What Are The Symptoms Of Chemotherapy
The main symptoms are pain, tingling, numbness, and weakness. Many of my patients describe feeling pins and needles or a burning sensation.
Patients who experience numbness in their hands and fingers may have difficulty buttoning buttons, typing on a computer, or holding a pen or fork. Those with numbness in their legs and feet may have difficulty walking, especially on stairs or uneven surfaces. Weakness occurs when the nerves that carry information from the brain and spinal cord to the muscle fibers are damaged.
Having a problem with balance is another common symptom. This occurs because the brain is not getting normal sensory signals from the feet and legs, which may change the way the person walks or may reduce ones ability to sense location or movement .
All these symptoms can make it difficult to carry out basic everyday tasks.
Taking Risk Factors For Neuropathy Into Account
The researchers found that several patient characteristics increased the risk of lingering neuropathy 24 months after treatment initiation: the presence of neuropathy before treatment older age being overweight or obese having a mastectomy and a greater number of lymph nodes containing cancer cells.
Because patients treated outside clinical trials are often older and less healthy than patients who enroll in clinical studies, the real-world percentage of women who experience chronic neuropathy after taxane-based chemotherapy is likely higher than reported in this study, Dr. Ganz explained.
Unfortunately, we currently dont have much to offer patients in terms of treating peripheral neuropathy, said Dr. OMara.
Some patients find limited relief with the drug duloxetine, but the best strategy for now remains trying to prevent neuropathy from occurring in the first place, Dr. Ganz added.
A wide range of chemotherapy regimens are currently endorsed by professional groups for women with breast cancer who are at high risk of recurrence, and choosing one of these regimens over another may result in only a small difference in survival, Dr. Ganz noted. And given that most women will live a long time after treatment, its become increasingly important to consider how treatment will impact their future health in initial decisions about therapy, she added.
We need a strategic way in which these get incorporated into treatment decision-making, Dr. Ganz concluded.
What Can I Do About Neuropathy In My Legs And Feet
An exclusive and effective treatment for neuropathy in the legs and feet, The Combination Electro-analgesia Therapy, , has been extremely effective in relieving pain and discomfort, reversing your numbness, and restoring your sensation while improving your acuity, balance, and strength in your hands and feet.
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Clinical Services At Peter Mac Parkville
The following services are available to patients of Peter Mac, Parkville. If you are treated elsewhere, please speak with your oncology team, as you may have different clinical service options.
- Physiotherapy services. Physiotherapists and exercise physiologists can assist with mobility and physical function before, during and after cancer treatment.
- Occupational therapy services. Occupational therapists can help you to improve your independence, safety, control, wellbeing and quality of life.
- Pain services. This service provides evidence-based, safe and effective pain management for people with current or past cancer.
- Optimisation Clinic. This multidisciplinary outpatient clinic is for cancer survivors with complex needs. Services include a dietitian, psychologist, physiotherapist and occupational therapist. For referrals please email or for further information.
Life After Cancer: Peripheral Neuropathy
The peripheral nervous system is the term for all the nerves outside the brain and spinal cord. . The peripheral nerves carry information back and forth between the CNS and the rest of the body. Peripheral neuropathy is caused by damage to these nerves. It’s a common problem, most often caused by chemotherapy. Peripheral neuropathy can cause pain, numbness, tingling, burning, and other problems around the body.
Peripheral neuropathy may last for only a short time after cancer treatment. It can get better as nerves heal over time. For some people, it can last months or years. It depends on how much chemotherapy you had and the type you had. It can also depend on where the tumor was and the type of radiation or surgery that was done. Other health conditions such as diabetes or thyroid problems have been linked to peripheral neuropathy, too. Long-term peripheral neuropathy needs to be managed.
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Coping With Nerve Problems
Managing symptoms, which can include nerve problems, is an important part of cancer care and treatment. This is called palliative care or supportive care. Talk with your health care team about any symptoms or side effects you or the person you are caring for experience. This is important to do both during your cancer treatment and after treatment is completed.
