Victor Forge
Blood cancer is a general term for cancers that affect the blood, bone marrow, and lymphatic system. Blood cancers such as leukaemia, lymphoma, and myeloma can present with various symptoms, including muscle pain and weakness. This pain can be caused by the cancer itself, its treatment, or both. Chemotherapy and radiation therapy can cause muscle aches, while cancer cells building up in the bone marrow can form a mass that presses on nerves or joints, causing pain. Bone and muscle function are closely interrelated, and cancer can alter this physiology, leading to muscle dysfunction and weakness. Cancer-induced muscle wasting (CIMW) is a significant clinical problem in advanced-stage cancer, often associated with bone pain, fractures, and nerve compression. While blood cancer symptoms vary depending on the specific type, muscle pain and weakness can be indicators of the disease and its treatment side effects.
| Characteristics | Values |
|---|---|
| Muscle pain caused by blood cancer | Yes, blood cancer can cause muscle pain, either directly or as a side effect of treatment |
| Muscle pain caused by blood cancer treatment | Yes, chemotherapy and radiation therapy can cause muscle pain |
| Muscle weakness caused by blood cancer | Yes, blood cancer can cause muscle weakness, especially in advanced stages |
| Muscle wasting caused by blood cancer | Yes, blood cancer can lead to muscle wasting, also known as cachexia |
| Muscle pain identification | Muscle pain caused by leukemia tends to come and go, flaring after physical activity, while bone pain lingers during rest |
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What You'll Learn
Lung cancer and muscle weakness
Muscle weakness is a symptom of lung cancer, often affecting the muscles in the upper body. It can range from moderate to severe and may be one of the first symptoms of lung cancer. Lung cancer patients often experience breathing difficulties due to the location of cancer tumors, which can cause a lack of oxygen supply to the muscles, resulting in fatigue and weakness. Tumors can also cause muscle inflammation, known as myositis, leading to weakness, swelling, and pain.
There are various reasons why lung cancer patients experience muscle weakness, including the spread of cancer, age, and health conditions such as diabetes. Tumors spreading to the bones can cause sudden weakness in the legs. Large-cell carcinoma, non-small cell lung cancer, or mesothelioma patients may find it challenging to prevent muscle weakness. Additionally, cancer treatments themselves, such as chemotherapy, can induce oxidative stress, leading to muscle weakness.
Lambert-Eaton syndrome is a rare autoimmune disease associated with small-cell lung cancer. It damages nerve endings, reducing acetylcholine release and weakening the signal to muscle cells, resulting in muscle weakness. This condition affects both voluntary and involuntary muscles, often starting in the upper legs, hips, arms, and shoulders. Patients may experience heavy feelings in their arms and legs, making walking, climbing stairs, or lifting their arms difficult.
While there is no cure for Lambert-Eaton syndrome, treatments like chemotherapy, surgery, radiation, and other therapies can help manage the symptoms. Amifampridine (Firdapse) is a medication approved to treat muscle weakness from this syndrome. It works by increasing acetylcholine release, strengthening nerve signals to the muscles. Proper nutrition and targeted exercises can also help treat muscle weakness in lung cancer patients.
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Blood cancer and muscle aches
Blood cancer symptoms vary depending on the type of blood cancer, such as leukaemia/leukemia, lymphoma, myeloma, myelodysplastic neoplasms (MDS), and myeloproliferative neoplasms (MPN). Blood cancer symptoms can be vague and easy to overlook, but it’s important to pay attention to changes in your body. Some of the most common signs include unexplained weight loss, fatigue, frequent infections, easy bruising or bleeding, night sweats, shortness of breath, and unusual lumps or swellings.
Muscle aches and pains are common in people with blood cancer, and can be caused by the cancer itself, its treatment, or both. Chemotherapy can cause painful mouth sores, headaches, muscle aches and stomach pains. Chemotherapy and, less commonly, radiation therapy can also cause nerve damage, leading to "peripheral neuropathy" (PN), which is often described as a "burning" or "tingling" sensation.
Leukaemia-related anemia can also cause muscle aches and joint pain, as it reduces the oxygen supply to tissues throughout the body. Bone pain is another common symptom of leukaemia, and can be distinguished from muscle pain as it tends to linger during rest, while muscle pain usually comes and goes, flaring after physical activity.
Cancer-induced muscle wasting (CIMW) is a major clinical problem in advanced-stage cancer, and is usually associated with bone pain, fractures, hypercalcemia and nerve compression. Bone and muscle function are interdependent physiologically, and cancer can alter this relationship. Cancer-associated muscle dysfunction is a deadly clinical problem with high mortality (80%) and increased treatment toxicity.
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Cancer-induced muscle wasting
Cachexia is not unique to cancer and is also observed in other advanced illnesses like heart disease, HIV, and kidney disease. It is characterised by a complex interplay of biological changes, including disruptions in metabolism, which cause the body to waste away. The immune system's release of certain chemicals, such as cytokines, into the blood contributes to inflammation and the breakdown of muscle and fat cells, resulting in severe weight loss.
