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Nerve Damage

Cancer and cancer treatment can sometimes result in nerve damage. Damage to the long nerves is called “peripheral neuropathy.” 

Peripheral neuropathy usually causes pain, numbness or tingling in the fingers and toes, but can progress up the limbs to involve the feet and legs, hands and arms.  

Some chemotherapy drugs are associated with nerve damage. These include cisplatin, oxaliplatin, paclitaxel, and vincristine.

Peripheral nerves can heal, so damage from peripheral neuropathy may not be permanent. 

Nerve Damage - Patient Handout

Peripheral neuropathy is nerve damage that affects the long nerves that go from the brain to the arms, hands, fingers, legs, feet and toes.  

These long (peripheral) nerves give us the ability to feel pain, touch, temperatures, position, and vibration (Sensory Nerves). They are also used for movement, muscle tone, and coordination (Motor Nerves).

Peripheral neuropathy most often affects arms, hands, fingers, legs, feet and toes.

When sensory nerves are damaged, symptoms may include: 

  • Feelings of tingling, “pins and needles,” cold, pinching, burning, or electric shocks (paresthesia) 
  • Feeling an unpleasant sensation when touching or being touched (dysesthesia) 
  • Numbness or decreased feeling (anesthesia) 
  • A sense that you can’t feel the floor under your feet or the shape of an object in your hand 
  • Trouble with feeling the difference between hot or cold temperatures 
  • Slipping out of your shoes if they are untied or if they don’t come up over the instep of your foot 
Symptoms when motor nerves are damaged may include:

  • Problems with balance, tripping, or falling
  • Trouble buttoning your shirt or tying your shoes, and trouble picking-up and holding objects
  • Problems doing tasks that need muscle strength and coordination
Other nerve-related symptoms can include dizziness, lightheadedness, loss of balance and clumsiness. 

If you have severe numbness you may not feel a new wound in your hands or feet. If wounds are not found early, they can lead to bad infections.

Some describe peripheral neuropathy as having a “Stocking and Glove Pattern”, where the numbness and tingling does not go above your wrist (the glove part) or over your ankle (the stocking part).

Symptoms may go away over time once chemotherapy has stopped. Yet as nerves heal, there may be an increase in symptoms. 

Before you start chemotherapy with drugs that might cause peripheral neuropathy, your doctor or nurse will ask questions to find out if you already have any symptoms of peripheral neuropathy. In people who have symptoms before chemotherapy, peripheral neuropathy might start sooner or be more severe.

 

Other causes of peripheral neuropathy are: diabetes, cancer, alcohol abuse, kidney disease, liver disease, vitamin deficiency, AIDS, hypothyroidism, rheumatoid arthritis, atherosclerosis (hardening of the arteries), and carpal tunnel syndrome.  It may also be passed down through your family.

 

Tell your health care team about any medications you are taking now or that you have taken regularly in the past. Include prescription and over-the-counter medications, as well as herbal supplements and vitamins.

 

Medical therapies may improve your symptoms. For example:

 

  • Medications may help ease pain
  • Physiotherapy can help with exercise programs and assistive tools
  • Occupational therapists can help you with footwear suggestions and finding useful tools to help with  activities
  • Podiatrists can help care for your feet

Do not take any medications or herbal supplements to help your peripheral neuropathy symptoms unless prescribed by your doctor.

 

Tell your doctor or nurse if you feel any nerve or muscle symptoms.  Treating pain early is more likely to be successful than waiting until it is severe. 

Daily life

  • Take care of your feet: wear loose cotton socks and protective shoes with good support. Check your skin daily to look for any cuts or bruises. 
  • Exercise: walking and stretching help keep your muscles flexible. If you exercise in a gym, tell the staff that you have peripheral neuropathy, as it may increase your risk of injuring yourself during exercises.
  • Massage your feet and hands: this may help ease stiffness (be careful to wash off slippery oils or lotions).
  • Take care of your nerves: skip alcohol or any other drugs that might make you unsteady.
  • Avoid sudden movements and take time when getting up from sitting.
  • Use helpful tools: special pens, pencils, knives and forks can be easier to hold. Special tools (e.g. zipper pulls, buttoners and stretchy shoe laces) can help you get dressed. 
  • If you have diabetes, keep up good control of your sugar levels. 

Safety

Safety is important for people with peripheral neuropathy due to the lack of feeling, impaired strength or muscle control. You may be at risk for falls. 

If you drive, talk with your health care team. You may have trouble lifting your foot from the gas pedal to the brake when you are driving.

Follow these helpful safety hints for your home: 

  • Have well-lit spaces, such as having a night light to light the way to the bathroom.
  • Make sure there are handrails on both sides of all stairways, and keep stairways clear of objects. 
  • Tape or tack down carpet edges securely. 
  • In the bathroom use non-skid strips or mats in the tub or shower.
  • Check the temperature of the water with a part of your body that has normal sensation, to avoid scalding yourself.
  • In the kitchen use lightweight and non-breakable glass, knives and forks, and plates. Hold mugs by the handle and not the cup, and wear rubber gloves when washing dishes. 
  • Remove furniture that has sharp edges or corners, and no not use furniture with wheels. 
  • In your yard or garage, store tools off the floor and avoid using motorized equipment such as electric saws or drills.
Call your doctor if you have any symptoms of peripheral neuropathy or if existing peripheral neuropathy is getting worse or spreading. 

Recommended websites: Nerve Damage Websites


Symptom management guidelines: Peripheral Neuropathy


Education and information for patients and health care professionals at The Foundation for Peripheral Neuropathy

A-Z list of cancer drugs from the National Cancer Institute 

 

Revised Jul 2015

 

Recommended websites: Nerve Damage Websites

Symptom management guidelines: Peripheral Neuropathy

Education and information for patients and health care professionals at The Foundation for Peripheral Neuropathy

A-Z list of cancer drugs from the National Cancer Institute 

 
SOURCE: Nerve Damage ( )
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