The right treatment for nerve problems depends on the cause, whether chemotherapy is completed, and your specific problems. You should know that these problems often go away a few months or years after treatment. But sometimes, they are long-lasting or permanent, so you need ways to make the best of your function and recovery.
Does Hand Foot Syndrome Go Away After Chemo
Severe cases can cause the skin to crack, peel, or have blisters. Symptoms can sometimes occur in other areas, such as the knees or elbows, but this is less common. Hand-foot syndrome can make it hard to use your hands and feet to do daily activities. Symptoms usually go away after chemotherapy treatment is finished.
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Late Effects Of Chemotherapy On The Nervous System
The major late effect of chemotherapy agents on the nervous system is theresidua of CIPN, much of which persists as a chronic pain syndrome. Discussion of anew late effect is emerging in the oncology and cancer survivor environment. Longterm cognitive impairments after chemotherapy are being described in animalmodels80 and inpatients81. Themechanistic basis for this phenomenon, referred to as chemobrain,is that chemotherapeutic agents may affect neurogenesis in the adult brain. Cranialirradiation would be expected to potentiate this effect. Although this field is ofgreat interest to investigators and patients, there is little research availableyet. As cancer survivorship increase, it will likely become an important area forstudy.
How Long Does It Last
As mentioned before, only about 30 to 40 percent develop CIPN. Symptoms can appear as soon as chemotherapy begins. Symptoms tend to get worse as the chemotherapy regimen progresses. Its a temporary problem for some, lasting only a few days or weeks. For others, it can last for months or years and can even become a lifelong problem. This may be more likely if you have other medical conditions that cause neuropathy or take other prescription drugs that cause it.
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Tips To Help You Cope With Nerve Changes
There are some things you can do to help ease discomfort and prevent injury:
- Keep your hands and feet warm.
- Take gentle exercise when possible.
- Wear well fitting, protective shoes and inspect your feet regularly for cuts or broken areas to the skin.
- Take care when using hot water you may not be able to feel how hot the water is and could burn yourself.
- Use oven gloves when cooking and protective gloves when gardening.
- Keep your skin moisturised and soft.
- Take care when cutting your nails.
- Keep floors clear from clutter to prevent falls.
- Make sure rooms are well lit and keep a light on during the night.
- Stand up slowly when feeling dizzy.
- Prevent constipation by eating enough fibre and drinking plenty of fluids.
- See an occupational therapist for specialist equipment, for example, a tool to help you fasten buttons.
- Talk to a counsellor or your specialist nurse if youre finding it hard to cope with the changes caused by peripheral neuropathy.
What Is The Treatment For Nerve Changes
Your doctors and nurses will keep a close eye on you. They may need to lower the dose of the drug causing the neuropathy. This might stop your symptoms from getting worse. Or they might stop the drug temporarily to allow the nerve changes to recover.
If your symptoms do get worse, your doctor might suggest a different cancer treatment.
Peripheral neuropathy caused by chemotherapy and targeted cancer drugs is not always easy to manage. How well treatment works varies a great deal from person to person.
Approach To Peripheral Neuropathy In Patient With Cancer
When evaluating a patient with cancer that develops a neuropathy, determiningwhether they have CIPN requires an analysis of the administered drugs, thecumulative dosage, as well as the clinical characteristics and time course of theneuropathic symptoms. First, has the patient received a neurotoxicchemotherapeutic? The taxanes, platinum drugs, vinca alkaloids,thalidomide and bortezomib, all have a high likelihood of inducing CIPN. For someother drugs the likelihood is low withonly single cases reported in the literature. Second, it is important toconsider the route of drug administration. Methotrexate is rarelyassociated with neurological toxicity except when administeredintrathecally2. Bortezomibneurotoxicity decreases with subcutaneous administration3. Third, hasthe patient received a drug dose commensurate with developing CIPN?Symptoms of CIPN typically begin during the first two months of treatment, progresswhile chemotherapy continues, and then stabilize soon after treatment is completed.While most CIPN occurs in a dose dependent fashion, other drug-specific features maybe present such as the acute neurotoxicity of paclitaxel and oxaliplatin, or theworsening of neuropathy after discontinuation of cisplatin . It would beunexpected for CIPN to appear weeks or months after the last dose of neurotoxicchemotherapy treatment. Table 1 shows asummary of most commonly used drugs, and also estimates a cumulative dose associatedwith neuropathy for each drug when available.
