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Every month, featured experts answer your questions about coping with cancer including specific answers to questions asked by caregivers.
For Any Cancer Diagnosis
I've heard recently about this condition - what is neuropathy?A.
Neuropathy, also called peripheral neuropathy, is a term that describes the special kind of pain and discomfort caused by nerve damage. It is typically characterized by a feeling of weakness, numbness, tingling, or burning in the hands and feet. It can result from a number of different medical issues including infection, diabetes, kidney disease, and traumatic injury. Peripheral neuropathy can also be a common side effect of certain chemotherapy treatments, and can develop after surgery (especially for breast or lung cancer).
If you have concerns that you or a loved may be experiencing symptoms of neuropathy, be sure to discuss the issue with your health care team as there are treatments available to help control the symptoms. A typical treatment regimen may include over-the-counter or prescription medications. Your doctors can work with you to find the best treatment or combination of treatments to manage your discomfort.
For additional information, CancerCare offers many resources about neuropathy.
You can also find information through The Neuropathy Association.
Any tips for dealing with neuropathy in cold weather?A.
Cold weather poses special challenges for people affected by neuropathy. Prolonged exposure to the cold causes the body to slow blood circulation to the hands and feet in an effort to preserve the body’s core temperature. The reduced blood flow can intensify neuropathy symptoms and potentially cause further damage to already affected peripheral nerves. This is of special concern to those who experience their neuropathy pain as a numbness or tingling sensation. Their ability to measure the effects of the cold is compromised since they already experience those physical warning signals that would otherwise indicate a need to get to warmer conditions.
Tips to lessen the pain and lower your risk of further nerve damage:
- Wear warm, dry clothing in cold weather.
- Protect your hands and feet by wearing thick socks, thick mittens or gloves.
- Take intermittent breaks from the cold to reduce your exposure to extreme temperatures.
- Limit or avoid caffeine before an outing as it can temporarily cause blood vessels to narrow.
- Do not smoke as cigarette smoke can slow circulation.
- Limit alcohol use since excessive consumption can lead to vitamin deficiency which can, in turn, damage peripheral nerves.
- Incorporate exercise into your routine to improve overall circulation.
- Explore comfort measures like massage or use of flexible splints for support.
The information I’ve shared above is meant to be helpful and educational, but is not a substitute for medical advice. Please be sure to consult with your health care team for personalized advice and guidance.
For more information about neuropathy, please view all CancerCare’s neuropathy resources.
I stopped cancer treatment some time ago and am still struggling with neuropathy. How long does neuropathy usually last? What treatments might I pursue?A.
Many cancer survivors experience post-treatment neuropathy. For some, the symptoms may lessen gradually over a period of weeks or months. For others, the symptoms may persist or even become chronic. It is difficult to provide a typical timeline of symptoms, because there is so much variation from case to case. Many factors impact the degree to which someone experiences neuropathy including:
- the type of chemotherapy drug or combination of drugs used
- the chemotherapy dosage
- the overall length of the treatment regimen.
In addition, each person responds differently to chemotherapy.
It’s important to seek out a consultation with an experienced neurologist if you are experiencing neuropathy. Fortunately, there are a number of treatments available to help manage the chronic pain and discomfort caused by neuropathy. For mild symptoms, over-the-counter pain relievers like Tylenol or Motrin may be adequate. For more severe symptoms, your doctor may prescribe stronger pain medication; anti-convulsant medication to help calm the nerves and central nervous system; or antidepressants to decrease the chemicals in the brain that transmit pain signals. Physical therapy may improve balance and strength while occupational therapy may improve the fine motor skills used in tasks like writing or buttoning a shirt. Alternative treatments such as biofeedback, acupuncture, or transcutaneous nerve stimulation (TENS) are also available. Your health care team can work with you to determine the best treatment or combination of treatments to address your situation.
