University of Michigan
Ann Arbor, Michigan
Professor of Internal Medicine and Daniel F. Hayes MD Breast Cancer Research Professor
Breast Oncology Disease Lead, Rogel Cancer Center
Interim Chief of the Division of Hematology and Oncology
Reducing aromatase inhibitor side effects and improving quality of life of breast cancer survivors.
For patients with estrogen receptor (ER)-positive breast cancer, anti-hormone treatments taken for five to ten years reduce the risk of recurrence and dying from the disease. However, up to half of patients stop taking endocrine therapy earlier than recommended, primarily because of aggravating side effects. Dr. Henry and her team are looking to understand why some patients develop these bothersome side effects and to identify more effective ways to prevent or decrease toxicity of these treatments.
Aromatase inhibitors (AI), which significantly lower estrogen concentrations, are a key treatment for patients diagnosed with hormone receptor-positive early-stage breast cancer. Their main side effects are aromatase inhibitor-induced musculoskeletal symptoms (AIMSS) which include aches, pains, and stiffness thought to be due, in part, to inflammation. Three interventions effective for treating AIMSS are acupuncture, exercise, and the antidepressant duloxetine, but they only work for a subset of patients. Therefore, there is a critical need to identify additional effective treatments for AIMSS so that more breast cancer survivors can continue taking cancer treatment.
Many patients will not try acupuncture to treat AIMSS because of the cost and lack of available practitioners. Acupressure, which involves self-administering pressure to specific points on the body, has been shown previously to reduce fatigue, and may be more acceptable to patients than acupuncture for treating AIMSS. Dr. Henry will conduct a pilot randomized controlled trial of acupressure for treating AIMSS. If effective, the team plans to confirm these findings in a larger multi-site clinical trial. Additionally, they will investigate the effects of AI therapy on gut bacteria. For some people, most of the bacteria in their stool are associated with inflammation, whereas others have more anti-inflammatory bacteria. Previous studies have shown that altering estrogen levels in the body can affect the types of gut bacteria, and the team will investigate if specific gut bacteria are affected by AI treatment and are associated with symptoms. Identifying patterns of bacteria that are associated with AIMSS could suggest potential interventions to reduce AIMSS and improve AI therapy adherence.
Norah Lynn Henry, MD, PhD, a medical oncologist, is Professor of Internal Medicine and Interim Chief of Hematology/Oncology at the University of Michigan Medical School and the Daniel F. Hayes, MD, Breast Cancer Research Professor at the Rogel Cancer Center. She completed her PhD in Structural Biology at Stanford University School of Medicine, and her medical degree at Washington University in St Louis. She then completed her internal medicine residency at Brigham and Women’s Hospital in Boston, followed by hematology/oncology fellowship training at the University of Michigan.
Dr. Henry was appointed to the faculty at the University of Michigan Medical School in 2007 and since that time has developed expertise in breast cancer management, acute toxicity and late effects of cancer therapy, symptom management, survivorship, and patient-reported outcomes. She has published over 130 peer-reviewed manuscripts and collaborates with colleagues throughout the United States. Dr. Henry has served as national Study Chair for two large randomized clinical trials in SWOG focused on symptom management and persistence with endocrine therapy. Since 2015, she has served as co-chair of the SWOG Symptom Management and Quality of Life committee and served as Scientific Program Chair for the 2021 ASCO Annual Meeting. Dr. Henry serves as primary mentor for numerous medical students, fellows, and early career faculty.
Dr. Henry has received grant funding from the National Cancer Institute, American Cancer Society, Damon Runyon Cancer Research Foundation, V Foundation, American Society of Clinical Oncology, Expedition Inspiration, the University of Michigan Rogel Cancer Center, and the Breast Cancer Research Foundation.
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