Pain after chemotherapy

After chemotherapy, some patients experience severe pain in different parts of the body. This means that there is a high degree of damage to the internal organs - the heart, liver, kidneys, lungs, urinary and genital organs. In this case, severe pain after chemotherapy can bother the patient for several months.

Severe pain in the heart area requires increased attention. First of all, you need to inform your doctor about these symptoms and take precautions. You need to rest more often during the day, including daytime sleep, and sleep more at night. Do not overdo active movements and behavior. It is recommended to do only what requires necessary actions.

There may also be pain in the stomach and lower abdomen. This means that the gastrointestinal tract has also experienced the effects of chemotherapy drugs. Bowel movements in some patients may be accompanied by severe pain and painful spasms. Severe pain and cramping are also observed in patients during urination.

Patients may experience pain or itching in the anus, accompanied by the appearance of hemorrhoidal cones. This indicates that the patient's immunity has dropped, and his body is exposed to various infections. To avoid worsening the condition, patients need to use soft toilet paper. Severe sore throat and irritation are also a consequence of the above-mentioned decrease in immunity and the penetration of infections into the body.

Severe pain after chemotherapy can be observed in the extremities - arms and legs, as well as in the back. Some patients experience periodic headaches.

After chemotherapy, severe toothache and gum inflammation may occur. In this case, you should consult a dentist and also change your regular toothbrush to a soft-bristled one.

Toothache and pain in the lower jaw can also be a manifestation of toxic neuritis and polyneuritis, which requires consultation with a neurologist, as well as additional treatment.

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Causes of pain after chemotherapy

In fact, the key causes of pain after chemotherapy have just been named. And these are the results of the action of medications, which are administered in fairly large doses and repeatedly to achieve the desired therapeutic effect. After their administration, the active substances enter the bloodstream, where they bind to blood plasma proteins and are carried throughout the body, penetrating not only the tissues of the malignant neoplasm, but also practically all the others...

All cytostatic drugs - derivatives of bis-β-chloroethylamine, oxazaphosphorine, nitrosourea or platinum compounds - are capable of damaging the mucous membrane of the gastrointestinal tract, disrupting the normal functioning of the liver, kidneys, spleen, pancreas, heart, bladder, spinal cord and brain, reproductive organs, hematopoietic and autonomic nervous systems.

Thus, platinum compounds such as Cisplatin, Oxaliplatin, Methotrexate, Platinex, etc. behave as strong nephrotoxins, causing dysfunction and pain in the kidneys after chemotherapy.

Methotrexate, used for breast cancer, rarely causes vomiting, but often simultaneously affects all mucous membranes, which leads to inflammation of the gastrointestinal mucosa and stomach pain after chemotherapy. Paclitaxel is used in patients with lung, esophageal, and bladder cancer, and this drug penetrates into the tissues of the intestines, liver, joints, and muscles. As a result, patients experience joint pain after chemotherapy, as well as severe muscle pain after chemotherapy.

And the drug Vincristine, which is used to fight leukemia, non-Hodgkin's lymphoma, bone sarcoma and many other oncological diseases, causes liver pain after chemotherapy, bone pain after chemotherapy and pain in other locations.

Long lists of side effects of antineoplastic drugs of this pharmacological group include peripheral neuropathic pain (peripheral neuropathy, polyneuropathy). This is quite severe pain after chemotherapy, the appearance of which is caused by the neurotoxic effect of cytostatics. This action consists of damage to the cytoskeleton of pain (nociceptive) neurons of the peripheral nervous system and disruption of the conductivity of pain signals from peripheral pain receptors (nociceptors), which are located not only in the skin and subcutaneous tissue, but also in the periosteum, joints, muscles and all internal organs. Oncologists associate muscle pain after chemotherapy with this action, as well as bone pain after chemotherapy (for example, in the lower jaw, in the shoulder blades, in the sternum).

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How does pain manifest itself after chemotherapy?

Let's try to find out how pain manifests itself after chemotherapy? The specific manifestation of pain syndrome after the use of cytostatic drugs depends on which organs have become the target of their side effects. And also on the dosage, the number of treatment courses and, of course, on the individual characteristics of the body and the stage of the disease. However, headache after chemotherapy is a side effect of most cytostatics, independent of the listed factors.

Damage to the cells of the mucous membrane of the upper respiratory tract is most often manifested by painful sensations in the throat. From ordinary pain, say, with acute tonsillitis (angina), a sore throat after chemotherapy is practically no different. But it should be borne in mind that after chemotherapy, leukopenia develops, that is, the number of leukocytes in the blood decreases sharply, primarily B-lymphocytes that provide immunity. For this reason, it is easier for cancer patients to catch an infection (the same tonsillitis). And this applies to all infections without exception.