Since other health issues may cause or further aggravate nerve damage, it is important to consult regularly with your medical team. Other underlying medical conditions can contribute to your symptoms. Diabetes, autoimmune disorders, kidney disease, or physical trauma are just a few of the other common causes of neuropathy. Your health care team should conduct a thorough assessment of your risk to determine whether other kinds of interventions would be helpful for you.
It’s also a good idea to keep track of your neuropathy symptoms, so that you can provide detailed reports about your symptoms to your health care team.
I'm having several lymph nodes removed from under the arm—what can I expect?A.
Lymph nodes are small, bean-shaped masses of tissue that are located in clusters throughout the body, including in the armpit. Lymph nodes play a crucial role in helping to fight infection; they filter and trap bacteria, viruses, and other unwanted substances in the body, so that special white blood cells (called lymphocytes) can then destroy them.
When treating cancer, doctors sometimes choose to remove and biopsy nearby lymph nodes to learn whether any of the nodes contain cancer cells. This information helps determine whether the cancer has spread to other parts of the body, a process known as “staging.” This information also helps the health care team decide on an appropriate and tailored treatment plan.
As with any surgical procedure, there might be side effects. You may sustain some degree of nerve damage during the procedure, resulting in tingling, numbness, or weakness in your arm. These neuropathy symptoms can be mild or more severe, depending on the extent of nerve involvement. You may experience swelling in the arm due to a build-up of lymph fluid that is no longer draining effectively through the remaining lymph nodes; this condition is called lymphedema. You may experience a temporary inflammation of blood vessels in your armpit as well as a higher potential for blood clotting and infection at the biopsy site.
If your health care team has recommended this procedure for you, it is likely because they feel that the benefits outweigh any of these potential risks. Nevertheless, it is always a good idea to have a frank discussion with your surgeon about possible side effects and any preventive measures you can take to lower your risk of experiencing them.
For more information about lymphedema, please visit The National Lymphedema Network.
To learn more about lymph node removal surgery, please visit The National Cancer Institute.
For Colorectal Cancer
After two surgical operations on my rectum and colon and receiving chemotherapy, I have numbness and reduced sensitivity in my fingers and feet. My doctors suggested Gabapentin, but it gave me problems with my sense of balance. Is there anything else I can do to lessen these symptoms?A.
The numbness and reduced sensitivity in your fingers and feet is called peripheral neuropathy, which is nerve damage that often results from certain chemotherapy treatments (e.g., oxaliplatin). It is sometimes referred to as the “glove and stocking sensation,” as it feels similar to wearing gloves or thick stockings on your hands or feet.
Certain medications can reduce the pain and annoying physical sensations that accompany neuropathy while the nerves repair themselves. Gabapentin relieves the pain of neuropathy by changing the way your body senses pain. It is meant to control your condition but will not cure it. Fortunately, there are several other types of medications for neuropathy, including anticonvulsants, antidepressants, local anesthetics, and opioids, that can be taken individually or in combination. Work with your doctor to find the right approach for you. Keep in mind that it can take one to two years or more for symptoms to go away completely.
Here are some tips that may help you manage and cope with the symptoms of peripheral neuropathy:
- Avoid drinking alcohol, which can damage nerves.
- Wear sneakers or shoes with “rocker bottoms” that allow the feet to roll while walking, provide better traction and can relieve some of the pressure on the soles.
- Remove throw rugs from your home to reduce the chance of slipping and falling.
- Rather than stand, sit down while doing activities such as drying your hair, applying makeup or preparing food.
- Use hand tools, kitchen utensils, and even toothbrushes and pens with wider grips, to make them easier to hold.
- If you have diabetes, manage your blood sugar level very carefully, as high levels can have a negative impact on nerves.
- Join a support group to learn how others lived with, and overcome, the challenges of neuropathy.
- Consult a psychiatrist, physical therapist, or occupational therapist who can provide guidance tailored to your specific circumstances.
- CancerCare has several resources to help you learn more about living with neuropathy. Listen to our Connect Education Workshop podcast, Understanding Peripheral Neuropathy.
For additional help and support, visit the The Neuropathy Association’s website.
The Foundation for Peripheral Neuropathy