BALNEOTHERAPY FOR BREAST CANCER PATIENTS UNDERGOING ENDOCRINE THERAPY

January 30, 2025 updated by: Parc de Salut Mar

EFFECTS OF BALNEOTHERAPY IN BREAST CANCER PATIENTS UNDERGOING ENDOCRINE THERAPY

Endocrine therapy is the mainstay of adjuvant therapy in premenopausal women with hormone receptive-positive (HR+) breast cancer as it has been demonstrated that it reduces long-term recurrences and increases survivial. However, this therapy, which suppresses estrogen production and estrogen-induced effects, is associated with the development of joint pain which can significantly reduce quality of life and lead to treatment discontinuation.

The main question the study aims o answer is:

Can balneotherapy (BT) alleviate muscle-skeletal pain (primary objective) derived from endocrine therapy and improve quality of life (secondary objective) in young women with HR+ breast cancer?

Study Overview

Status

Status

Indicates the current recruitment status or the expanded access status.
Not yet recruiting

Conditions

Conditions

The disease, disorder, syndrome, illness, or injury that is being studied. On ClinicalTrials.gov, conditions may also include other health-related issues, such as lifespan, quality of life, and health risks.

Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.

Detailed Description

PATIENTS AND METHODS

Inclusion Criteria:

  • Premenopausal women diagnosed with early-stage hormonal receptor (HR+) breast cancer (stages I-III) undergoing ovarian suppression and aromatase inhibitor therapy (i.e., endocrine therapy) for at least three months.
  • Reported musculoskeletal pain (VAS score ≥2) associated with the initiation of the endocrine therapy.

Exclusion Criteria:

  • Chronic musculo-skeletal conditions predating the initiation of endocrine therapy.
  • Anxiety-depression syndrome predating the initiation of endocrine therapy that is pharmacologically treated.
  • Fear of water
  • Fecal and urinary incontinence
  • Severe venous insufficiency
  • Epilepsy
  • Physical disabilities that may hinder the performance of BT/aquatic exercises

Participants will be recruited in Hospital del Mar's Oncology department and in the hospital's Mineral Metabolism Clinic (Internal Medicine Department).

In addition, Caldes de Montbui's City Council will also advertise the project for patient recruitment on its public website.

Patient selection and recruitment will be performed by the study's investigators at the Hospital del Mar Research Institute.

STUDY DESIGN Prospective randomized controlled study.

STUDY FLOW Eligible particpants will undergo an initial visit (baseline) in which clinical data will be reviewed and registered. Forty-eight participants will be randomly assigned to the BT group and 48 to the control group through a lottery method. At this time point, participants will be asked to answer/complete the following scales/questionnaires: visual analog scale for pain (VAS), the SF-36 quality of life test, the Hospital Anxiety and Depression Scale (HADS), and the Pittsburgh Sleep Quality Index (PSQI). These tools measure pain severity (primary objective), quality of life, levels of anxiety and depression, and sleep quality, respectively. All results will be recorded in an anonymized database managed by the Hospital del Mar Research Institute.

Treatment Program: Participants allocated to BT group will undergo 12 sessions over four weeks (3 weekly sessions) involving thermal water exercises at 32°C (10 min inhalation, 10 min warm-up, 20 min specific exercises, 10 min relaxation), thermal showers (7 min jet or circular showers), and 30 minutes rest. Participants in the control group will be asked to not initiate new physical therapies and to continue with their usual care.

At the end of the BT program (or 4 weeks after baseline for the participants allocated to the control group), participants will be asked to answer/complete the same questionnaires/scales they did at baseline (second timepoint).

All participants will be asked to answer again the same questionnaries 6 months after BT completion or 7 months after baseline in the case of the participants of the control group (third timepoint).

Study outcomes will be obtained by calculating the differences in scores for the study variables (VAS (primary objective), SF-36, PSQI, and HADS (secondary objectives) between the end of BT and baseline, and the third timepoint vs baseline. Outcome analysis will be conducted by a qualified professional who is blinded to the two groups (BT group and control group).

In addition, the following data will be collected at baseline for each patient and included in the database for the study: age (years), Body Mass Index (BMI) (kg/m2), current medications, and time since the initiation of adjuvant endocrine therapy (months).

These data will be used as study variables and for adjustment in the multivariable analysis. The database and analyses will be managed by the principal investigator.

