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How Cancer Treatment Can Affect Your Bones and Joints

If you’re being treated for cancer, you probably know about some of the common side effects, like fatigue from chemotherapy, skin irritation from radiation and sexual side effects from hormones. 

But you may not know as much about the ways cancer treatments can affect your musculoskeletal system. Crystal Vendrell, a physical therapist with Banner MD Anderson Cancer Center, explained more about how cancer treatments can impact your bones and joints. By knowing about these possible side effects, you can take steps to manage them.

Bone density loss

Chemotherapy, radiation treatments and hormonal therapy can make your bones less dense and more fragile, leading to conditions called osteoporosis and osteopenia. With them, your risk of fracturing a bone is higher.

You’re at higher risk of bone loss if you’re older, have treatment for cancer for a longer time and have lifestyle factors such as a sedentary lifestyle, smoking, excessive alcohol consumption and poor nutrition. 

“Chemotherapy treatments and radiation treatments, especially long-term chemotherapies, can increase the risk of bone and muscle loss, which can impact strength, increase fall risk and increase fracture risk,” Vendrell said.

To slow bone loss, your health care 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 medicines.

You may need regular bone density scans and assessments to look for changes early so you can make decisions about your treatment.

You can reduce your risk of fractures by removing tripping hazards, using assistive devices like canes or walkers, practicing balancing 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 an inability to bear weight or use the affected body part. 

Joint pain and stiffness 

A few different cancer treatments can cause joint pain and stiffness. Radiation therapy and some medications can cause inflammation in your joints. Some chemotherapy drugs cause joint pain (arthralgia). And when you’re not moving around much during cancer treatment, your joints can get stiff.

Over-the-counter (OTC) or prescription pain medications may help, and applying hot or cold packs to your joints may also reduce pain.

Your joints may be more flexible and less stiff if you get 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, spine restoration (kyphoplasty) and others.

“Surgical side effects can result in decreased range of movement, 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 from cancer treatments cannot be prevented but they can be managed and treated. One of the best ways to help is to see a physical therapist with experience in orthopedics and oncology,” Vendrell said. “They can do a comprehensive evaluation and physical exam and come up with a plan that includes exercises for mobility, strength and balance, functional movements such as walking and transfers and manual therapies to address the side effects and impairments.” 

In addition, you may find it helpful to choose a well-balanced diet with:

  • Calcium-rich foods such as dairy products, leafy greens and fortified foods. 
  • Vitamin D from fatty fish and fortified foods. You can also get vitamin D from sunlight exposure.
  • Protein from lean meats, poultry, fish, beans and nuts.

Maintaining a healthy weight is important for lowering your risk of side effects. Excess weight can stress your bones and joints and increase your fracture risk. 

It can be a challenge to exercise during cancer treatment, but if you are able you may want to try:

  • Low-impact activities like walking, swimming, cycling and tai chi, which are gentle on the joints. 
  • Strength-training exercises using your body weight, resistance bands or light weights to help make your muscles stronger and your joints more stable.
  • 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 can also help to take part in activities that bring you joy and help you relax, such as spending time with loved ones, pursuing hobbies or enjoying nature. 

Connecting with orthopedic care

During and after cancer treatment, orthopedic health care providers can work with you to reduce pain, improve mobility and make it easier 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’re getting the care you need for both the cancer and any side effects treatments are causing in your bones or joints. 

You may also work with other health care 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 health care team. They can provide guidance, offer treatment options and connect you with resources.

You might also get support and care from:

  • Patient education materials from your providers.
  • Orthopedic rehab centers that can provide physical therapy, occupational therapy and pain management. 
  • 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’re being treated for cancer, side effects from chemotherapy, radiation, hormonal treatments or surgery could cause problems with your bones and joints. Your health care team can work with you to minimize and manage these issues.

If you would like to connect with an expert who can help evaluate and treat your orthopedic issues, reach out to Banner Health.

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