Chemotherapy involves the use of drugs to treat cancer. The drugs target the rapidly-growing cancer cells to either slow their growth or destroy the cancer entirely.

Common side effects of chemotherapy are fatigue and lack of energy. A person is likely to experience these side effects the day of and the day after their chemotherapy appointment. The further along someone is with their treatment plan, the more severe the fatigue can be.

While pain is not a common side effect of chemotherapy, a person may experience pain during or after chemotherapy delivery.

This article will explore when pain may occur during and after chemotherapy. It will also explore what other side effects of chemotherapy may occur, how to cope and manage chemotherapy-related pain, and chemotherapy recovery.

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A person can receive chemotherapy in several different ways, including:

  • Oral: The chemotherapy drug is in the form of pills or liquids that the person swallows.
  • Intravenous (IV): A healthcare professional delivers the chemotherapy drug intravenously.
  • Injection: A healthcare professional administers the drug as a shot into a muscle, under the skin, in the space between tissues that cover the brain and spinal cord (intrathecal), in an area that contains organs (for example, intraperitoneal), or directly into an artery (intra-arterial).
  • Topical: A person applies the drug directly on the skin as a cream.

Routes such as topical and oral delivery tend to be painless. A person may experience pain at the injection site with IV and injection routes.

Some people may experience myalgia (muscle pain) in the injected muscle. Certain chemotherapy drugs may also cause leg cramps, which are painful contractions of the leg, foot, or ankle muscles.

Rarely, extravasation can occur. This is an accidental complication where the injected chemotherapy drug leaks out of a blood vessel and into the surrounding tissue.

This may happen as a result of a mistake made by the medical professional administering the drug, or because of the drug’s properties.

Chemotherapy extravasation can cause acute burning pain and swelling at the injection site.

Some people may experience pain after their chemotherapy appointment. Pain after receiving chemotherapy can occur in different ways.

Headache pain

Some chemotherapy drugs have the potential to cause a headache, such as drugs used to treat breast cancer. This can result in a throbbing, sharp, steady, or dull pain in the head.

Oral pain

Chemotherapy drugs target rapidly-growing cancer cells. But they also target the healthy, fast-growing cells of the body. These cells include hair follicles and cells that line the mouth and intestines.

This may result in pain or swelling in the mouth, known as oral mucositis. Sores and ulcers may develop in the mouth as well, which can be painful. A person may experience pain in their mouth when eating or drinking, as these sores may become irritated.

Abdominal pain

Because chemotherapy drugs can affect the lining of the intestines, some people may experience abdominal pain and cramps.

Peripheral neuropathy

Another type of pain that may occur with chemotherapy is chemotherapy-induced peripheral neuropathy (CIPN). This is a set of symptoms that can happen because of nerve damage. The affected nerves are the peripheral nerves, which are outside the brain and spinal cord.

This is a side effect of chemotherapy drugs. Symptoms that a person with CIPN may experience in their hands or feet include:

  • tingling
  • burning sensation
  • numbness
  • weakness
  • pain or ache
  • cramps in the feet
  • inability to feel hot or cold sensations

These chemotherapy-related pain symptoms may resolve after chemotherapy has ended. But side effects such as CIPN may last for weeks, months, or years after a person has completed treatment.

Bone or joint pain

Some chemotherapy drugs that doctors use to treat breast cancer can lead to pain in the bones or joints. This pain can range from mild discomfort that goes away without treatment to severe pain that requires medication to relieve it.

The chemotherapy drugs that can lead to bone or joint pain include:

  • albumin-bound or nab-paclitaxel
  • ixabepilone
  • methotrexate
  • docetaxel

Not every person receiving chemotherapy will experience side effects. The severity of the side effects will depend on the type of chemotherapy drug and cancer.

Some of the common side effects of chemotherapy include:

  • fatigue
  • hair loss
  • bruising and bleeding
  • infection
  • nausea
  • vomiting
  • constipation
  • diarrhea
  • difficulty swallowing
  • mood changes
  • changes in sexual function and libido
  • bladder and kidney changes
  • fertility problems
  • appetite loss
  • memory problems
  • problems with sleeping

Some chemotherapy drugs may cause long-term effects, or late effects, although many people do not have long-term problems after completing chemotherapy. These side effects can occur months or years after chemotherapy completion.

Examples of late effects include:

  • memory loss
  • problems concentrating
  • personality changes
  • problems with walking and movement
  • bone loss
  • changes in sexual function
  • sleep disturbance
  • blurred vision
  • light sensitivity
  • hearing loss
  • heart problems
  • weak joints
  • shortness of breath
  • dry cough

Click here to learn more about the side effects of chemotherapy.

If a person is experiencing pain while receiving chemotherapy treatment, they should speak with their cancer team and doctor.

The team may be able to prescribe different pain medications or investigate the cause of the pain. Once they have determined the potential cause, the medical team will be able to provide specific treatment recommendations to address it.

There are also things that the person experiencing the pain can do at home. The American Cancer Society recommends the following:

  • warm baths
  • gentle massages or pressure to decrease the pain
  • taking part in enjoyable activities to distract from the pain
  • doing relaxation exercises such as slow, rhythmic breathing
  • drinking plenty of fluids and eating a lot of fiber
  • keeping track of the pain levels
  • joining a support group

A person may also benefit from complementary and alternative therapies alongside conventional chemotherapy to aid their pain.

Examples of therapies that may help include:

People should always discuss complementary and alternative therapies with their medical team before starting them, even when their cancer center has these therapies available.

The length of chemotherapy treatment will depend on a variety of factors. These include:

  • the type of cancer and how advanced it is
  • the goal of chemotherapy
  • the type of chemotherapy

Many people receive chemotherapy treatment in cycles. This is where a person undergoes a period of chemotherapy treatment followed by a period of rest. For example, one cycle may include chemotherapy every day for 1 week followed by 3 weeks of no chemotherapy.

The rest period allows the body to recover and build healthy cells.

Learn more about how long chemotherapy lasts here.

It is common to experience some side effects even after completing chemotherapy. Some people may still experience these effects weeks, months, or even years after completing chemotherapy.

After chemotherapy, it may take some time for the immune system to recover. This is because chemotherapy weakens the immune system.

There are things a person can do to improve and maintain their recovery. These include:

  • doing activities that reduce stress such as meditation and yoga
  • taking part in moderate exercise such as walking, biking, and swimming
  • eating a moderate and balanced diet
  • avoiding or quitting smoking
  • wearing protective clothing and sunscreen when in the sun

Chemotherapy is a drug therapy option that targets cancer. It slows or stops the fast-growing cancer cells.

Chemotherapy may lead to pain during treatment sessions, such as when a healthcare professional uses a needle to administer the drugs. Some people may also experience pain after chemotherapy sessions.

It is common for people to experience some side effects after they have completed chemotherapy. Some of these side effects may be lifelong.