Unravel Neuropathy

Like many physicians, neuro-oncologist Lisa Rogers, D.O., is propelled by concern for her patients’ quality of life. And she has a double dose of concern when it comes to patients who experience neuropathy, a side effect of chemotherapy.

“These patients are really uncomfortable,” she says. Symptoms can include pain, tingling, burning or numbness in the hands and feet. Decreased muscle tone and loss of feeling in the feet can cause balance problems and trigger falls.

“We often can’t cure these symptoms, but there’s a lot we can do to help people,” Dr. Rogers says. She notes that certain chemotherapies can cause inflammation or directly damage the nerves.

Common culprit medications include taxanes, vincristine, bortezomib and platinum-based chemotherapies. However, not everyone receiving these drugs will develop neuropathy. Additionally, the duration and severity of neuropathy are unpredictable.

First, the patient’s symptoms are evaluated, and a rating scale is used to grade the neuropathy and the patient’s quality of life, Dr. Rogers says. Electromyography may be done to identify nerve damage in select patients. Specific treatment strategies are then designed for each patient.

Treatments may include oral and topical medications and/or acupuncture to reduce pain. Physical and occupational therapy can strengthen muscles and assist in adjusting to numbness. Following treatment, patients undergo an evaluation to grade the neuropathy and
measure quality of life.

Research into the mechanisms of chemotherapy related to neuropathy is ongoing.

Because the processes by which neuropathy occurs are not fully known, “it is difficult to prevent this complication, but we actively investigate new treatments,” Dr. Rogers says. “I use all available therapies and in different combinations. Integrative therapies, including massage therapy, relaxation therapy, stress management, guided visualization and good nutrition are also being explored.”

“In the future, clinical trials and research will provide greater hope for our patients,” Dr. Rogers says.