Side Effects of Chemotherapy- Peripheral Neuropathy
Side Effects of Chemotherapy — Peripheral Neuropathy
In clinical anti-tumor treatment, certain specific drugs may cause neurotoxicity, which is one of the most common adverse reactions to chemotherapy. When neurotoxicity occurs, doctors may reduce or limit the use of certain medications. In some cases, this may affect treatment efficacy. Severe neurotoxicity can lead to peripheral neuropathy, which impacts patients physically, psychologically, and in terms of overall quality of life.
Peripheral neuropathy occurs when the nerves are damaged, often leading to numbness, tingling, pain, or loss of sensation. These symptoms usually begin in the fingers or toes. Patients may find it difficult to perform fine motor tasks such as buttoning clothes, zipping zippers, or typing. Peripheral neuropathy can also cause balance problems, difficulty walking, and foot pain, particularly at night. In most cases, mild numbness in the hands and feet is a manifestation of mild peripheral neurotoxicity.
Common chemotherapy drugs that may cause neurotoxicity include: Paclitaxel, Docetaxel, Vinorelbine, Eribulin, Oxaliplatin, Cisplatin, Carboplatin. The severity of neurotoxicity varies among different drugs. Additional factors that may worsen neurotoxicity include diabetes, hypothyroidism, alcoholism, vitamin deficiencies, cancer, cardiovascular disease, and smoking or drinking habits. Elderly patients, due to decreased liver and kidney function, may have higher drug accumulation, leading to greater neurotoxicity. Using multiple neurotoxic drugs simultaneously can also increase toxicity.
When evaluating for neurotoxicity, your doctor may check your thyroid function, vitamin B12 and folate levels, conduct a complete blood count (CBC) and metabolic panel, and possibly measure hemoglobin A1c to assess for diabetes.
How to Relieve Chemotherapy-Induced Neurotoxicity
Most cases of peripheral neuropathy are mild to moderate, and symptoms may gradually improve months or even years after stopping the medication. Your doctor will consider multiple factors—including your overall health and the characteristics of the drugs used—to design a treatment plan that minimizes the risk and severity of neuropathy. Some non-drug therapies may help relieve symptoms, such as physical therapy, which can help restore some muscle function. Massage and exercise may also be beneficial. Other possible options include acupuncture, cognitive-behavioral therapy, biofeedback, and nerve stimulation therapy.
Medications That May Help Alleviate Symptoms (Consult your doctor before using any medication.)
• Antidepressants: Duloxetine, Venlafaxine, Nortriptyline
• Anticonvulsants: Gabapentin, Pregabalin
• Nutritional supplements: Glutamine, Vitamin B complex
• Topical pain relief: Lidocaine
Daily Life Recommendations
• Limit exposure to cold (especially if using oxaliplatin): avoid cold drinks, inhaling cold air, and touching cold surfaces like refrigerators.
• Avoid direct contact with hot objects: do not handle cups of hot water or hot water bags; use warm—not scalding—water when bathing.
• Wear rubber gloves when washing dishes, and wear thick cotton gloves when taking items out of the refrigerator or freezer.
• Avoid wearing metal accessories such as rings, watches, or glasses; avoid direct skin contact with metal objects like doorknobs or faucet handles.
• Dress warmly in cold weather: wear insulating clothing such as thermal socks, gloves, scarves, and hats.
If you have any concerns or questions, please consult your oncology care team to determine the most appropriate management and treatment options for your condition.