Research has identified a "cross-talk" between tumour cells and cells in fat, muscle, the brain, and other body parts. Cytokines, such as Interleukin-6, play a central role in the cycle of tumour growth and cachexia. Additionally, bone-derived proteins like RANKL and lipocalin 2 may contribute to muscle loss in ovarian and pancreatic cancers, respectively. Mitochondrial dysfunction and nerve deterioration supporting skeletal muscles are also implicated in the process.
The treatment for cachexia aims to preserve muscle mass and improve strength. Carnitine supplementation has shown promise in experimental and clinical trials, either alone or in combination with other drugs. Exercise, particularly resistance training, can induce muscle hypertrophy and improve insulin sensitivity. However, exercise programs must consider factors like chronic fatigue and cardiac dysfunction that may accompany cancer. Nutritional interventions are also crucial, as adequate nutrition can enhance the benefits of exercise.
While progress has been made in understanding and treating cancer-induced muscle wasting, further research is needed to clarify the underlying mechanisms and develop more effective therapies.
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Cancer treatment and muscle weakness
Muscle weakness is a symptom of many types of cancer, including lung cancer and blood cancer. It is a debilitating consequence of malignancies and has a negative impact on patient wellbeing and treatment outcomes. The muscle weakness can occur with or without muscle atrophy or cachexia (severe wasting due to loss of skeletal muscle mass caused by abnormal metabolism).
Cancer-associated muscle weakness is a major paraneoplastic syndrome with a high mortality rate of 80%. It is often caused by bone metastases, which disrupt normal bone remodelling and result in morbidity that includes muscle weakness. Tumours in the bone stimulate excessive osteoclast activity, causing a release of growth factors that fuel tumour growth and bone destruction. This results in skeletal muscle weakness due to reduced muscle mass and function.
Cancer treatments, such as chemotherapy, can also cause muscle weakness. Chemotherapeutic drugs have been shown to promote skeletal muscle wasting and weakness, and there are currently no approved treatments for this side effect. The lack of approved treatments highlights the need for novel interventions and a better understanding of the underlying causes.
The interrelated bone and muscle physiology is altered in cancer patients. Bone releases growth factors during remodelling that affect muscle function. Tumour metastasis to the bone disrupts the interaction between osteoclasts and osteoblasts, releasing pro-inflammatory cytokines that accelerate muscle degradation and apoptosis. This can lead to a spectrum of clinical manifestations, ranging from muscle weakness and fatigue to cachexia, accompanied by bone pain, fractures, and neuropathy.
Managing muscle weakness in cancer patients can be challenging. While diet and exercise alone are not sufficient to prevent weakness, they can help manage the condition. Anti-inflammatory foods, such as salmon, tuna, olive oil, avocado, and berries, are associated with reduced inflammation and pain. Light exercise, several times a week, can assist in reducing muscle weakness, and physical therapy can improve strength and mobility while reducing pain. However, each patient is different, and cancer patients should consult their doctors before starting any rigorous exercises.
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Bone metastases and muscle weakness
Bone metastases occur when cancer cells break away and spread to a bone. Nearly all types of cancer can spread to the bones, but some cancers are more likely to spread to bone, including breast cancer, kidney cancer, lung cancer, multiple myeloma, prostate cancer, and thyroid cancer. Bone metastases can cause bones to break more easily, and may cause pain and stiffness in the neck or back from pressure on the spinal cord.
Bone metastases can also cause muscle weakness. Tumors in the bone stimulate excessive osteoclast activity, which causes the release of growth factors stored in the mineralized bone matrix. These factors fuel a vicious cycle of tumor growth and bone destruction. Evidence indicates that these bone-derived growth factors can act systemically to cause muscle weakness. Muscle weakness can be caused by reduced muscle mass or reduced muscle function; in advanced disease, it is likely due to a combination of both reduced quantity and quality of muscle.
In addition, calcium from the bones can be released into the bloodstream, causing high levels of calcium in the blood, or hypercalcemia. This can lead to muscle weakness, as normal muscle contraction is dependent on precise calcium signaling in the muscle cell. Hypercalcemia can also cause nausea, vomiting, constipation, confusion, and fatigue.
Recent research indicates that cachexia, a common paraneoplastic syndrome characterized by severe wasting due to loss of skeletal muscle mass, is far more common among cancer patients than previously suspected. Cachexia can persist even after the cancer is successfully treated and cured, and can have a devastating impact on the quality of life for cancer survivors. Tumors can destroy the blood vessels of muscles even when the muscles are nowhere close to the tumor, and fixing blood vessels in cancer patients and survivors could be a way to prevent or reverse cachexia.
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Frequently asked questions
Blood cancer symptoms vary depending on the type of blood cancer, but some of the most common signs include unexplained weight loss, fatigue, frequent infections, easy bruising or bleeding, night sweats, shortness of breath, and unusual lumps or swellings.
Muscle weakness is a common symptom of cancer, especially in advanced stages. This is due to a combination of reduced muscle mass and function. Blood cancer treatments such as chemotherapy and radiation therapy can also cause muscle aches.
There are pharmacologic therapies currently in pre-clinical and clinical testing that appear promising as adjuncts to current therapies for cancer-induced muscle wasting (CIMW). Such therapies include resiniferitoxin and selective androgen receptor modulators.
