If you are receiving cancer treatment, you probably know some of the common side effects, such as fatigue from chemotherapy, skin irritation from radiation, and sexual side effects from hormones.
But you may not know much about the ways cancer treatments can affect your musculoskeletal system. Crystal Vendrell, a physical therapist at Banner MD Anderson Cancer Center, explained more about how cancer treatments can affect bones and joints. By knowing these potential side effects, you can take steps to manage them.
Loss of bone density
Chemotherapy, radiation treatments, and hormone therapy can make bones less dense and more brittle, leading to conditions called osteoporosis and osteopenia. With them, the risk of breaking a bone is greater.
You have a higher risk of bone loss if you are older, receiving cancer treatment for a longer period of time, and have lifestyle factors such as a sedentary lifestyle, smoking, excessive alcohol consumption, and poor nutrition.
“Chemotherapy and radiation treatments, especially long-term chemotherapies, can increase the risk of bone and muscle loss, which can impair strength, increase the risk of falls, and increase the risk of fractures,” Vendrell said.
To slow bone loss, your healthcare provider may recommend weight-bearing exercise, calcium and vitamin D in your diet and/or through supplements and medications such as bisphosphonates and other bone-strengthening medications.
You may need regular bone density scans and evaluations to look for early changes so you can make decisions about your treatment.
You can reduce your risk of fractures by eliminating tripping hazards, using assistive devices such as canes or walkers, practicing balance exercises, and avoiding high-impact activities that stress your bones.
Get immediate medical attention for any signs of a fracture, such as persistent pain in a specific area, swelling, bruising, deformity, or inability to bear weight or use the affected body part.
Joint pain.
Some different cancer treatments can cause joint pain. Radiation therapy and some medicines can cause inflammation in your joints. Some chemotherapy medicines cause joint pain (arthralgia). And when you don’t move much during cancer treatment, your joints may stiffen.
Over-the-counter or prescription pain relievers can help, and applying hot or cold compresses to the joints can also reduce pain.
Your joints may be more flexible and less stiff if you do some low-impact physical activity like swimming or yoga. Exercise can also reduce fatigue and improve your overall well-being.
Surgical side effects
Your cancer treatment may include surgeries such as removing the cancerous area (resection), reconstruction, moving tissue from one part of the body to another (flaps), prosthetic implants, amputation, spinal restoration (kyphoplasty), and others.
“Side effects of surgery can include decreased range of motion, decreased flexibility, muscle weakness, decreased balance, difficulty walking and difficulty with activities of daily living,” Vendrell said.
How to manage these side effects
“Many of the orthopedic side effects of cancer treatments cannot be prevented, but they can be controlled and treated. One of the best ways to help is to go to a physical therapist with experience in orthopedics and oncology,” Vendrell said. “They can perform a comprehensive evaluation and physical examination and develop a plan that includes mobility, strength and balance exercises, functional movements such as walking and transfers, and manual therapies to address side effects and impairments.”
Additionally, you may find it helpful to choose a well-balanced diet that includes:
- Calcium-rich foods such as dairy products, green leafy vegetables, and fortified foods.
- Vitamin D from fatty fish and fortified foods. You can also get vitamin D through sun exposure.
- Protein from lean meats, poultry, fish, beans and nuts.
Maintaining a healthy weight is important to reduce the risk of side effects. Excess weight can stress bones and joints and increase the risk of fractures.
It can be challenging to exercise during cancer treatment, but if you can, you can try:
- Low-impact activities such as walking, swimming, cycling, and tai chi, which are easy on the joints.
- Strength training exercises using body weight, resistance bands, or light weights to help strengthen muscles and stabilize joints.
- Stretching and range of motion exercises to help improve flexibility, reduce stiffness and increase mobility.
Stress management is important for your overall well-being. You may want to try mindfulness meditation, deep breathing exercises, progressive muscle relaxation, guided imagery, or yoga. It may also be helpful to engage in activities that bring you joy and help you relax, such as spending time with loved ones, pursuing hobbies, or enjoying nature.
Connection to orthopedic care
During and after cancer treatment, orthopedic healthcare providers can work with you to reduce pain, improve mobility, and make it easier for you to do the things you need to do. They may recommend medications, physical therapy, or surgical procedures.
Your orthopedic specialist can work closely with your oncologist to make sure you are getting the care you need for both the cancer and any side effects the treatments are causing in your bones or joints.
You can also work with other healthcare providers, such as pain management specialists, dietitians who can provide nutritional counseling, and behavioral health professionals who can support your mental health.
Be sure to share your concerns and questions about your bone and joint health with your healthcare team. They can provide guidance, offer treatment options, and connect you to resources.
You can also receive support and care from:
- Patient educational materials from your providers.
- Orthopedic rehabilitation centers that can provide physical therapy, occupational therapy, and pain treatment.
- Support groups and online communities where you can connect with others facing similar challenges, share experiences, and exchange tips and coping strategies.
The bottom line
If you are receiving cancer treatment, the side effects of chemotherapy, radiation, hormone treatments, or surgery could cause bone and joint problems. Your healthcare team can work with you to minimize and manage these problems.
If you would like to connect with an expert who can help evaluate and treat your orthopedic problems, contact Banner Health.