National Cancer Survivors Day

Coping® is a proud sponsor and publisher of the exclusive coverage of National Cancer Survivors Day®.


Click here for Coping® magazine's Exclusive Coverage of National Cancer Survivors Day® 2017 (pdf).

Return to Previous Page

Chemotherapy-Induced Peripheral Neuropathy

Answering Your Questions about this Common Nerve Condition Caused by Chemotherapy Treatment

by Robert Knoerl, BSN, RN, and Grace Kanzawa, BSN, RN, with Ellen M. Lavoie Smith, PhD, APN-BC, AOCN

Knowledge image

Peripheral neuropathy can cause a pins-and-needles sensation in your hands or feet.

If chemotherapy is part of your cancer treatment regimen, you may develop a condition known as chemotherapy-induced peripheral neuropathy, or CIPN for short. Up to 68 percent of cancer survivors may experience this common chemotherapy side effect.

What is chemotherapy-induced peripheral neuropathy?
As chemo­therapy drugs spread throughout your body, they can sometimes damage peripheral nerves – or the nerves farthest from your brain. This peripheral nerve damage can result in chemotherapy-induced peripheral neuropathy.

Your risk of CIPN is greater with certain chemotherapy drugs, including oxaliplatin, cisplatin, paclitaxel, bor- tezobmib, thalidomides, and docetaxel. It may develop days or even months following chemotherapy treatment.

What are the symptoms?
CIPN primarily affects your hands and feet. Symptoms may include pain, burning, loss of feeling, hot or cold sensitivity, and a pins-and-needles sensation in your hands or feet. These symptoms can sometimes have a negative effect on cancer survivors’ quality of life and physical function. Tell your nurse or doctor about any CIPN symptoms you are experiencing right away so that you can take steps to manage them. If CIPN symptoms become severe, your chemotherapy dosage may need to be decreased, or chemotherapy treatment stopped altogether.

Up to 68 percent of cancer survivors may experience this common chemotherapy side effect.

Author of Article photo

Robert Knoerl

Can CIPN be prevented or treated?
Though researchers have yet to discover a way to prevent CIPN, the good news is that your CIPN symptoms can be treated. One medication – duloxetine – has been approved for treating CIPN, though its use is limited. Duloxetine has only been shown to be useful to treat painful CIPN caused by paclitaxel and oxaliplatin. It is unknown whether this medication works for non-painful CIPN symptoms, or for CIPN caused by other neurotoxic drugs.

If duloxetine is not an option for you, your doctor may prescribe another drug that is effective in treating pain caused by other types of nerve damage, such as diabetic neuropathy. For example, anti­depressants (such as nortiptyline and desipramine) and anticonvulsants (such as gabapentin or pregabalin) have proven effective in treating nerve damage.

Author of Article photo

Grace Kanzawa

Researchers have also found early evidence suggesting that a number of complementary therapies may be effec­tive in treating CIPN. These treatments include electrical nerve stimulation, acupuncture, and mind-body therapies, such as relaxation techniques, guided imagery, biofeedback, and yoga. Clini­cal trials are currently underway to evaluate their effectiveness in manag­ing CIPN.

How can I protect my hands and feet if I have CIPN?
If your CIPN symp­toms include loss of sensation in your hands or feet, you may be more suscep­tible to injury. This loss of sensation can increase your risk of falling or tripping over uneven surfaces, burning yourself, or cutting yourself.

To avoid injury, follow these impor­tant safety tips:
Make sure your house is well lit so that you don’t trip over an object you can’t feel or see. You may even want to install nightlights in key locations throughout your home so that you can better see your surroundings if you get up during the night.
Always keep walkways clear.
Use supportive handrails along stairwells.
Make sure the rugs in your home are nonslip, and tape down carpet edges.
Wear gloves when cleaning with very hot water or working with sharp objects.
Wear warm gloves and footwear whenever you may be exposed to cold temperatures.
Wear shoes with hard soles that com­fortably cover your feet.
Check your feet regularly for injuries, as foot injuries can lead to infections or other complications if they are not promptly treated.

Most importantly, talk with your healthcare team about your CIPN symp­toms and any trouble they may be causing you. Not all CIPN treatments work for everyone, but your doctor will help you to find the one that is best for you. You doctor may also offer additional recommendations for managing your CIPN or refer you to a specialist who can help you better control your CIPN symptoms.

♦ ♦ ♦ ♦ ♦

Robert Knoerl and Grace Kanzawa are PhD students at the University of Michigan School of Nursing. They are both interested in studying the use of nonpharmacological interventions to improve quality of life in cancer survivors with CIPN. Dr. Ellen Lavoie Smith is the director of the University of Michigan School of Nursing PhD program.

To learn more about managing chemotherapy-induced peripheral neuropathy and other common side effects of cancer treatment, visit

This article was published in Coping® with Cancer magazine, September/October 2015.