Neuropathy is a set of symptoms affecting the nervous system. Peripheral neuropathy affects your nerves, or those on the periphery of your body: Skin, fingers, toes, etc. Chemotherapy-induced peripheral neuropathy is when these symptoms are the result of chemotherapy.
Symptoms of Neuropathy
- Pain This may be constant, or it may come and go like a sharp, shooting/stabbing pain.
- Tingling, pins, and needles or electric shock type pain.
- Muscle cramps
- Muscle fatigue
- Burning sensation
- Lack of dexterity, trouble buttoning shirt etc.
- Problems with balance
- Sensitivity to cold/heat
- Trouble swallowing
- Blood Pressure changes
- Decrease in reflexes
Symptoms tend to start farthest away from your head (toes and feet) and move closer to your head over time. They are usually bilateral, affecting both sides of the body at the same time.
If Neuropathy Comes Knocking
If you notice symptoms of neuropathy (or any change in your health and well-being) tell your oncologist immediately. They need to know as soon as possible how your body is reacting to the treatment you are on. Then, your doctor can make any necessary changes in your treatment plan and address your concerns when side effects are more easily managed.
Also, see a neurologist to rule out any underlying neurological problems that might be causing your symptoms. If you haven’t had a recent brain MRI, talk to your doctor about getting one.
Consult an orthopedist. They can check your musculoskeletal structure for problems that could be affecting your feet and legs.
Chemotherapy and Neuropathy
Chemotherapy is used to kill cancer cells. It can also affect nerves that connect the spinal cord to the patient’s muscles, skin and internal organs.
Whether a patient develops chemotherapy-induced neuropathy depends on many factors, including the type of chemotherapy used, and at what doses it’s given. And, of course, the individual patient’s health also plays a part. It can begin at any time after treatment starts and often gets worse as treatment goes on.
Chemotherapy-induced neuropathy may go away after treatment is completed, or it may be a long-term or even permanent problem.
Preventing chemotherapy-induced neuropathy.
Before beginning any treatment plan, discuss the risks of chemotherapy-induced peripheral neuropathy and the ways you can work with your medical team to prevent it.
Is the potential neuropathy from any given treatment usually temporary or is it often permanent?
Find out what side effects to should watch for.
Ask your doctor what their preferred way of receiving messages is. Many doctors are moving to electronic charting. Some still prefer to get a phone call.
Your doctor might change the way he or she gives you your chemotherapy. He/she might:
- Reduce the dose of the chemotherapy
- Administer smaller doses more frequently
- Deliver chemotherapy as a slow, non-stop infusion over a longer period of time
Medical Treatments for Chemotherapy-Induced Neuropathy
- Steroids (short term)
- Low dose antidepressants
- Prescription pain medication (opioids)
Medical Marijuana (in states where it is legal) (1)
- Steroidal creams (short term)
- Lidocaine, which is a numbing cream or ointment
- Capsaicin, which is made from the capsaicin oils of hot peppers
- To help with fine motor coordination (Buttons and shoelaces etc.)
- To decrease the risk of falls
Research has proven that these, and other relaxation techniques, can greatly reduce pain levels in patients. (2)
For more information, read this article from the Foundation for Peripheral Neuropathy. (3)
Research has shown that Acupuncture improves nerve conduction in peripheral neuropathy. (5) Be sure to use a licensed acupuncture specialist. More and more chiropractors are learning acupuncture.
I have been receiving acupuncture at a pain clinic for the pain in my feet. I was skeptical of the practice until I experienced its benefits.
My doctor told me what led him to become licensed in acupuncture. His father in law is a veterinarian. One day he said, “Grant, I want to show you something.” He then proceeded to perform acupuncture on a dog who was suffering from arthritis in her hips. After the acupuncture session was over, the dog could walk with no problems. “There’s no placebo effect in animals,” he pointed out. Seeing was believing, and my doctor went back to school to learn an additional way of helping his patients.
Manual Lymph Drainage
Because manual lymph drainage is contraindicated in the presence of metastatic cancer, and its benefits have not been well established, I will not go into detail on this alternative treatment for neuropathy other than to say that the reason this is potentially harmful is because of the way the lymphatic system can be used to transport cancer cells around the body with metastasis. You certainly don’t want to help the process out. If you don’t have metastatic cancer and would like to investigate further, check with a reputable massage therapist.
Exercise to improve your circulation. Consider pool therapy or swimming if pain makes “regular” exercise or walking too painful. Check with your doctor to make sure that the pool is safe for you. Some people need to avoid chlorinated water because of its effects on their skin. There is also an increased risk of infection. Your doctor will be able to help you weigh the benefits and risks.
Some Additional Suggestions
Avoid alcohol, since it can cause and/or make nerve damage worse.
If you have neuropathy in your fingers, be careful when handling sharp objects. Wear protective gloves while gardening or doing other chores which could damage your hands.
Likewise, if you have neuropathy in your feet, avoid walking barefoot or in open-toed shoes. If the neuropathy in your feet affects your balance, or you stumble on occasion because of it, use supportive aids(handrails, cane, walker). Have grab bars installed in your bathroom.
Avoid extreme temperatures. Check the temperature that your hot water heater is set on so that you don’t scald yourself accidentally.
Eat a high fiber diet if constipation is a problem. Not only can neuropathy affect your bowel habits, but so can the medications you take to manage pain.
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In 2012 doctors diagnosed my husband, Dan, with stage IV lung cancer. Since then, our family has been learning what it means to face cancer. I’ve focused my writing and speaking on helping cancer patients and their families advocate for themselves and live life to the fullest, in spite of their illness. My goal is to help people face cancer with grace.
My book Facing Cancer as a Friend: How to Support Someone Who Has Cancer, is available on Amazon.com
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- The Neuropathy Journal, Treating Neuropathic Pain with Medical Marijuana. Morrow, David
- Western Journal of Medicine. 2001 Oct; 175(4): 269–272. Pub Med.gov
- The Foundation for Peripheral Neuropathy. https://www.foundationforpn.org/living-well/integrative-therapies/mind-and-body/
- Acupuncture treatment improves nerve conduction in peripheral neuropathy. Eur J Neurol. 2007 Mar;14(3):276-81. Pub Med.gov