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 internal organs - the heart, liver, kidneys, lungs, urinary and genital organs. In this case, severe pain after chemotherapy can disturb the patient for several months.

Strong pain in the heart requires a lot of attention. First of all, it is necessary to inform about these symptoms of the attending physician, as well as take precautions. It is necessary to rest more often during the day, including daytime sleep, and at night to sleep more. Do not abuse the active movements and behavior. It is recommended to do only what requires the necessary action.

There may also be pain in the stomach and in the lower abdomen. This means that the gastrointestinal tract has also experienced the effects of chemotherapy drugs. Emptying of the intestine in some patients can be accompanied by strong pain and painful spasms. Strong pain and rezi are observed in patients and with urination.

Patients may experience pain or itching in the anus, which are accompanied by the appearance of hemorrhoids. This indicates that the patient's immunity has fallen, and his body is exposed to various infections. To avoid deterioration, patients need to use soft toilet paper. Severe sore throat and perspiration 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 limbs - arms and legs, as well as in the back. Some patients experience recurring headaches.

After chemotherapy, severe toothache and gingival inflammation can occur. In this case, you need to consult a dentist, and change the usual toothbrush to a brush with soft bristles.

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

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Causes of pain after chemotherapy

Actually, the key causes of pain after chemotherapy were just named. And this - the results of the action of medications, which, in order to achieve the desired therapeutic effect, are administered in sufficiently large doses and, moreover, repeatedly. After their introduction, the active substances enter the bloodstream, where they bind to blood plasma proteins and spread throughout the body, penetrating not only the tissues of the malignant neoplasm, but also virtually all other ...

All cytostatic drugs - derivatives of bis-β-chloroethylamine, oxazaphosphorin, nitrosoureas or platinum compounds - can damage the mucous membrane of the gastrointestinal tract, disrupt the normal functioning of the liver, kidneys, spleen, pancreas, heart, bladder, spinal cord and brain, reproductive organs, hematopoietic and autonomic nervous system.

So, containing platinum compounds Cisplatin, Oxaliplatin, Methotrexate, Platinex, etc. Behave like strong nephrotoxins, causing impaired functions and pain in the kidneys after chemotherapy.

Used for breast cancer Methotrexate rarely causes vomiting, but often affects all mucous membranes at the same time, which leads to inflammation of the gastrointestinal mucosa and stomach pain after chemotherapy. Paclitaxel is used in patients with oncological diseases of the lungs, esophagus, and bladder, and this drug penetrates the tissues of the intestine, liver, joints and muscles. As a result, patients experience joint pain after chemotherapy, as well as severe muscle pain after chemotherapy.

A drug Vincristine, which is struggling with leukemia, non-Hodgkin's lymphoma, sarcoma of bones and many other cancers, causes pain in the liver after chemotherapy, bone pain after chemotherapy and pain of other localization.

In long lists of side effects of antineoplastic drugs of this pharmacological group, peripheral neuropathic pains (peripheral neuropathy, polyneuropathy) appear. These are quite strong pains after chemotherapy, the appearance of which is caused by the neurotoxic effect of cytostatics. This action consists in damage to the cytoskeleton of painful (nociceptive) neurons of the peripheral nervous system and disturbance of the conductivity of pain signals from the peripheral pain receptors (nociceptors), which are not only in the skin and subcutaneous tissue, but also in the periosteum, joints, muscles and in all internal organs . It is with this action that oncologists associate muscle pains after chemotherapy, as well as pain in the bones after chemotherapy (for example, in the lower jaw, in the shoulder blades, in the sternum).

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How does pain appear after chemotherapy?

Let's try to find out, how does the pain appear after chemotherapy? The specific manifestation of the pain syndrome after the use of cytotoxic drugs depends on which organs have become the target of their side effects. And also on the dosage, the number of courses of treatment and, of course, on the individual characteristics of the organism and the stage of the disease. However, headache after chemotherapy is a side effect of most cytotoxic drugs, not dependent on the listed factors.

The defeat of the cells of the mucosa of the upper respiratory tract is most often manifested by painful sensations in the throat. From the usual pain, say, with acute tonsillitis (angina), the pain in the throat after chemotherapy is practically the same. But it should be borne in mind that after chemotherapy, leukopenia develops, that is, the number of leukocytes in the blood, which primarily protects B-lymphocytes, is sharply reduced. 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 the cytostatics reached the gastrointestinal tract and liver, then there may be pain in the stomach 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 indicates the development of toxic enterocolitis or colitis - inflammation of the small and large intestine. Periodic cramping acute pain in the right hypochondrium after 10-15 days after the administration of cytostatics is a symptom of cholecystopathy (inflammation of the gallbladder and bile ducts). And when against a background of diarrhea or constipation of pain after chemotherapy are felt not only in the abdominal region, but also in the perineum (in particular, during the emptying of the intestine), then toxic proctitis (inflammation of the rectum) is diagnosed without error.

The feeling of heaviness on the right under the ribs and pain in the liver after chemotherapy, as oncologists note, are almost inevitable in most cases. This is the result of hepatotoxic effects of cytotoxic drugs, since their biochemical decomposition with the formation of metabolites occurs precisely in this organ - by the efforts of the hepatic enzyme system of cytochrome P-450. And a lot of metabolites are active and continue to affect the liver cells. In such extreme conditions, the liver does not withstand overloads and provides a pain signal.

Manifestations of peripheral neuropathy can be limited to paresthesia (numbness and tingling) of the fingers, and can cause pain in the legs after chemotherapy, aching pain in the hands after chemotherapy, debilitating back pain after chemotherapy, as well as bone pain and muscle pain after chemotherapy.

