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Peripheral neuropathy in persons with cancer

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Peripheral neuropathy is a term used to describe sick or injured nerves. The peripheral nerves are the ones located outside your brain and spinal cord.

Many diseases and conditions can cause nerve damage. The common causes are diabetes, alcoholism, vitamin deficiencies, HIV infection, and cancer. In people with cancer, radiation treatments, chemotherapy, or the cancer can be the cause of nerve damage. This article is written for people who have peripheral neuropathy with cancer.

Symptoms

Clasped Hands

Symptoms of peripheral neuropathy depend on the type of nerve(s) affected and where the nerve is located in the body. If nerves to the skin are affected you may have:

  • Numbness and tingling (pins and needle feeling)
  • A feeling you are wearing an invisible glove or sock
  • Extreme sensitivity to touch
  • Burning feeling in toes or fingers
  • Can’t feel hot or cold, or the ability to feel hot/cold is lessened

If nerves to the internal organs are affected you may have:

  • Dizziness
  • Constipation
  • Bladder difficulties
  • Sexual problems

If nerves to the muscles are affected you may have:

  • Muscle weakness (trouble turning a knob)
  • Muscle cramping
  • Muscle spasms
  • Problems with balance

It may not be possible to prevent nerve damage. But it may be possible to keep it from getting worse.

The most important thing that people with neuropathy symptoms can do is to tell their doctor or nurse right away.

If the nerve damage is due to a drug, the drug may be stopped. If it is due to a tumor the tumor may need to be treated. If it is due to a lack of a certain vitamin, vitamins will be prescribed by the doctor.

There are remedies to sooth the symptoms of peripheral neuropathy. Many patients learn what helps by means of trial and error. Some people need just one try to find what works for them. Others may need to try many methods. Sometimes a combination of methods will take away the symptoms. Patients need to tell their doctor or nurse what methods work or don’t work so that a plan can be formed.

Possible treatments

Pain medicines

  • Non-narcotic pain relievers (Tylenol, Motrin)
  • Narcotics—strong pain relievers can almost always relieve the pain of neuropathy, but the side effects can be a problem
  • Topical anesthetics—proven in clinical trials to relieve some painful sensations of neuropathy
  • Tricyclic antidepressants—decrease the chemicals in the brain that transmit pain signals
  • Anti-convulsants—help calm down the nerves and the central nervous system.

Exercise

Exercise prescribed by a doctor and supervised by a physical therapist, can increase strength, circulation, and coordination. It is important to keep as much muscle strength and function as possible.

Alternative/complimentary treatments (CAM)

There is not a lot written to support the effects of complimentary and alternative treatment of peripheral neuropathy, though some people report being helped by them.

Massage can increase circulation and promote relaxation. It is sometimes useful in treating the symptoms of peripheral neuropathy. Massage, in some conditions could be harmful. Check with your doctor before having massage therapy.

If you have heard of a CAM treatment you want to try, talk to your doctor.

Safety concerns

People with peripheral neuropathy are at more risk for accidents or injuries because of the lack of sensation, weakness, and clumsiness that may come with damage to the nerves of the skin and muscles. Some of the safety measures include:

  • Make sure the lights are on when entering a room.
  • Use a lighted key ring to open locked doors.
  • Remove throw rugs. Clear walkways of clutter, toys, footstools.
  • Wear sturdy shoes. Avoid slippers and running shoes with thick soles.
  • Wipe up spills right away.
  • Use skid free shower and bathroom mats.
  • Use liquid soap instead of bar soap.
  • Clear garages and work areas of oil spills. Store rakes, nails, and garden tools out of the walkways.
  • Wear warm socks and gloves during cold weather.
  • Lower water temperature in the home water heater to avoid burns. Use a bath thermometer to make sure the water temperature in a shower or tub is 120 degrees or below.
  • Use protective gloves when washing dishes.
  • When driving, be sure you can feel brake pedals and steering wheel. Be alert for changes in reaction time.
  • Be sure you have enough strength and coordination when driving.
  • Use a cane or walker if you find yourself limping or having difficulty walking.

Adaptive devices

If weakness of hands or feet interfere with daily activities, adaptive equipment may be needed. An occupational therapist may be consulted to fit devices that will help with muscle weakness.

Foot and hand care

It is important to take care of your skin when nerves are damaged. You may have less sensation and not be able to feel the discomfort that would normally alert you that a problem is present.

  • Inspect hands and/or feet for sores or blisters.
  • Do not wear ill-fitting shoes and/or socks.
  • Moisturize feet and hands daily. Dry in between toes after bathing to avoid fungal infections.
  • Keep toenails trimmed. If hand weakness makes this difficult, a health professional, such as a podiatrist, can do this for you.

Source: UI Cancer Information Services