What Can I Do To Deal With Cipn
There are some things you can do to better manage the symptoms of CIPN, such as:
- Talk to your doctor or nurse about the problems you are having in daily life. They might be able to suggest ways to make you feel better or function better.
- If you are taking pain medicines, use them as your doctor prescribes them. Most pain medicines work best if they are taken before the pain gets bad. See Cancer Pain to learn more about pain, how to talk about it, and how to manage it.
- Avoid things that seem to make your CIPN worse, such as hot or cold temperatures, or snug clothes or shoes.
- Give yourself extra time to do things. Ask friends for help with tasks you find hard to do.
- Dont drink alcohol. It can cause nerve damage on its own, and might make CIPN worse.
- If you have diabetes, control your blood sugar. High blood sugar levels can damage nerves.
- Talk to your doctor or nurse about whether it is safe for your to exercise. A physical therapist can make suggestions for what might be most helpful to you.
- If constipation is a problem, follow your doctors recommendations about laxatives and exercise. Drink plenty of water and eat fruits, vegetables, and whole grains to get enough fiber.
- If the neuropathy is in your feet, sit down as much as possible, even while brushing your teeth or cooking.
- If your neuropathy is permanent, your doctor may refer you to an occupational therapist . They are experts who help people lead more normal lives despite physical limits.
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Can It Be Prevented
So far, no treatment has been proven to prevent peripheral neuropathy. However, if you start having symptoms during chemotherapy treatment, your doctor may reduce the doses of chemotherapy drugs or give them to you further apart. This adjustment sometimes allows the nerves to recover and prevents permanent damage.
In some cases, you may need to stop having a particular chemotherapy drug. You can talk to your doctor about how they will balance the risk of changing the chemotherapy plan against the risk of the nerve damage becoming permanent.
Researchers are studying whether wearing ice mitts and ice booties during chemotherapy treatment could help prevent the cell damage that causes peripheral neuropathy. However, there is not yet enough evidence that this works. Talk to your treatment team for more information.
Although there is no way to prevent peripheral neuropathy developing, you may be able to reduce your risk. If you have diabetes, it will be important to make sure the diabetes is well managed throughout your cancer treatment. Limiting how much alcohol you drink and not smoking may also lower the risk.
Treating Nerve Pain After Chemotherapy: An Option That Works
The antidepressant duloxetine has been found to help relieve neuropathic pain, a tingly feeling felt by many cancer survivors.
Once cancer treatment ends, a challenging and lasting side effect can remain: peripheral neuropathy, a tingling feeling usually felt in the toes, feet, fingers and hands.
For some, the sensation is uncomfortable, notes Ellen M. Lavoie Smith, Ph.D., an associate professor at the University of Michigan School of Nursing.
But for about 30 percent of breast cancer patients, peripheral neuropathy is a painful sensation. People treated for gastrointestinal, urologic and other cancers can also be affected.
This problem stems from the cancer drugs causing damage to the peripheral and central nervous system structures. The damage can lead to lasting abnormalities in how the brain processes pain signals.
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Autonomic Neuropathy After Chemotherapyis It Permanent
Dear Mayo Clinic: After six months of chemotherapy, I developed autonomic neuropathy. I have been done with chemotherapy for a few months, but the neuropathy has not gone away. Is there a chance it could be permanent?
A: Autonomic neuropathy can be a rare side effect of certain chemotherapy drugs. Because it is rare, and because there are many causes of autonomic neuropathy, your doctor should evaluate you to ensure that there is not another cause for your symptoms.
