Chemo-related nerve pain can be ongoing

A new study has found that neuropathy or nerve pain brought on by chemotherapy can continue for many years after treatment has finished.

The US study, published in the Journal of Clinical Oncology, followed more than 500 female cancer survivors (75% of whom had been treated for breast cancer).

The researchers found that those women who experienced Chemotherapy-Induced Peripheral Neuropathy or CIPN also had worse physical functioning and a significantly higher risk of falls.

Peripheral neuropathy is caused by damage to the nerves that relay signals between the spinal cord and the rest of the body. Those with the condition experience numbness and tingling in the hands and feet and can also experience difficulty with the spatial positioning of their arms and legs.

The lead author, Dr Kerri Winters-Stone says neuropathy can have a significant impact on a cancer survivor’s quality of life.

“One of the most troubling feelings for patients is when they can’t feel their feet. For example, they take a step forward, and can’t feel the curb; it can feel like walking on soft sand,” she says.

“Many cancer survivors are told these chemo-related symptoms will eventually go away, but our study found that’s just not the case.”

The researchers assessed data on 512 women who had enrolled in clinical trials designed to test exercise interventions to prevent falls and fractures after cancer treatment. More than two-thirds of the women had breast cancer, and others had lung, colorectal, ovarian, or blood cancers.

They found:

  • Six years after diagnosis, 47% of women were still experiencing peripheral neuropathy symptoms. 
  • Those with symptoms had significantly poorer physical functioning.
  • Those with symptoms reporter greater difficulty in carrying out everyday activities.

Dr Winters-Stone says altered walking patterns – not muscle weakness – appeared to be the underlying factor among the women in the new study.

She says leg strength (measured by a maximal strength test) did not differ between women with neuropathy and those without.

Dr Winters-Stone says this has implications for how to best target rehabilitation exercise programs.

“Unlike older adults whose falls are often linked to muscle weakness, we may need to use a different approach to fall prevention in cancer survivors with CIPN. Findings from this study give a clue that rehabilitation should be focused on mobility during walking and tasks of daily living,” she says.

Dr Winters-Stone says their study only focused on women, but stressed that men may face similar long-term risks because they are as likely as women to experience chemotherapy-induced neuropathy symptoms. 

BCAC chairperson, Libby Burgess, says it’s always valuable to learn more about the potential long-term side-effects of treatment.

She says those who have finished breast cancer treatment but continue to suffer from peripheral neuropathy should discuss physical rehabilitation options with their doctor.

30 June 2017

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