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Joint pains 

Patients commonly report aches in the joints following cancer therapies. Fortunately this is most often mild and usually wears off within a few weeks. This is a particular problem with some chemotherapy agents including the taxanes (taxol and taxotere). Hormone therapies, in the longer term are also associated with joints pains. About 12% of patients who have taken tamoxifen have joint pains but this increases to around 35% among patients with breast cancer taking the aromatase inhibitors drugs. Some biological agents can also contribute to joint pains such as herceptin.

How can you help?

Joints are often regarded as a barometer of our health. Excluding specific medical arthritic conditions, arthalgia or joint discomfort, it is often associated with changes in our general sense of well being. They are thought to be particularly sensitive to ingested toxins although the precise mechanism for this is unknown. One theory is that the dietary toxins get caught in the micro vessels of the joints. A good example of this is gout where excess uric acid, often caused by dietary excess gets trapped in the joint. 

Other dietary toxin also may cause irritation in the joint itself but in addition to the direct damage they cause, the body’s immune system can make it worse. Defence cells and proteins attach to the toxins forming large complexes which can then clot in the small joints, particularly those of the fingers and toes. The immune attack on the toxins, then further causes collateral damage to delicate joint tissues. A diet low in man made chemicals is therefore certainly well worth a try. Washing fruit and vegetables is a good step but many consider organic food if joint pains persist. Avoiding processed food or commercially packaged snack or sweets with reduce the intake of preservative, colourings and flavouring. Fizzy sugary drinks are also often packed with food additives and, although often difficult through lack of choice could be replaced by more health drinks such as purdy’s, fresh juices or if all else fails water!

Joints, by the nature of their mechanism, endure a great deal of wear and tear. Extra strain is put on them by excessive weight or bad posture. Being overweight is associated with arthralgia and later arthritis in the major weight bearing joints such as the hips, knees & back – needless to say if overweight, it would be a good idea to slim down.

Posture is a more complex issue. Most of us do not even know we are slouching until someone points it out or we see a video or photograph of ourselves. Bad posture particularly leads to neck, lower back and shoulder pains. Patients are either more vulnerable to a long standing bad posture after chemotherapy or with its associated fatigue can develop bad habits especially if there has also been some weight gain. Simply being aware of a deterioration on posture is a good start as most of us know what to do – the old adage is relevant – walk tall, chin in, shoulders back, stomach in. It may be worth a strong course of physiotherapy or osteopathy. If you have a good gym nearby a session with a personal trainer may well be money well spent.

Exercise may seem incongruous if joint pains have already set in, but particularly if combined with stretching is a fantastic way to help immediate pain and prevent further relapse. 

Try a simple experiment yourself - stretch an arm out horizontally in front of you with the palm of your hand facing the floor. Then move the hand upwards bending the wrist. Compare this with someone older then younger than yourself. The younger will  be able to move the wrists upwards with a much greater movement. In fact, most elderly people cannot move the wrist up at all. 

After chemotherapy or prolonged recovery from surgery the normal problems we all experience with aging seems to be exacerbated so extra effort needs to be made. Try to follow these simple instructions:

  • get the joints moving - unless there is extensive joint discomfort there is usually an exercise which is possible to get the ball rolling; walking dancing, swimming or even machines in the gym.

  • exercise with a friend - exercising with a friend or other members of a support group would be a good start. Most patients after treatments will often be told by their relative – I wish I could do more to help – well here is their opportunity

  •  join a walking group, gym or dance class together, squeeze on the training shoes and off you go 

  • stretch after exercise - stretching may be a little more difficult at the beginning, even if previously healthy there may be  a degree of re-training required either alone or in a group; it is well worth putting aside 10 minutes every day for stretching in a fairly regimented programme which ensures all the joints are stretched; start from the head down moving the joints into the fullest range possible without causing pain; develop a system which works but try to include the neck, shoulders back hips, knees, hands and feet. 

  • try yoga or pilates class - if time and local facilities allow consider joining a yoga or pilates class – you don’t have to be contortionist to participate; a good class should have levels for everyone.

  • find a personal trainer -  if you lack time or a suitable local class a personal trainer coming to the house for a few weeks will provide motivation, exercise and stretching guidance all in one! (a complete list of national personal trainers, gyms exercise, aerobic, dance, yoga and pilates classes can be found on in the exercise section. 

 

Resources and links

Cancernet-UK: What is cancerAbout specific cancers; Breast | Prostate | Bowel.  About cancer treatments; Chemotherapy | Radiotherapy | Hormones | Biological agents | Complementary.  Lifestyle advice; Exercise | Diet | Smoking | Sunbathing | Alcohol.  Cope with symptomsTraveling | Insurance  | Tests for cancer | Clinical trials. ...site map
Micro-nutrient testing Empower yourself to make dietary choices specific to your personal make up. This Cancer Risk Nutritional Profile, analyses your blood profile and recommends specific dietary and supplement advice to ensure you have the best possible nutritional status to fight cancer an aid recovery from treatments....read more
Download a free chapter describing how to avoid cancer forming chemicals (Carcinogens) in our diet and environments  from the new edition of the best selling evidence based book    "Lifestyle after Cancer - the facts"
Protect your lips during chemotherapy There is evidence that natural oil based creams are better than petroleum based creams. natureMedical lip balm has been specifically design to soothe and moisturise the lips during and after chemotherapy or after sun exposure. It only contains only natural waxes and essential oils selected for their anti-inflammatory and DNA stabilizing properties...read more/order
Protect your nails during chemotherapy. Nails can become painful and disfigured during and after chemotherapy. We describe the latest nail care guidelines and  number of useful tips to keep them healthy, including cooling and moisturizing ...read more 
Poems and cancer   Cancer is emotional and stressful time not only for the patients but friends and relatives. This emotional can inspire reflection, sentiment and creative writing and poetry. Hundreds of poems have been kindly submitted by users of cancernet. Caution: take a tissue some of these are real emotional bombshells!.. Read poems or...submit your own poem  
Lifestyle and cancer - the facts. This 2011, edition with a foreword from Paula Radcliffe has been extensively re-written with evidence from the latest research from around the world which demonstrates how diet, exercise and lifestyle changes can; help avoid cancer (read chapter 9 free), cope with treatments side effects; slow the rate of progression of cancer and help prevent  relapse.  This comprehensive essential lifestyle guidebook can be ordered online (£8.95), or downloaded via kindle
Prepared for cancer treatments. Patients and professionals, teamed up with Sue Lawley to produce this 21 minute film which explains chemotherapy & radiotherapy while you watch patients, describing their experiences, side effects and methods to alleviate them. Awarded the NHS communication prize ...  read more / order individually or in bulk for your oncology department 
Support groups and self help organisations throughout the UK and internationally. Links to Asian support organisations; Read patient stories, poems and links to the Cancer active website addressing a wide range of complementary issues related to cancer and their a quarterly magazine (ICON)..  submit a link to your group