If cytostatics have reached the gastrointestinal tract and liver, there may be stomach pain after chemotherapy - a sign of toxic gastritis (inflammation of the gastric mucosa). There may be dull and aching pain in the abdomen after chemotherapy, which indicate the development of toxic enterocolitis or colitis - inflammation of the small and large intestines. Periodic cramping sharp pains in the right hypochondrium 10-15 days after the introduction of cytostatics are a symptom of cholecystopathy (inflammation of the gallbladder and bile ducts). And when, against the background of diarrhea or constipation, pain after chemotherapy is felt not only in the abdomen, but also in the perineum (in particular, during bowel movements), then toxic proctitis (inflammation of the rectum) is almost unmistakably diagnosed.

A feeling of heaviness on the right side under the ribs and pain in the liver after chemotherapy, as oncologists note, are almost inevitable in most cases. This is the result of the hepatotoxic effect of cytostatic drugs, since their biochemical breakdown with the formation of metabolites occurs precisely in this organ - through the efforts of the hepatic enzyme system of cytochrome P-450. Moreover, many metabolites are active and continue to affect liver cells. In such extreme conditions, the liver cannot withstand the overload and gives a pain signal.

Symptoms of peripheral neuropathy may be limited to paresthesia (numbness and tingling) in the fingers, or they may cause leg pain after chemotherapy, aching pain in the arms after chemotherapy, debilitating back pain after chemotherapy, as well as bone pain and muscle pain after chemotherapy.

Headache after chemotherapy

Some chemotherapy drugs affect certain areas of the brain, which manifests itself in the occurrence of headaches. Pain after chemotherapy can vary in intensity - from mild and moderate to severe and debilitating. Headaches usually occur periodically, and only in a small number of patients can they be constant. Patients may also experience pulsating pain in the temples.

It is essential to inform a neurologist about the occurrence of headaches, who will prescribe appropriate treatment.

Headache can also be one of the symptoms of an incipient infectious disease. A decrease in the patient's immunity after chemotherapy is favorable for the spread of pathogenic microorganisms and the emergence of foci of infection.

Joint pain after chemotherapy

Many patients experience pain in their joints after a course of chemotherapy – knees, etc. Pain may be accompanied by swelling.

The occurrence of pain is associated with general intoxication of the body, which can be of several degrees - from zero to fifth. The presence of pain in the joints characterizes the first or second degree of damage to the body and is the immediate complication after chemotherapy.

Symptoms of joint pain after chemotherapy are relieved by painkillers taken simultaneously with Cerucal. In any case, the prescription of drugs should be carried out by the attending physician and self-treatment in this case is unacceptable.

The appearance of painful sensations in the joints of patients with diabetes may indicate an exacerbation of arthrosis, which is a complication of diabetes. The occurrence or exacerbation of arthrosis is usually provoked by chemotherapy drugs, which thus affect the condition of patients with metabolic disorders. These manifestations are related to the remote consequences after chemotherapy and occur one to two weeks after the end of the course of treatment. The condition of such patients should be corrected by reducing blood sugar levels, which always increase in patients with diabetes after chemotherapy.

Long-term joint pain after chemotherapy indicates, for example, over a six-month period, that degenerative changes have occurred in the cartilaginous tissue of the joints. In such cases, it is necessary to conduct an X-ray examination or ultrasound of the joints to confirm or refute this assumption and prescribe appropriate treatment.

Low hemoglobin levels can also be accompanied by pain in the joints of the body. In this case, it is necessary to take measures to increase the number of red blood cells and hemoglobin in the blood.

Leg pain after chemotherapy

Some patients report experiencing leg pain of varying intensity after chemotherapy.

Leg pain after chemotherapy may be caused by the following reasons:

• The appearance of polyneuropathy - damage to the fibers of the peripheral nervous system, which leads to many unpleasant sensations, including pain in the legs.
• Damage to the bone marrow, which is responsible for the function of hematopoiesis.
• Deterioration of the condition of the veins and arteries after chemotherapy.

Bone pain after chemotherapy

After chemotherapy, some patients experience moderate to severe bone pain. This is because the drugs primarily affect the bone marrow, which performs hematopoiesis functions. Bone marrow cells divide and develop quickly, and the action of chemotherapy drugs is aimed precisely at rapidly multiplying cells, which include malignant ones.

