Chemo Induced Peripheral Neuropathy

Posted on: 08/09/2016

Chemo Induced Peripheral Neuropathy

Chemo-induced peripheral neuropathy (CIPN) is a common adverse effect of many anticancer drugs. The body’s nervous system is divided into two major systems, the central nervous system and the peripheral nervous system. The peripheral nervous is also divided into two systems the somatic nervous system and the autonomic nervous system. The somatic nervous system consists of peripheral nerve fibers that send sensory information to the central nervous system and motor nerve fibers that send signals to skeletal muscle. The autonomic nervous system controls smooth muscle of the internal organs.  CIPN results from damage to the peripheral nerves from certain chemotherapy drugs, such as vincristine, cisplatin, thalidomide and interferon. The exact pathophysiology of CIPN is unknown, which makes it more difficult to treat.  Primary areas affected by CIPN are the hands and feet, which may move gradually in a “stocking-glove” type fashion. Also affected may be the face, back and chest.

Symptoms of CIPN include:

• Numbness, tingling of hands and/or feet. Feeling of pins and needles

• Burning of hands and/or feet

• Loss of sensation to touch

• Loss of positional sense

• Weakness and leg cramping

• Difficulty picking things up or buttoning clothes

Treatment of CIPN

Treatment may often help ease some of the symptoms of CIPN. Sometimes these symptoms decrease or go away. Other times symptoms may last for a longer period of time. Severe CIPN may never go away. Treatment is mostly given to relieve the pain associated with CIPN. Some of the medications include:

• Topical gel treatment containing baclofen, amitriptyline, and ketamine. Another gel is menthol or capsaicin cream

• Antidepressant medications, such as, amitriptyline or duloxetine

• Anti-seizure medicines, which are used to help nerve pain, such as gabapentin

• Narcotics are used to treat severe pain

Other treatments that may be tried to ease nerve pain and it effects on quality of life include:

      • Occupational therapy
      • Physical therapy
      • Relaxation therapy
      • Guided imagery
      • Acupuncture
      • Biofeedback