Chemotherapy-Induced Peripheral Neuropathy

This video is an overview of the causes, symptoms, risk factors as well as some of the things patients can do to reduce the risk of peripheral neuropathy.

Read the full video transcript below:

Chemotherapy can cause a condition called peripheral neuropathy. 

This video is an overview of neuropathy symptoms, management, and things you can do to reduce the risk.

The human nervous system is split into the central nervous system, which consists of the brain and spinal cord, and peripheral nerves, which leave the spinal cord and go out to innervate distant parts of the body like the hands and feet. Chemotherapy-induced peripheral neuropathy mostly affects the most distant parts of the peripheral nerves in the hands and feet. 

Not all chemotherapy agents cause peripheral neuropathy; the most common agents associated with peripheral neuropathy include taxane drugs like docetaxel, platinums, vincristine, bortezomib, and other drugs.

Treatment-related risk factors of developing peripheral neuropathy include higher doses of chemotherapy, longer courses of treatment, and multi-drug combinations. 

Patient-specific risk factors for developing neuropathy include older age, a history of diabetes, certain vitamin deficiencies, as well as a history of neuropathy.

The good news for patients is there are some things you can do to reduce your risk of peripheral neuropathy from chemotherapy. Regular exercise and maintaining a balanced diet are probably two of the most important things you can do. Managing chronic diseases like diabetes will also reduce the risk of developing neuropathy, as well as limiting alcohol intake and treating any vitamin deficiencies.

Unfortunately, there is currently no known medication or supplement that can completely prevent the development of peripheral neuropathy from chemotherapy. 

Most patients want to know “how will I know if I’m developing peripheral neuropathy?”. 

One of the first and most common signs is typically numbness and tingling, like a pins and needles feeling in the fingers and toes. Other common symptoms include pain, especially in the fingers and toes, weakness in the legs, as well as increased sensitivity to temperature.

The typical onset of neuropathy is weeks to months after chemotherapy, but some patients have reported the onset of neuropathy within even hours to days of chemotherapy. If you feel you may have some of the symptoms of neuropathy during chemotherapy, the best thing to do is immediately report it to your care team.

Here are some simple tips for patients who are diagnosed with peripheral neuropathy from chemotherapy. 

Injury avoidance in the house with the use of handrails, as well as oven mitts for handling hot dishes. Certain medications can be helpful at managing the symptoms of neuropathy, including over-the-counter pain control, lidocaine patches, menthol creams, and a drug called Duloxetine. More severe cases of peripheral neuropathy may require intervention from physical therapy, occupational therapy, or rehab to restore patients to their normal level of function. Finally, there are some clinical trials underway to test new medications at managing peripheral neuropathy. 

Most patients with peripheral neuropathy want to know “how quickly will this go away?”.

Typically, symptoms improve gradually over time, which can be very frustrating. While the actual time to improvement varies from patient to patient, it's reasonable to expect a course of improvement over several months as opposed to several days or weeks. In some cases, symptoms of neuropathy may actually be permanent. 

Ask your healthcare provider for some guidance on what to expect if you're diagnosed with neuropathy. 

This is not medical advice. Talk to your doctor before making any medical decisions.