Can chemotherapy for cancer cause rheumatism?
• Postchemotherapy rheumatism: myalgias and migratory arthralgias can occur in some patients 1 to 3 months after therapy for carcinoma of breast, ovary, or non-Hodgkin’s lymphoma. This usually resolves within 1 year.
• Aromatase inhibitors (AIs): arthralgias and joint stiffness occurs in up to 50% of breast cancer patients treated with aromatase inhibitors. Symptoms tend to occur within 1 to 3 months of starting therapy and commonly affect hands, wrists, and knees. Magnetic resonance imaging may show intraarticular fluid and tenosynovitis in the hands. NSAIDs are of limited benefit. Changing to an alternate AI may reduce the symptoms. Patients unable to tolerate an AI may be able to tolerate tamoxifen as an alternative, which can cause fewer musculoskeletal symptoms.
• Bleomycin: may cause Raynaud’s and systemic sclerosis.
• Taxanes: can cause arthralgias, myalgias, and skin rash similar to subacute cutaneous lupus in breast cancer-treated patients.
• Interferon-α: can cause arthralgias, positive autoantibodies, systemic lupus erythematosus-like syndrome, and autoimmune thyroid disease.
• Gemcitabine: can cause systemic sclerosis-like illness with critical digital ischemia.
• Hydroxyurea: can cause a dermatomyositis-like rash.