Data will be analyzed using descriptive statistics for qualitative variables and parametric or non-parametric tests for continuous variables. Changes in pain, quality of life, and emotional scores will be evaluated using linear models, with adjustments for confounders. Statistical significance will be set at α = 0.05.

Adverse events will be registered throughout the duration of the study. If participants allocated to the BT group report significant adverse effects directly associated with BT, they will discontinue the therapy.

Study Type

Study Type

Describes the nature of a clinical study. Study types include interventional studies (also called clinical trials), observational studies (including patient registries), and expanded access.
Interventional

Enrollment (Estimated)

Enrollment

The number of participants in a clinical study. The "anticipated" enrollment is the target number of participants that the researchers need for the study.
96

Phase

Phase

The stage of a clinical trial studying a drug or biological product, based on definitions developed by the U.S. Food and Drug Administration (FDA). The phase is based on the study's objective, the number of participants, and other characteristics. There are five phases: Early Phase 1 (formerly listed as Phase 0), Phase 1, Phase 2, Phase 3, and Phase 4. Not Applicable is used to describe trials without FDA-defined phases, including trials of devices or behavioral interventions.
  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Contact

The name and contact information for the person who can answer enrollment questions for a clinical study. Each location where the study is being conducted may also have a specific contact, who may be better able to answer those questions.

Study Contact Backup

Study Locations

  • Spain
      • Barcelona, Spain, 08003
        • Parc de Recerca Biomèdica de Barcelona
        • Sub-Investigator:
          • Tamara Martos, MD
        • Contact:
        • Contact:
        • Principal Investigator:
          • Natalia Garcia Giralt, PhD
        • Sub-Investigator:
          • Diana Ovejero, MD, PhD
        • Sub-Investigator:
          • Xavier Nogues, MD, PhD
        • Sub-Investigator:
          • Anna Ribes, MSc
        • Sub-Investigator:
          • Sònia Servitja, MD, PhD
        • Sub-Investigator:
          • Joan Albanell, MD, PhD

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Eligibility Criteria

The key requirements that people who want to participate in a clinical study must meet or the characteristics they must have. Eligibility criteria consist of both inclusion criteria (which are required for a person to participate in the study) and exclusion criteria (which prevent a person from participating). Types of eligibility criteria include whether a study accepts healthy volunteers, has age or age group requirements, or is limited by sex.

Ages Eligible for Study

  • Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

Premenopausal women diagnosed with early-stage hormonal receptor (HR+) breast cancer (stages I-III) undergoing ovarian suppression and aromatase inhibitor therapy (i.e., endocrine therapy) for at least three months.

- Reported musculoskeletal pain (VAS score ≥2) associated with the initiation of the endocrine therapy.

Exclusion Criteria

  • Chronic musculoskeletal conditions predating the initiation of endocrine therapy and/or unrelated to effects derived from the endocrine therapy (i.e. fibromyalgia)
  • Anxiety-depression syndrome predating the initiation of endocrine therapy that is treated with drugs.
  • Fear of water
  • Fecal and/or urinary incontinence
  • Severe venous insufficiency
  • Epilepsy and physical disabilities that may hinder the performance of Balneotherapy (BT)/aquatic exercises.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Single

Arms and Interventions

Participant Group / Arm

Participant Group / Arm

A group or subgroup of participants in a clinical trial that receives a specific intervention/treatment, or no intervention, according to the trial's protocol.
Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.
Experimental: Balneotherapy group
These participants will be premenopausal women with estrogen receptor positive early breast cancer treated with adjuvant endocrine therapy allocated to receive 4 weeks of 3 weekly sessions of balneotherapy.
Other: Balneotherapy
The intervention consists in 3 weekly sessions of balneotherapy during 4 weeks.
No Intervention: Control group
These participants will be premenopausal women with estrogen receptor positive early breast cancer treated with adjuvant endocrine therapy that will not receive balneotherapy but that will be asked to respond to the same scales and questionnaires as the balneotherapy group at the same timepoints.

What is the study measuring?

