Side Effect: Arthritis

• Arthritis is a condition in which one or more joints become inflamed. This can cause pain, stiffness, and decreased range of motion in joints of the hands (including fingers and wrists), ankles, elbows, knees, among others.
• Arthritis can affect people of all ages, genders, and ethnicities, and can occur in any joint in the body.

The symptoms of arthritis can vary depending upon the type and severity of the disease.

Common symptoms in the affected joint include:

• pain
• stiffness
• swelling
• warmth

In more severe cases, arthritis can lead to joint deformities and disability.

While arthritis is not directly caused by cancer, patients with cancer may be at higher risk for developing joint pain. Cancer that occurs near or in a joint, such as cancer that has spread to the bones, can lead to this type of pain and cause inflammation that mimics arthritis.

• Leukemia can also cause arthritis in cases where the cancer cells have gathered in the joints.
• Chemotherapy and radiation therapy can weaken the immune system and increase the risk of infections that can lead to reactive arthritis.

Additionally, patients being treated for cancer may be more likely to experience joint pain and stiffness as a side effect of certain medications. Types of cancer treatments that are known to cause joint pain include:

• Paclitaxel and Docetaxel
• Bleomycin
• Cladribine
• Anastrozole, exemestane, and letrozole
• Filgrastim, pegfilgrastim, and sargramostim (supportive care medications)
• Fulvestrant, tamoxifen
• Ado-trastuzumab
• Olaparib
• Medications used to treat bone loss such as bisphosphonates and denosumab

Preventing arthritis during cancer treatment involves managing the underlying cancer, minimizing the risk of infection or other complications that can lead to joint inflammation, and recognizing when medicatinos may be contributing to arthritis.

Because it can be difficult to identify the cause or causes of arthritis, it is often helpful to keep a journal of your symptoms to show to your doctor, and include things such as:

• time of onset
• intensity of pain
• location
• what makes it worse
• what makes it better

• Whenever possible your physician will try to treat the underlying condition that is causing the joint pain.
• Mild pain can sometimes be relieved with stretching, hot or cold compresses, massage, or sometimes acupuncture.
• In cases where the pain persists, working with a physical therapist is often helpful for improving joint function and reducing pain.
• Your physician might also recommend pain relievers, steroids, anticonvulsants designed to help with nerve pain, or antibiotics if the joint is infected.