Why is Neuropathy Prevalent in Cancer Patients?

How is Chemotherapy Connected to the Development of Neuropathy?

Chemotherapy is an intense drug treatment used to kill cancer cells developing in the body. While this is often an effective way to prevent the spread of cancer, the treatment itself can be extremely taxing, and comes with some symptoms of its own. Many cancer patients undergoing chemotherapy report symptoms of hair loss, infections, anaemia, fatigue, and oftentimes, neuropathy. 

Although the treatment is only meant to kill cancer cells, it sometimes will attack healthy cells as well, including nerves. When a nerve is damaged, it can send unnecessary pain signals to the brain. 

This condition can cause a variety of problems, primarily in the peripheral nervous system. For example, patients may experience changes in their hair, skin, and nails, and can have difficulty controlling muscles. This may lead to feelings of tingling, numbness, and extreme pain extending down to the feet.

Patients that experience these symptoms may face difficulty walking or doing tasks that they once found simple. Patients that develop peripheral neuropathy as a result of chemotherapy have a condition that is clinically known as CIPN, chemotherapy-induced peripheral neuropathy. 

What is Peripheral Neuropathy?

Our peripheral nervous system is composed of the nerves that connect to the brain and spinal cord. This system is primarily responsible for two main functions – the autonomous nervous system, which is responsible for involuntary bodily functions, and the somatic nervous system which controls muscle movements. 

When these vital peripheral nerves are damaged, it becomes difficult to regulate important autonomous functions such as heart rate, digestion, and blood pressure. For this reason, patients may experience the following life-threatening symptoms:

  • Irregular heart rate
  • Difficulty eating or swallowing
  • Diarrhea
  • Constipation
  • Loss of bladder control

If you are experiencing any of these symptoms as a result of CIPN, you should consult your doctor immediately. 

Aside from autonomous functions, CIPN patients may find themselves experiencing other symptoms relating to their somatic nervous system, which controls voluntary movements. Damage to these functions can result in a variety of symptoms, including pain or numbness in the hands, legs, and feet. Some patients even report their symptoms being so intense that they cannot walk or have difficulty using their hands. 

 How Common is CIPN?

A diagnosis of CIPN can be extremely daunting, however, is it important to understand that this is very common in cancer patients who have undergone chemotherapy. Recent studies have shown that 68% of patients undergoing chemotherapy will develop some form of neuropathy within the first month of treatment, 60% at three months, and 30% after six months. Additionally, it has been found that the severity of the symptoms typically reflect the dosage of chemotherapy the patient receives. 

CIPN symptoms typically become noticeable weeks or months after treatment. If you notice that your symptoms are worsening with time, it is very important to routinely consult with your doctor. Even patients who are cancer-free after chemotherapy treatment may still experience neuropathy symptoms. This condition is so prevalent that many cancer patients have reported that neuropathy is the most overlooked and debilitating symptom associated with chemotherapy. 

How is Neuropathy Diagnosed?

If you suspect that you or a loved one may have developed neuropathy as a result of chemotherapy, it is important to get an official diagnosis as soon as possible. The first step is to schedule an appointment with your primary physician or cancer specialist to go over your symptoms. Most doctors will begin by reviewing your health history to see why you may be experiencing neuropathy-related symptoms. Next, your doctor will perform a physical exam to see where you are experiencing pain or numbness. This will allow them to tell you if your pain could be a result of CIPN. 

After the initial appointment, your physician or specialist may recommend that you schedule additional diagnostic testing. Some options include, but are not limited to:

  • Neurologic exam – Determines reflexes and muscular reactions
  • Nerve conduction studies – Electrodes are placed on nerves and the reactions are measured to determine nerve damage
  • Blood work – Can detect irregular mineral or vitamin levels 
  • Imaging – Imaging, such as MRIs, can identify pinched nerves or tumors

Can CIPN Be Conservatively Treated?

Unfortunately, chemotherapy-induced peripheral neuropathy cannot be reversed. However, it is possible to control symptoms through pain management methods. By being proactive in seeking treatment, many patients are able to target symptoms before they become extremely debilitating. 

Upon initial diagnosis, most patients will be prescribed medications based on the symptoms they are experiencing. Common medications used for pain management includes:

  • Antidepressants
  • Anti-seizure medications
  • Headache medications

Aside from medications, there are therapies available that can help neuropathy patients find new ways to manage their pain. Physical therapy, for example, is an excellent way to help patients who have difficulty walking or balancing due to pain or numbness in the legs or feet. Through controlled exercises, patients can rebuild muscles, regain balance, and extend their range of motion that may be limited. Steroid injections are another option for patients dealing with extreme centralized neuropathy pain. These are anti-inflammatories that can minimize the pain.

Neuropathy Surgery with BEST

If conservative methods are found to be ineffective, there are surgical options available for CIPN patients. At our BEST Health System location in Cincinnati, Dr. Girton is our neuropathy specialist who performs steroid injections and spinal cord stimulator procedures. Dr. Girton is a spine and orthopaedic surgeon who specializes in minimally invasive surgeries. BEST believes that, with the introduction of modern technology, intensive surgery is no longer the norm. In fact, it can be avoided in most surgical situations. 

If you have been diagnosed with neuropathy as a result of chemotherapy for cancer, seek help today. Although this condition is not reversible, it is manageable. Our excellent surgeons seek to help patients find the most effective, least invasive treatment option to ensure they receive the BEST help.