Help from specialists for 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 – heart, liver, kidneys, lungs, urinary and genital organs. In this case, severe pain after chemotherapy may 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 naps, and sleep more at night. Do not overuse active movements and behavior. It is recommended to only do what requires necessary action.

Pain in the stomach and lower abdomen may also occur. This means that the gastrointestinal tract also experienced the effects of chemotherapy drugs. In some patients, bowel movements may be accompanied by severe pain and painful spasms. Severe pain and cramping are observed in patients when urinating.

Patients may experience pain or itching in the anus, which is accompanied by the appearance of hemorrhoidal bumps. This indicates that the patient’s immunity has dropped, and his body is exposed to various infections. To avoid worsening the condition, patients should use soft toilet paper. Severe sore throat and sore throat 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 recurrent headaches.

After chemotherapy, severe toothache and gum inflammation may occur. In this case, you need to consult a dentist, and also change your regular 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 with a neurologist, as well as additional treatment.

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 in order to achieve the desired therapeutic effect are administered in fairly large doses and, moreover, repeatedly. After their administration, the active substances enter the bloodstream, where they bind to blood plasma proteins and are distributed throughout the body, penetrating not only into the tissues of the malignant neoplasm, but also into almost all other tissues…

All cytostatic drugs – derivatives of bis-chlorethylamine, oxazaphosphorine, nitrosourea 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 systems.

Thus, platinum-containing compounds 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 pain in the stomach after chemotherapy. Paclitaxel is used in patients with cancer of the lungs, esophagus, and bladder, and this drug penetrates into the tissues of the intestines, liver, joints and muscles. Patients end up experiencing 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 cancers, causes pain in the liver after chemotherapy, pain in the bones after chemotherapy and pain in other localizations.

The long list of side effects of antineoplastic drugs of this pharmacological group includes peripheral neuropathic pain (peripheral neuropathy, polyneuropathy). These are quite severe pains 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 conduction 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 . It is with this effect that oncologists associate muscle pain after chemotherapy, as well as bone pain after chemotherapy (for example, in the lower jaw, in the shoulder blades, in the sternum).

How does pain manifest after chemotherapy?

Let’s try to find out how pain manifests itself after chemotherapy? The specific manifestation of pain after the use of cytostatic drugs depends on which organs are 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 body and the stage of the disease. However, headache after chemotherapy is a side effect of most cytostatics, independent of these factors.

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

If cytostatics have 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 intestines. Periodic cramping acute pain in the right hypochondrium 10-15 days after the administration of cytostatics is 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, in most cases is almost inevitable. This is the result of the hepatotoxic effects 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 overload and sends a pain signal.

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

Headache after chemotherapy

Some chemotherapy drugs affect certain areas of the brain, which results in 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 throbbing pain in the temple area.

You must inform your neurologist about the appearance of headaches, who will prescribe the appropriate treatment.

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

Joint pain after chemotherapy

Many patients, after a course of chemotherapy, experience pain in the joints – knees and so on. 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 joint pain 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 with painkillers, which are taken simultaneously with Cerucal. In any case, the prescription of medications must be carried out by the attending physician and independent treatment in this case is unacceptable.

The appearance of pain in the joints in 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 refer to long-term consequences after chemotherapy and occur one to two weeks after the end of the course of treatment. The condition of such patients needs to be corrected by lowering blood sugar levels, which always increases in diabetic patients after chemotherapy.

Prolonged joint pain after chemotherapy indicates, for example, over a six-month period, that degenerative changes have occurred in the cartilage 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 after chemotherapy report the appearance of pain in the legs of varying degrees of intensity.

Leg pain after chemotherapy can 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 hematopoietic function.
• Deterioration of the condition of veins and arteries after chemotherapy.

Bone pain after chemotherapy

After chemotherapy, some patients experience moderate to severe bone pain. This occurs due to the fact that drugs primarily affect the bone marrow, which performs hematopoietic functions. Bone marrow cells quickly divide and develop, and the effect of chemotherapy is aimed specifically at rapidly multiplying cells, which include malignant ones.

Bone marrow is located in the spongy bones and medullary cavities. At the same time, bone marrow is actively involved in the production of blood cells (red blood cells, white blood cells, etc.) and bone structure. Due to 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.

Abdominal pain after chemotherapy

The occurrence of abdominal pain, which is accompanied by painful cramps, is often a complication after chemotherapy. In addition to pain, after chemotherapy, frequent loose stools with mucus may appear, and in very rare cases, 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 compliance with certain treatment measures:

If spasmodic pain in the abdomen appears along with tenesmus – a false urge to empty the bowel, accompanied by pain and a complete absence of feces, then the patient can be diagnosed with toxic rectitis.

Pain in the abdomen, namely in the right hypochondrium, can signal 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 genital organs.

Back pain after chemotherapy

Back pain after chemotherapy can be caused by various reasons:

• Damage to the kidneys, 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 appearance 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 health. The appearance of pain after treatment directly depends on the drugs used for chemotherapy. The patient’s individual reaction to prescribed medications is also of great importance.

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

Diagnosis of pain after chemotherapy

Diagnosing pain after chemotherapy involves determining its cause. To do this, oncologists have enough methods at their disposal: laboratory tests of blood and urine, radiography, ultrasound examination, computed tomography. However, without consulting specialists, it is impossible to accurately determine the pathology that arose after chemotherapy and makes itself felt through pain.

Therefore, the diagnosis of pain after chemotherapy – depending on its location – is carried out with the mandatory involvement of gastroenterologists, urologists, neurologists, proctologists, etc.

Treatment of pain after chemotherapy

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

Non-steroidal anti-inflammatory drugs (NSAIDs) can be prescribed: Paracetamol, Diclofenac sodium (Dicloberl), Ibuprofen, Indomethacin, etc., for short-term use – Ketorolac. For headaches, it is enough to take a Paracetomolol tablet (synonyms: Acetaminophen, Celifen, Efferalgan, etc.). And for moderate and severe pain in joints and muscle pain, Diclofenac sodium (25 g tablets) works better. It is taken 1-2 tablets 2-3 times during the day (before meals); The maximum daily dose is 6 tablets (150 mg), and the maximum duration of use is 6 weeks. 0,5-1 tablet three times a day Diclofenac is taken when it is necessary to relieve back pain or pain in the legs after chemotherapy.

To treat pain after chemotherapy caused by peripheral neuropathy, the antiepileptic drug in the form of Gabapentin capsules (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 the painful form of diabetic neuralgia. This medicine is taken once a day; the standard daily dose is 60 mg. Also, for neuropathic pain after chemotherapy, vitamins B1, B6, PP and glutamic acid preparations are prescribed.

It is difficult to name pharmaceutical drugs that do not cause 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.