[Debbie L.]

Sarah, what a GREAT overview article. Thank you for posting it. I don't remember seeing it before (although it's several years old).

I particularly like that it touches (barely) on something I've long wondered about. We know from many studies that AIs offer a small benefit over Tamoxifen in preventing recurrences. However, I have yet to see any of the studies looking at OTC NSAID use (or rx use, for that matter) in women on AIs. Many patients have some degree of "arthralgia", and my sense is that they self medicate with NSAIDs (or even aspirin). We know there is an association between use of NSAIDs/aspirin and cancer incidence and possibly recurrence. I wonder if this could be a big enough confounder to explain, at least partially, the small increased benefit of the AIs. I wonder why no one has included this focus in the many studies that have been done.

I also like that many other ideas to reduce pain are mentioned (including yoga and Vitamin D). As the author notes, more study is needed on all fronts.

I also wish we could figure out why for most, the pain is annoying but tolerable/treatable -- while for a few it is disabling and intolerable.

Thanks again for sharing the article.

Debbie Laxague