Peripheral neuropathy that leads to numbness, tingling and pain in the hands and feet is much more commonly associated with chemotherapy medications than autonomic neuropathy. When peripheral neuropathy develops as a result of chemotherapy, symptoms typically fade away within several months of the end of treatment. But it can sometimes take longer than that. Although it’s uncommon, in some cases peripheral neuropathy caused by chemotherapy can last for years, or it may be permanent. Treatment is available to help manage symptoms.
While some chemotherapy drugs may cause neuropathy, others do not. Even with the drugs known potentially to be toxic to nerves, only about 30 percent of patients who receive them will develop peripheral neuropathy due to treatment. Risk of developing neuropathy, however, is one of the main reasons for limiting the amount of chemotherapy a person is given.
©2017 Mayo Foundation for Medical Education and Research Distributed by Tribune Content Agency, LLC.
Does Exercise Help Neuropathy
Why Exercise? While the general benefits of aerobic and flexibility exercises are well-known,increasing movement and heart-rate are particularly important for people suffering with peripheral neuropathy. Physical activity can improve blood circulation, which strengthens nerve tissues by increasing the flow of oxygen.
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Cancer And Peripheral Neuropathy
You have some risk of peripheral neuropathy if you have cancer. Certain factors raise your risk of getting it from cancer or its treatment. These include:
Where the tumor is. A tumor might press on or grow into a nerve. This could cause nerve damage.
Some chemotherapy drugs. Some chemotherapy drugs can damage your nerves, especially in high doses. These include:
Platinums, including cisplatin , oxaliplatin , and carboplatin
Taxanes, including docetaxel and paclitaxel
Vinca alkaloids, including vincristine , vinorelbine , and vinblastine
Before cancer treatment begins, ask your doctor if your chemotherapy includes any drugs on this list. If so, talk with your doctor about your risk for developing peripheral neuropathy after receiving chemotherapy. This is especially important for people who already have neuropathy or who have conditions that may put them at greater risk for developing neuropathy, such as diabetes or a personal or family history of neuropathy.
ASCO does not recommend the use of the dietary supplement acetyl-L-carnitine or any other medication or supplement to prevent peripheral neuropathy caused by chemotherapy. Always talk with your doctor before taking any supplement or over-the-counter medication, because they can interact with cancer treatments.
Radiation therapy. Radiation therapy might damage nerves. It might be years before you notice signs of nerve damage.
Surgery. Lung or breast surgery can cause nerve problems. So can removing an arm or leg.
How Common Is Peripheral Neuropathy After Chemotherapy
The main cause of peripheral neuropathy in people affected by cancer is treatment with certain chemotherapy drugs. For these types of chemotherapy, about 7 out of 10 people will experience some symptoms one month after treatment, and 3 out of 10 people will still have symptoms six months after treatment. The risk differs between different chemotherapy drugs.
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What Are The Treatments For Cipn
There are several treatments, depending on your particular symptoms. For pain and tingling, there are medicines offering relief, which can be prescribed by a physiatrist or a neurologist.
Physical therapy, occupational therapy, and exercise can help you cope with numbness, loss of balance, or loss of strength. Exercises like yoga and tai chi can help maintain or restore your balance.
Some symptoms of CIPN may get better over time, but others may be permanent.
Learn more about ways to manage symptoms and get tips for staying safe while you have peripheral neuropathy.
What Role Does Complementary Medicine Play In Preventing Or Treating Cipn
Studies have suggested that acupuncture may help relieve some of the symptoms of CIPN. MSKs Integrative Medicine Service has specialists who can provide these treatments and are trained in working with people with cancer.
Some people take herbs or supplements that claim to prevent or treat CIPN, but these have not been shown to be effective in rigorous clinical trials. If you decide to take any herb or supplement, its important to talk to your medical team. These products may have harmful interactions with other medications you are taking, including chemotherapy drugs. You can also consult MSKs About Herbs database for more information.
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