Finding relief from nerve damage associated with chemotherapy

Chemotherapy is known to cause a number of side effects that can affect a patient’s quality of life. Many of them, such as fatigue, nausea, and hair loss, are usually temporary. Peripheral neuropathy varies. Characterized by nerve damage that can affect patients’ ability to walk, balance, carry objects and perform other key functions, it is likely to become permanent, affecting not only patients’ quality of life but sometimes your ability to continue treatment.

Nerve damage can affect patients in a number of ways: triggering pain, numbness and tingling, reducing fine motor skills, and limiting movement, for example. Treating these symptoms the moment they reappear can help prevent them from worsening and compound patients’ physical and mental challenges, says Shima Kazmi, MD, a hematologist and oncologist at our Hospital of Philadelphia. However, some patients are reluctant to open up, fearing to “anger” others with their complaints, and suffer in silence.

Talk to your doctor

Dr. Kazemi says it’s important for clinicians to listen to patients about all of their symptoms, from difficulty picking up coins or a shirt button to limited reactions and sensitivity to cold or heat. Even seemingly minor changes, such as tingling in the fingertips, are worth mentioning and paying attention to, says Dr. Kazmi, because they may indicate more serious problems to come. It can also be an indication that the dose, timing or duration of chemotherapy may need adjusting. “Never feel like, ‘This is normal,’” Dr. Kazmi says. “Always talk about it.”

What the medical world calls chemotherapy-induced peripheral neuropathy (CIPN) occurs when weak nerves far from the brain and spine are damaged by drugs intended to attack cancer. Symptoms of CIPN may depend on the type of nerve affected. Most of the time, symptoms develop evenly on both sides of the body and usually affect the hands and feet. They can include stabbing and shooting pains, a tingling sensation, sensitivity to cold, or numbness, indicating damage to the sensory nerves. Less common feelings of weakness or imbalance can indicate motor nerve damage, while constipation or dizziness can indicate autonomic nerve damage. Symptoms of CIPN often come on slowly and can get worse over time. On the other hand, acute CIPN can develop suddenly and then disappear.

“If there is so numbness that I can no longer lift my cup of coffee, or numbness where I stumble, or lose my balance? We are getting to the NIPC with a moderate and severe degree,” says Dr. Kazmi. to become permanent and irrevocable.

Who is at risk?

The risk of developing peripheral neuropathy may be higher for patients who take stronger doses of chemotherapy for a longer period of time, are elderly, have diabetes, or use tobacco. Genetic and nutritional deficiencies can also play a role. The drugs most commonly associated with CIPN are those in the taxane family, such as paclitaxel, and platinum-based drugs, including cisplatin, oxaliplatin, and carboplatin, all of which are first-line chemotherapy drugs for breast, ovarian, and carcinomas. colon and rectum. Alkaloids such as vincristine, which is often used to treat lymphoma, have also been associated with peripheral neuropathy.

In addition to changing the way medications are given, a variety of supportive therapies can help prevent and manage severe NIPC. Treatments that can help with pain include supplements, other physical therapy treatments, pain relievers, antidepressants, acupuncture, massage, and meditation. Physical therapy can help cancer patients adapt to balance problems and other challenges that can result from sensory changes, says Caroline Lammersfield, MD, vice president of integrative medicine at the Cancer Treatment Centers of America (CTCA). “The most important message is that the moment you feel numb or tingly, speak up.”

Learn more about how comprehensive care can help cancer patients manage peripheral neuropathy.