Chemotherapy and Neuropathy

People can survive cancer, but then spend years coping with persistent problems from the treatment. The cancer is gone but the effects of the chemotherapy that helped cure the cancer remain. There are many side effects people can have from chemotherapy. The side effects are specific to the chemotherapy that is or was being given. Some of these side effects occur for days to weeks, and, when the therapy stops, the side effects begin to stop too. But some side effects get more intense during chemotherapy and then persist, if not worsen, after the therapy ends.

One group of side effects that can persist are "neuropathies," or nerve damage. Neuropathies can cause pain; sensitivity to hot or cold; and numbness or tingling, often in the hands and feet. People with neuropathy may lose a sense of where their feet are. Yet knowing where our feet are lets us walk safely, even in the dark, so people with neuropathy may be at risk to fall. Eliminating throw rugs, making walking surfaces of non-skid material, and using night lights help. The nerve damage may make it difficult to tie shoe laces, button shirts, or wash dishes. Neuropathies can also mean that feeling very hot or very cold materials is impaired; this impairment can lead to problems such as burns on the hands.

Some types of neuropathy are specific to a particular drug. For example, oxaplatin produces a cold sensitivity that makes it extremely uncomfortable for people to swallow ice cream or be in an air conditioned space. Some of these people get relief wearing gloves and a hat. Other drugs can cause different problems, such as severe constipation.

Who will develop a neuropathy from chemotherapy, or to what degree, cannot be predicted.

Note that not all neuropathic pain in people with cancer is caused by chemotherapy. Radiation therapy, infections such as herpes zoster in patients with compromised immune systems, or nerve impingement from a tumor can all cause neuropathic pain.

Physical therapists can offer great help: they have lots of ways to help people cope with neuropathies.