Treatment Side Effects - Neuropathy

Some people receiving treatment for blood cancer experience peripheral neuropathy, a type of damage to the nerves. The peripheral nerves carry information from the brain to parts of the body and from those parts of the body back to the brain. Some types of chemotherapy can cause peripheral neuropathy as a side effect. The effects of peripheral neuropathy can vary, depending on which nerves are affected: the sensory, motor, or autonomic nerves.¹

Damage to the sensory nerves

The sensory nerves detect pain, heat, cold and pressure. Patients experiencing peripheral neuropathy to sensory nerves may have symptoms of:

• Tingling or numbness in hands, arms, feet, and/or legs, sometimes called "pins and needles" sensations
• Difficulty detecting heat or cold
• Inability to feel pain in the extremities
• Shooting pains or a burning feeling, especially in the fingers or toes
• Hearing loss^1,2

Damage to the motor nerves

Motor nerves communicate to the muscles to regulate movement. Patients with peripheral neuropathy to motor nerves may experience:

• Weakness
• Achy muscles
• Loss of balance
• Difficulty walking
• Frequent tripping or falling
• Difficulty with fine motor skills, like using buttons or picking up small objects
• Muscle twitching or cramping
• Muscle wasting
• Difficulty swallowing or breathing (if the chest or throat muscles are affected)^1,2

Damage to the autonomic nerves

Autonomic nerves control bodily functions like heart rate, temperature, digestion, blood pressure, and urination. Patients who have peripheral neuropathy that affects autonomic nerves may experience:

• Low blood pressure, causing dizziness or faint feelings
• Digestion issues, like constipation or diarrhea
• Sexual difficulties
• Sweating too much or too little
• Trouble with urination, like leaking or difficulty emptying the bladder^1,2

Managing peripheral neuropathy

Any patient who experiences peripheral neuropathy during treatment for blood cancer should report it to their doctor. Early treatment is the best way to help limit the damage, reduce pain and control these symptoms.¹

Treating peripheral neuropathy will depend on what is causing it, as it may be caused by other conditions (like diabetes or rheumatoid arthritis) or other medications. If the neuropathy is related to chemotherapy, doctors may reduce the dosage or change the chemotherapy agents. For pain associated with neuropathy, patients may be prescribed pain medications.^1,2

In addition to medication, lifestyle strategies to manage peripheral neuropathy include:

• Getting regular exercise to maintain circulation (check with your doctor if you have an exercise restriction)
• If the neuropathy is caused by diabetes, managing the diabetes with proper diet and medication to control blood sugar
• Limiting alcohol use
• Protecting your hands and feet from injury, wearing shoes and using caution with sharp utensils
• Avoiding using heating pads and hot water bottles
• Preventing falls by removing throw rugs and using bathmats in showers or tubs
• Trying complementary approaches like acupuncture, massage, physical therapy, or yoga^1,2

Because peripheral neuropathy is caused by damage to the nerves, it is difficult to predict how long symptoms will last. Some people may experience partial recovery, while others may have continued symptoms.²