Bone marrow is located in the spongy substance of bones and bone marrow cavities. At the same time, bone marrow actively participates in the production of blood cells (erythrocytes, leukocytes, etc.) and bone structure. As a result of damage to the bone marrow, toxins and dead cells accumulate in it, which can cause pain in the bones.

To reduce bone pain after chemotherapy, you need to use a diet that restores the structure and functioning of the bone marrow. How to do this was described in the sections on increasing hemoglobin, red blood cells and white blood cells.

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Abdominal pain after chemotherapy

The occurrence of abdominal pain, which is accompanied by painful spasms, is often a complication after chemotherapy. In addition to pain, after chemotherapy, there may be frequent loose stools with mucus, in very rare cases - with blood. These symptoms are a manifestation of enterocolitis, which is caused by the irritating effect of cytostatics on the intestinal mucosa.

Symptoms of enterocolitis require certain treatment measures:

1. Constantly under the supervision of the attending physician.
2. Staying in a state of rest for two to three days after the onset of signs of the disease.
3. By using a gentle diet.

If abdominal pain of a spasmodic nature appears together with tenesmus – false urges to empty the bowels, accompanied by pain and a complete absence of feces, then the patient can be diagnosed with toxic rectitis.

Abdominal pain, namely in the right hypochondrium, may indicate damage to the liver and gallbladder. Severe and sharp pain in the lower abdomen after chemotherapy means the manifestation of cystitis, as well as inflammatory diseases of the genitals.

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Back pain after chemotherapy

Back pain after chemotherapy can be caused by various reasons:

• Kidney damage, which causes pain in the lower back.
• Damage to the adrenal glands, which manifests itself, among other things, in painful sensations in the area above the kidneys.
• Spinal cord lesions.
• The emergence of symptoms of polyneuropathy, which manifests itself in damage to the peripheral nervous system, expressed, among other things, in pain.

It should be noted that not all patients suffer from severe pain after chemotherapy. Most patients note only some complications that have arisen in the body and a deterioration in well-being. The appearance of pain after treatment directly depends on the drugs that were used for chemotherapy. The individual reaction of the patient to the prescribed drugs is also of great importance.

If pain occurs after chemotherapy, it is recommended to consult with the attending physician regarding its duration and the presence of negative consequences for the patient's health.

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Diagnosis of pain after chemotherapy

Diagnosis of pain after chemotherapy consists of determining its cause. Oncologists have enough methods for this: laboratory tests of blood and urine, X-ray, ultrasound, computed tomography. However, without consultations with specialists, it is impossible to accurately determine the pathology that arose after chemotherapy and makes itself known through pain syndrome.

Therefore, the diagnosis of pain after chemotherapy - depending on its localization - is carried out with the obligatory involvement of gastroenterologists, urologists, neurologists, proctologists, etc.

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Treatment of pain after chemotherapy

Treatment of pain after chemotherapy is symptomatic, i.e. with the help of painkillers. Which drugs should be taken in each specific case and in what doses, only the attending physician decides!

Non-steroidal anti-inflammatory drugs (NSAIDs) may be prescribed: Paracetamol, Diclofenac sodium (Dicloberl), Ibuprofen, Indomethacin, etc., for short-term use - Ketorolac. For headaches, it is enough to take a tablet of Paracetamolol (synonyms - Acetaminophen, Celiphen, Efferalgan, etc.). And for moderate to severe joint pain and muscle pain, Diclofenac sodium (in tablets of 25 g) works better. It is taken 1-2 tablets 2-3 times a day (before meals); the maximum daily dose is 6 tablets (150 mg), and the maximum duration of use is 6 weeks. Diclofenac is taken 0.5-1 tablet three times a day when it is necessary to relieve back pain or leg pain after chemotherapy.

To treat pain after chemotherapy caused by peripheral neuropathy, the antiepileptic drug in the form of capsules Gabapentin (Gabastadin, Gabalept, Neurontin and other generics) is used. In addition, the antidepressant Cymbalta (Duloxetine, Intriv) can be used, which - according to the instructions for the drug - is used for depression, fibromyalgia and painful diabetic neuralgia. This drug is taken once a day; the standard daily dose is 60 mg. Vitamins B1, B6, PP and glutamic acid preparations are also prescribed for neuropathic pain after chemotherapy.

It is difficult to name pharmaceutical drugs that would not have any side effects. And in the case of drugs that suppress the proliferation of cancer cells and tumor growth, drug complications are inevitable. One of them is pain after chemotherapy.