Peripheral Neuropathy and Cancer Treatment

Some cancer treatments cause peripheral neuropathy. This is the result of damage to the peripheral nerves—the nerves that carry information from the brain to other parts of the body.

The side effects you feel depend on which nerves are affected. There are three kinds of peripheral nerves: sensory nerves, motor nerves, and autonomic nerves. Each kind does a different job, so damage to each kind causes different problems.

Sensory nerves help you feel pain, heat, cold, and pressure. When these nerves are damaged, you may notice:

• Tingling, numbness, or a pins-and-needles feeling in your feet and hands. This feeling may spread to your legs and arms.
• Not being able to feel hot or cold, such as a hot stove.
• Not being able to feel pain, such as from a cut or sore on your foot.

This is why many people first notice neuropathy as strange feelings in their hands and feet. It's also why extra care matters: if you can't feel heat or pain the way you used to, it's easier to get burned or to miss an injury.

Motor nerves help your muscles move. Damage to these nerves can cause:

• Weak or achy muscles. This may cause you to lose your balance, trip easily, or have difficulty with small tasks like buttoning shirts or opening jars.
• Muscles that twitch and cramp, or muscle wasting if you don't use your muscles regularly.
• Swallowing or breathing difficulties, if the muscles of your chest or throat are affected.

Autonomic nerves control functions your body handles on its own, such as blood pressure, digestion, heart rate, temperature, and urination. Damage to these nerves can cause:

• Digestive changes, such as constipation or diarrhea
• Feeling dizzy or faint, due to low blood pressure
• Sexual problems—men may be unable to get an erection, and women may not reach orgasm
• Sweating problems, either too much or too little
• Urination problems, such as leaking urine or difficulty emptying your bladder

If you start to notice any of these problems, talk with your doctor or nurse. Getting nerve problems diagnosed and treated early is the best way to control them, prevent further damage, and reduce pain and other complications.

NCI lists steps you may be advised to take to prevent or manage problems related to nerve changes. Discuss with your care team which steps make sense for you:

• Prevent falls. Have someone help you prevent falls around the house. Move rugs out of your path so you won't trip on them. Put rails on the walls and in the bathroom so you can hold on and balance yourself. Put bathmats in the shower or tub. Wear sturdy shoes with soft soles. Get up slowly after sitting or lying down, especially if you feel dizzy.
• Take extra care in the kitchen and shower. Use potholders to protect your hands from burns. Be careful when handling knives or sharp objects. Ask someone to check the water temperature to make sure it's not too hot.
• Protect your hands and feet. Wear shoes both inside and outside. Check your arms, legs, and feet for cuts or scratches every day. When it's cold, wear warm clothes to protect your hands and feet.
• Ask for help and slow down. Let people help you with difficult tasks. Give yourself more time to do things.

You may be prescribed pain medicine for nerve-related pain. Sometimes integrative medicine practices—such as acupuncture, massage, physical therapy, and yoga—may also be advised to lower pain. Talk with your health care team to learn what is advised for you.

One more helpful habit: prepare for your visits by making a list of questions to ask. Knowing what to watch for, and which problems to call about, can help you and your team catch nerve changes early.

• Call 911 or go to an emergency department if you struggle to breathe, or swallowing stops working properly. NCI links both to damage in the motor nerves that supply the chest and throat muscles.
• Call 911 or go to an emergency department if weakness or numbness in both legs comes on over hours or days, or arrives with new trouble holding urine or stool, or numbness around the groin and inner thighs. That pattern is not ordinary treatment neuropathy — pressure on the spinal cord can cause it, and the window to protect the nerves is short.
• Call your care team the same day if you find a burn, cut, or sore on a hand or foot that you never felt happen, or if you faint or come close to it when you stand up. Low blood pressure from autonomic nerve damage is one cause of that dizziness.
• Call your care team within a day or two if tingling or numbness spreads gradually along your limbs, small jobs like buttons and jar lids become difficult, your balance is going, or your bladder or bowels change slowly over weeks. NCI's point is that getting nerve problems diagnosed early is the best way to limit them.