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Take Control of Chemotherapy-Induced Neuropathy

by Cindy Tofthagen, PhD, ARNP

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Neuropathy is a common side effect of many chemotherapy drugs. Scientists are looking for ways to prevent chemotherapy-induced neuropathy, but until a solution is found, you can manage this side effect with help from members of your healthcare team.

If you have numbness or tingling in your hands or feet, you probably have peripheral neuropathy. It starts in the fingertips or the toes, and over time can affect more of the hands and arms or feet and legs. Pain in the hands, feet, and legs may also be present. You may have trouble with your balance or have weakness in your legs. Neuropathy in the hands can cause you to have trouble buttoning buttons, holding small objects, writing, and sensing hot or cold temperatures. Neuropathy in the feet can make it difficult to walk, drive a car, or stand for a long time. These symptoms may not become noticeable until you have had several chemotherapy treatments.

It is important for you to talk to your doctor if you are experiencing symptoms of neuropathy. Be sure to tell him or her how much of your hands or feet are affected, what specific symptoms you’re having, and how the symptoms affect your daily activities. If you are currently being treated with chemotherapy, your doctor may need to adjust the dose or try a different chemotherapy drug altogether. He or she may send you to a neurologist, a doctor who specializes in the treatment of diseases affecting the nervous system, to make sure the neuropathy you’re experiencing is caused by the chemotherapy and not something else. A neurologist can also help you manage your symptoms.

Be sure to tell your doctor how much of your hands or feet are affected, what specific symptoms you’re having, and how the symptoms affect your daily activities.

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Dr. Cindy Tofthagen

Treatment of chemotherapy-induced peripheral neuropathy has two main goals: controlling pain and helping you function at your best. Not everyone who has chemotherapy-induced neuropathy has pain, but for those who do, relief is possible. Controlling neuropathy pain usually requires different medications from those used for other types of pain. It is important to remember that not every medicine works for everyone, and different people require different dosages to get pain relief.

If neuropathy is affecting your ability to perform normal activities, it’s important to seek help. Many different types of healthcare providers can help you manage your neuropathy.

A physiatrist, a physician who specializes in cancer rehabilitation, can help get you functioning at your best. A physical therapist can help you manage neuropathy by recommending specific exercises to improve your muscle strength and balance. Physical therapy and exercise programs, like yoga and tai chi, can also enhance your emotional well-being. An occupational therapist can work with you to help you maintain your independence, adjust to physical limitations, and get back to doing your usual activities as quickly as possible.

When you have numb feet, it’s important to find shoes that are comfortable, fit properly, and help protect your feet, as small cuts or other foot injuries can go unnoticed. A podiatrist can help you take good care of your feet, recommend good footwear, and fit you for special inserts that will make walking more comfortable.

Case managers, registered nurses, and social workers can help you identify resources within your community to meet your specific needs and facilitate communication between you, your healthcare team, and your insurance company. Support groups and mental health professionals can help you cope emotionally with neuropathy. To locate a support group near you or find additional resources, visit the Neuropathy Association’s website, neuropathy.org.

You can take control of chemotherapy-induced neuropathy by keeping your doctors informed, seeking additional help from the resources above, and being persistent until you get the help that you need.

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Dr. Cindy Tofthagen is an assistant professor of nursing, an oncology nurse practicioner, and director of the oncology nurse practicioner concentration at the University of South Florida in Tampa. She is also a post-doctoral fellow at the University of Massachusetts and the Dana-Farber Cancer Institute.

This article was published in Coping® with Cancer magazine, November/December 2012.