"I know I need this medicine to help lower my chance of cancer recurrence, but it makes my joints ache and stiff. It makes me feel old and I am not sure I can take this medication much longer."
It's a story that oncologists across the country hear frequently from patients taking aromatase inhibitors, a medication that reduces circulating estrogen levels, which leads to lower breast cancer recurrences. Dr. Maryam Lustberg, an assistant professor at the Ohio State College of Medicine, knew the pain made some of her patients less compliant, possibly giving the cancer a foothold.
"Up to a third of my patients were reporting joint symptoms on aromatase inhibitor therapy which was impacting their quality of life and some had to stop taking the medication," says Lustberg.
Lustberg attended a seminar hosted by Ohio State's Center for Clinical and Translational Science (CCTS) designed to bring new TL-1 award recipients together to share research interests. There, she met Tonya Orchard, a doctoral student in nutrition working on a CCTS-funded study with post-menopausal women and the consumption of fatty acids - a nutrient essential to human health that had also been linked to reducing joint pain related to osteoarthritis and rheumatoid arthritis.
"Dr. Lustberg approached me with what she was seeing in her clinic and we quickly became excited about the prospect of working together to address the problem," recalls Orchard, now a visiting assistant professor in the Department of Nutrition at Ohio State. "We put together a grant proposal and the Cancer and Leukemia Group B awarded us pilot funding to see if omega-3's could help women taking these estrogen-blocking drugs."
This study - due to be completed in Spring 2012 - adds another chapter in Orchard's career that has included working with patients suffering from osteoporosis in a clinical setting and researching the health impacts of omega-3 fatty in post-menopausal women.
"Early on, I was fascinated with research showing a correlation between omega-3's and bone mineral density, but it was really after seeing my grandmother suffer from several lumbar fractures, a hip fracture and ultimately ending up in a nursing home that my interest in fatty acids was solidified," says Orchard.
The interest is continuing through the Women's Health Initiative working group at Ohio State, where Drs. Lustberg and Orchard are also collaborating with neuroscientist Dr. Courtney DeVries to investigate the effects of omega-3 supplementation on cognitive symptoms associated with chemotherapy. As many as one-third of breast cancer patients undergoing chemotherapy will experience problems with memory and verbal fluency, but these women's health researchers believe that the anti-inflammatory properties of fatty acids may provide a solution.
"Fatty acids are present in every cell of the body. They alter the production of signaling hormones and how cells communicate with each other in ways that may impact inflammation," says Orchard. "Omega-3 supplementation has been shown to be safe during chemotherapy and may offer solutions to multiple issues associated with cancer therapies where inflammation may be involved."
Orchard's work with fatty acids isn't stopping there.
"I'd like to further explore genetic interactions that might modify the relationship of omega-3's to fracture using Women's Health Initiative data," said Orchard. "I'm also interested in other nutritional components that impact inflammation and musculoskeletal disease."
Her research has definitely impacted her own diet, and Orchard says she has increased her own omega-3 intake by eating salmon and tuna about 1 - 2 times a week, adding flaxseed to her cooking and modifying several recipes to increase the omega-3 content.
Orchard offers the following simple cooking and food tips to increase omega-3 fatty acids:
•Substitute up to ¼ of the oil in baked goods with milled flaxseed (great in muffins and holiday breads)
•Use canola oil or a high omega-3 margarine with no trans-fat in place of corn, vegetable oil or butter for holiday baking or for sautéing
•Substitute canola oil for shortening or lard in pie crusts, decrease the water slightly and roll out between waxed paper
•Substitute omega-3 fortified products (sour cream, eggs, etc.) in holiday recipes
•Add English walnuts to your favorite dishes, such as hot oatmeal with raisins and cinnamon for breakfast
•Try adding a can of drained Albacore tuna to your favorite cheese-ball recipe
•Shrimp cocktail, smoked herring or sardines on peppered crackers make a great, high omega-3 party appetizer
Ohio State College of Medicine