After having my first dose of Taxol, my feet, hands, and fingers felt tingly and painful. Sometimes it was quick little stabs of pain, sometimes it lasted longer and felt like my fingers and toes were burning from the inside. My oncologist explained that this was peripheral neuropathy, a side effect of particular chemotherapy drugs. He prescribed something to help and taught me how to use it, to prevent the symptoms of neuropathy, or at least to reduce that pain.
Chemo Induced Peripheral Neuropathy - CIPN
Peripheral neuropathy -- a kind of nerve damage -- is a side effect that can be caused by certain chemotherapy drugs. The rates of peripheral neuropathy increase the more frequent the chemotherapy sessions are.
Taxanes, platinum-based drugs, vinca alkaloids, and Herceptin are a few of the items you'll find on a list of drugs that can cause neuropathy. Other conditions, diseases, medications, and injuries may also cause neuropathy. Peripheral neuropathy is not the same as hand-foot syndrome or Palmar-Plantar disorder, another chemotherapy side effect.
How Chemotherapy Causes Neuropathy
Here's one way to envision how chemo causes nerve damage. Your nerves function like wires, in that they carry electrical signals along a specific path. When you plug in your computer or a lamp, notice that the wire is coated with a protective covering of insulation. Nerves also have a covering (myelin) that protects them from damage and ensures that they work properly.
When repeated doses of chemotherapy strip away the myelin, your nerves can't send signals properly. Numbness occurs when nerves are no longer transmitting a signal, tingling happens if a false signal is sent. Pain is felt when information overloads your unprotected nerves.
Like other side effects of cancer treatment, neuropathy symptoms can build up and increase as treatment progresses, but should ease after you're finished with chemo.
Symptoms of Peripheral Neuropathy
You might not develop all the symptoms of neuropathy, but here are some of the most common signs that you may have it:
- Numbness and tingling in your hands, feet, fingers and toes
- Burning sensations in your hands and feet
- Reduced dexterity, trouble with buttons, difficulty picking up things
- Weakness of legs and leg cramps
- Numbness around your mouth area
- Constipation and pain during bowel movements
You will notice the most intense symptoms starting after each treatment, when the chemo is fresh in your circulation. If your infusions are scheduled every three weeks, your neuropathy may begin to fade just before your next appointment. Neuropathy symptoms can increase with each treatment, because the effects of chemotherapy are cumulative. After completing chemo, your neuropathy may fade away over several months, or it may decrease to fewer parts of your body.
Sometimes nerves can't rebuild or repair their protective covering, and in those cases, neuropathy can linger indefinitely.
Getting Relief From Neuropathy
Be sure to tell your doctor if you develop any symptoms of peripheral neuropathy. There are medications and nutritional supplements you can take that will help ease the pain and severity of neuropathy. Follow your doctor's instructions on how and when to use neuropathy treatments.
You can also establish some good habits that will reduce tingling and burning in your feet and hands. Always wear comfortable footwear, and avoid going barefoot to lessen irritation to your feet. Wear protective gloves when gardening, doing dishes, or doing chores that may chafe your hands and fingers. Take warm showers or baths, and skip using hot water on your skin, so you don't set off a nerve response to temperature changes. Keep some moisturizing creams and lotions on hand to pamper your skin and use it gently.
If neuropathy is causing you some constipation, remember to drink plenty of water and juice daily, eat high-fiber foods, and do some regular light exercise.
Sources:
Managing Chemotherapy Side Effects. Nerve Changes. National Cancer Institute. Posted: 11/24/2008.
Peripheral Neuropathy Caused By Chemotherapy. How does CIPN start? American Cancer Society. Last Medical Review: 12/22/2009.
