependent relaxation of strips contracted by norepinephrine. The maximal response was seen about 10 minutes after treatment. Estrogen-induced relaxation was not prevented by dactinomycin or L-NAME, suggesting that the response was not mediated by gene transcription or NO. CONCLUSIONS: Estrogen may be involved in relaxation of rabbit cavernous smooth muscle via a non-genomic NO-independent mechanism.