Navigating Chemotherapy: A Side Effect You Need To Know About

Having endured breast cancer and chemotherapy treatment, one patient reflected on the numbing experience of undergoing treatment. When she learned that chemotherapy was necessary for her recovery, she recalled- “I was given a notebook, and I didn't look over it because I was too overwhelmed. But I knew I had to start chemo right away.”  For many cancer patients, this sense of being overwhelmed by a long list of side effects is all too familiar. One shockingly common condition affects more chemotherapy patients than expected.

Chemotherapy is a cancer treatment where a powerful, cancer-fighting chemical is introduced intravenously (medicine enters the body through a vein). The vein carries the toxic drug throughout the body, which in turn weakens and kills the cancer cells. But, after lengthy chemo treatments, the chemical can begin to damage the peripheral nerves as the drug moves to the hands and feet, resulting in a condition called Chemotherapy-Induced Peripheral Neuropathy, or CIPN for short. The term neuropathy derives from the Greek roots neuro and pathy, meaning nerve and suffering.

CIPN symptoms often start out subtle and mild, but it’s crucial to pay attention to even slight signs throughout chemotherapy treatment, since ongoing therapy after symptoms are present can lead to progressively worsening symptoms - even manifesting well after the chemotherapy treatment has ended. CIPN encompasses a wide range of both sensory and motor symptoms, including: numbing, tingling, intense cold sensitivity, unstable balance, altered touch perception and muscle weakness, cramping, impaired fine motor control, and foot drop. Although symptoms may start out as minor inconveniences, they often escalate into debilitating complications - to the point where patients can no longer go about their everyday tasks.

Each year, around 1,900,000 people are diagnosed with cancer in The United States, and 53% (or 1 million) require chemotherapy. Of that group, 68% are given chemo drugs that can cause CIPN. Upwards of 70% of those patients will develop symptoms of CIPN in the first month of chemo treatment. Though symptoms often diminish over time, approximately 30% of patients continue to experience symptoms six months post treatment. That makes an estimated 500,000 new cases of CIPN in the U.S. each year. Those taking platinum compounds (cisplatin, oxaliplatin), taxanes (paclitaxel, docetaxel), vinca alkaloids, and bortezomib, are at risk of CIPN. Once diagnosed, it's uncertain whether the symptoms will subside after chemo treatment or continue well after treatment is over. In most cases, symptoms will gradually improve, yet persistent pain and numbness extending beyond four months often results in chronic and potentially irreversible neuropathy.

In summary, CIPN is a common side effect that affects many chemotherapy patients. Symptoms occur in the hands and feet and it is important to look out for slight symptoms and report them to your oncologist promptly, as prolonged exposure to chemo after symptoms start can cause chronic pain and discomfort that could potentially last a lifetime.