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Acute pain syndromes associated with chemotherapy and/or hormonal therapy

Acute pain syndromes associated with chemotherapy and/or hormonal therapy
Syndrome Description
Chemotherapy-induced headaches Common after treatment with intrathecal methotrexate for leukemia, lymphoma, or leptomeningeal carcinomatosis, all trans retinoic acid (ATRA) for leukemia
May be associated with vomiting, nuchal rigidity, fever, irritability, and lethargy
May last for several days or longer, and may or may not occur with repeated administration
Arthralgia and myalgia Pain in joints or muscles
Reported by 20 percent of patients treated with paclitaxel
Palmar-plantar erythrodysesthesia (hand-foot syndrome) Painful rash on the palms and soles following administration of specific chemotherapies (particularly liposomal doxorubicin and capecitabine)
Rash may progress to bullous formation and desquamation
Postchemotherapy acute limb ischemia (Raynaud's phenomenon) Reduced blood supply to the fingers and toes, described in survivors of testicular cancer, who were treated with bleomycin, vinblastine, and cisplatin
Fluoropyrimidine-induced angina Fluorouracil (FU) and capecitabine increase risk of cardiac ischemic episodes, presumably resulting from coronary vasospasm
Postchemotherapy gynecomastia Prevalent when receiving chemotherapy for testicular cancer
Painful and usually transitory
Steroid-induced perineal burning Perineal burning: has been described immediately (within 30 seconds) after intravenous steroid infusion
Diffuse bone pain Known to occur with all trans-retinoic acid (ATRA)
Flare syndrome in advanced prostate cancer, after initiation of LHRH agonist alone Characterized by increased bone pain, at times associated with added risk of cord compression, bladder outlet obstruction and hypercoagulability
Can result from treatment with LHRH (lutenising hormone releasing hormone) agonist therapy
Flare syndrome in advanced breast cancer Characterized by diffuse musculoskeletal pain, skin erythema, change in liver function studies and hypercalcemia
Can result from initial administration of tamoxifen or other estrogen receptor agonists
Interferon-associated myalgias Pain in joints, possibly accompanied by fever and severe fatigue, appearing shortly after initial diagnosis
Typically decreases in severity after repeated dosing
Pain_synd_chemo.htm
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