Headache after chemotherapy

Some chemopreparations affect certain areas of the brain, which is manifested in the occurrence of headaches. Pain after chemotherapy is of varying intensity - from mild to moderate to severe and exhausting. Headaches usually occur periodically, and only a small number of patients can be permanent. Also, patients may experience pulsatile pain in the temples.

The appearance of headaches should be reported to a neurologist who will prescribe the appropriate treatment.

Headache is also one of the symptoms of an infectious disease that begins. Decreased immunity of the patient after chemotherapy is beneficial for the spread of pathogenic microorganisms and the emergence of foci of infection.

Joint pain after chemotherapy

Very many patients after a course of chemotherapy face the pain in the joints - knees and so on. Painful sensations can be accompanied by the appearance of swelling.

The emergence of pain is associated with a general intoxication of the body, which is several degrees - from zero to five. The presence of pain in the joints characterizes the first or second degree of damage to the body and are the closest complications after chemotherapy.

Symptoms of joint pain after chemotherapy are removed with anesthetic drugs, which are taken simultaneously with Cerucal. In any case, prescribing medicines should be performed by the attending physician and independent treatment in this case is unacceptable.

The appearance of pain in joints in patients with diabetes mellitus may indicate an exacerbation of arthrosis, which is a complication of diabetes. The occurrence or exacerbation of arthrosis, usually, is provoked by chemotherapy drugs, which thus affect the condition of patients with metabolic disorders. These manifestations relate to distant consequences after chemotherapy and occur one to two weeks after the end of the course of treatment. Correct the status of such patients need a decrease in blood sugar, which is always increased in diabetic patients after chemotherapy.

Long-term pain in joints after chemotherapy suggests, for example, during the semiannual period, indicate that there have been degenerative changes in the cartilaginous tissue of the joints. In such cases it is necessary to perform an X-ray examination or ultrasound of joints to confirm or disprove this assumption and prescribe appropriate treatment.

A low level of hemoglobin 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.

Pain in the legs after chemotherapy

Some patients after chemotherapy note the occurrence of pain in the legs of varying degrees of intensity.

Pain in the legs after chemotherapy can be caused by the following reasons:

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

Bone pain after chemotherapy

After chemotherapy, some patients experience pain in the bones of medium or strong intensity. This is due to the fact that drugs primarily affect the bone marrow, which carries out the functions of hematopoiesis. Cells of the bone marrow quickly divide and develop, and the action of chemotherapy is directed, precisely, to rapidly multiplying cells, which include malignant ones.

The bone marrow is located in the spongy substance of the bones and bone marrow cavities. At the same time, the bone marrow actively participates in the production of blood cells (erythrocytes, leukocytes, etc.) and the structure of the bone. Due to damage to the bone marrow, it accumulates toxins and dead cells, 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 it, was told in the sections on the increase of hemoglobin, erythrocytes and leukocytes.

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Abdominal pain after chemotherapy

The occurrence of abdominal pains, which are accompanied by painful spasms, is often a complication after chemotherapy. In addition to pain after chemotherapy, a frequent loose stool with mucus impurities may appear, 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. Permanent control under the supervision of the attending physician.
2. Stay at rest for two to three days after the appearance of signs of the disease.
3. The use of a gentle diet.

If pains of a spasmodic nature in the abdomen appear along with tenesmus - false calls for bowel movement, accompanied by soreness and total absence of fecal masses, the patient can be diagnosed with a toxic rectum.

Pain in the abdomen, namely in the right hypochondrium, can signal the lesion of the liver and gallbladder. Strong and sharp pains in the lower abdomen after chemotherapy mean the manifestation of cystitis, as well as inflammatory diseases of the genital organs.

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Back pain after chemotherapy

Back pain after chemotherapy can be caused by different reasons:

• Defeat the kidneys, which causes pain in the lower back.
• Defeat of the adrenal glands, which is manifested, including, in painful sensations in the zone above the kidneys.
• Lesions of the spinal cord.
• The emergence of symptoms of polyneuropathy, which manifests itself in the defeat of the peripheral nervous system, expressed, in particular, in pain sensations.

It should be noted that not all patients after chemotherapy suffer from the appearance of severe pain. Most patients note only some complications that have arisen in the body, and a deterioration of 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 prescribed medications is of great importance.

In case of pain after chemotherapy, it is recommended to consult with the doctor in charge, regarding their duration and the negative consequences for the patient's health.

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Diagnosis of pain after chemotherapy

Diagnosis of pain after chemotherapy is to determine its cause. To do this, oncologists have enough methods: laboratory tests of blood and urine, radiography, ultrasound examination, computed tomography. However, without consultations of narrow specialists, it is impossible to accurately determine the pathology that emerged after chemotherapy and makes itself felt by the pain syndrome.

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

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Treatment of pain after chemotherapy

Treatment of pain after chemotherapy is symptomatic, that is, with the help of pain medication. What medications should be taken in each specific case and in what doses, the treating doctor decides only!

Non-steroidal anti-inflammatory drugs (NSAIDs) may be prescribed: Paracetamol, Diclofenac sodium (Dicloberb), Ibuprofen, Indomethacin, etc., for short-term use - Ketorolac. With a headache, it is enough to take a tablet of Paracetemolol (synonyms - Acetaminophen, Celiphen, Efferalgan, etc.). And with moderate and severe pain in the joints and muscle pain, Diclofenac sodium (in tablets of 25 g) acts 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. On a 0.5-1 tablet three times a day, diclofenac is taken when it is necessary to relieve back pain or leg pain after chemotherapy.

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

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