Peripheral Neuropathy and Cancer

Understanding Your Symptoms

People living with cancer may experience nerve pain often described as tingling, burning, or numbness. Problems with coordination also may be present. These symptoms may be associated with a peripheral neuropathy. In this condition, nerves outside the brain and spinal cord have been damaged, often by the cancer treatments themselves.

Sometimes symptoms are temporary and gradually decrease after cancer treatment is completed. Sometimes they persist and require ongoing medical attention. In some patients the neuropathy affects only one nerve, but in others it occurs in several nerves. Conditions not associated with cancer may cause peripheral neuropathy, so it is very important to get a proper diagnosis for this condition.

What causes peripheral neuropathy?

In people with cancer, peripheral neuropathy is usually caused by damage to nerves from surgery; radiation treatment; or, most commonly, chemotherapy. It also can be caused by a tumor pressing on or invading a nerve, or an infection that affects the nerves, such as shingles. Chronic health problems, such as diabetes or excessive use of alcohol, also can cause or contribute to a neuropathy. Peripheral neuropathy associated with chemotherapy most often affects the hands and feet.

Practical Tips for Patients

• Having the right diagnosis is essential.

• If you are in active treatment, not only may your regimen need adjustment, but also the symptom needs to be treated.

• Make sure that you are not using toxic substances. For example, alcohol is toxic to nerves: just 1 or 2 drinks may make the neuropathic pain worse.

• If you have diabetes, be sure your blood sugar levels are under control. (Sugar can be a toxin to nerves.)

• Keep ahead of the pain: Sometimes different types of medications are needed to manage nerve damage pain (eg, antidepressants, anticonvulsants, topical local anesthetics, opioids).

• Non-drug measures are important too, and include relaxation therapy, meditation, acupuncture, and TENS, or transcutaneous nerve stimulation.

• Physical and occupational therapy can be extremely helpful.

• If your pain is not being well controlled, ask to be referred to a pain management team.

• Pay extra attention to your feet if that is the area of your neuropathy. At least once a week, use a hand-held mirror to inspect them for sores or open wounds.

• Pay attention to your shoes. Neuropathy often causes foot symptoms. Your physiatrist, physical therapist, or occupational therapist should be able to advise you on shoes and foot care.

• Pay attention to your hands if that is the area of your neuropathy. If they feel clumsy or weak, consider buying household tools (eg, knives, hammers) with wide grips.