Primary Outcome Measures

Primary Outcome Measures

In a clinical study's protocol, the planned outcome measure that is the most important for evaluating the effect of an intervention/treatment. Most clinical studies have one primary outcome measure, but some have more than one.
Outcome Measure
Measure Description
Time Frame
Changes in musculo-skeletal pain
Time Frame: 7 months
The primary objective is to determine changes in pain levels through the visual analogic scale (VAS) in the third and second timepoints vs baseline in all participants and to compare these outcomes between participants in the BT and control groups.
7 months

Secondary Outcome Measures

Secondary Outcome Measures

In a clinical study's protocol, a planned outcome measure that is not as important as the primary outcome measure for evaluating the effect of an intervention but is still of interest. Most clinical studies have more than one secondary outcome measure.
Outcome Measure
Measure Description
Time Frame
Changes in quality of life
Time Frame: 7 months
To asses changes in quality-of-life scores through the SF-36 questionnaire in the third and second timepoints vs baseline in all participants and to compare these outcomes between participants in the BT and control groups.
7 months
Changes in sleep quality
Time Frame: 7 months
To asses the changes in sleep quality and sleep disturbances through the Pittsburgh Sleep Quality Index (PSQI) in the third and second timepoints vs baseline in all participants and to compare these outcomes between participants in the BT and control groups.
7 months
Changes in anxiety and depression symptoms
Time Frame: 7 months
To assess the changes in anxiety and depression symptoms through the Hospital Anxiety and Depression Scale (HADS) in the third and second timepoints vs baseline in all participants and to compare these outcomes between participants in the BT and control groups.
7 months

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Sponsor

The organization or person who initiates the study and who has authority and control over the study.
Parc de Salut Mar

Collaborators

Collaborators

An organization other than the sponsor that provides support for a clinical study. This support may include activities related to funding, design, implementation, data analysis, or reporting.
European Regional Development Fund
Biomedical Research Networking Center on Frailty and Healthy Aging (CIBERFES)
Caldes de Montbui's City Council

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Estimated)

Study Start

The actual date on which the first participant was enrolled in a clinical study. The "anticipated" study start date is the date that the researchers think will be the study start date.
February 10, 2025

Primary Completion (Estimated)

Primary Completion

The date on which the last participant in a clinical study was examined or received an intervention to collect final data for the primary outcome measure. Whether the clinical study ended according to the protocol or was terminated does not affect this date. For clinical studies with more than one primary outcome measure with different completion dates, this term refers to the date on which data collection is completed for all the primary outcome measures. The "anticipated" primary completion date is the date that the researchers think will be the primary completion date for the study.
August 30, 2026

Study Completion (Estimated)

Study Completion

The date on which the last participant in a clinical study was examined or received an intervention/treatment to collect final data for the primary outcome measures, secondary outcome measures, and adverse events (that is, the last participant's last visit). The "anticipated" study completion date is the date that the researchers think will be the study completion date.
May 31, 2027

Study Registration Dates

First Submitted

First Submitted

The date on which the study sponsor or investigator first submitted a study record to ClinicalTrials.gov. There is typically a delay of a few days between the first submitted date and the record's availability on ClinicalTrials.gov (the first posted date).
January 23, 2025

First Submitted That Met QC Criteria

First Submitted That Met QC Criteria

The date on which the study sponsor or investigator first submits a study record that is consistent with National Library of Medicine (NLM) quality control (QC) review criteria. The sponsor or investigator may need to revise and submit a study record one or more times before NLM's QC review criteria are met. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
January 30, 2025

First Posted (Actual)

First Posted

The date on which the study record was first available on ClinicalTrials.gov after National Library of Medicine (NLM) quality control (QC) review has concluded. There is typically a delay of a few days between the date the study sponsor or investigator submitted the study record and the first posted date.
March 25, 2025

Study Record Updates

Last Update Posted (Actual)

Last Update Posted

The most recent date on which changes to a study record were made available on ClinicalTrials.gov. There may be a delay between when the changes were submitted to ClinicalTrials.gov by the study's sponsor or investigator (the last update submitted date) and the last update posted date.
March 25, 2025

Last Update Submitted That Met QC Criteria

Last Update Submitted That Met QC Criteria

The most recent date on which the study sponsor or investigator submitted changes to a study record that are consistent with National Library of Medicine (NLM) quality control (QC) review criteria. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
January 30, 2025

Last Verified

Last Verified

The most recent date on which the study sponsor or investigator confirmed the information about a clinical study on ClinicalTrials.gov as accurate and current. If a study with a recruitment status of recruiting; not yet recruiting; or active, not recruiting has not been confirmed within the past 2 years, the study's recruitment status is shown as unknown.
January 1, 2025

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

Other Study ID Numbers

Identifiers or ID numbers other than the NCT number that are assigned to a clinical study by the study's sponsor, funders, or others. These numbers may include unique identifiers from other trial registries and National Institutes of Health grant numbers.
  • 2024/11531/I

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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