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Chemo induced Peripheral Neuropathy

Buzzard
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I have had 4 cycles of chemo with the use of a platinum based drug. Immediately following the infusion I experienced sensitivity to touch and cold in my hands, feet, legs, and face. The last cycle finished on 15th June 2023 and I felt well, with no symptoms of nerve damage. Six weeks after this date, my hands and feet started to feel numb. These symptoms have progressed into electric shock type sensations on reaching out, or with everyday movements of the hands and feet.

All blood tests to rule out other causes have come back negative.

My questions iare as follows : Why has the neuropathy been delayed for 6 weeks? Is this normal, or does it mean that I will have the CIPN for a longer period? What are the stats for full recovery from this debilitating problem?

  • Hello Buzzard

    Thanks for getting in touch. My name is Helen, I’m one of the Cancer Information Nurses on the Macmillan Support Line.

    Welcome to the online community.

    I was sorry to read how debilitating the chemotherapy-induced peripheral neuropathy (CIPN) has been for you.

    You mentioned the symptoms appeared after stopping the treatment; this is called coasting. Either an accumulation of doses or a delay in the impact on the peripheral nerves results in symptoms of numbness accompanied by sharp electric shock-type pain developing weeks or even months after completing treatment.

    Commonly, patients have increasing symptoms during treatment, which allows the clinician to consider reducing the dose to inhibit further side-effects, but sometimes the situation is as you describe, which makes limiting further damage difficult.    

    The evidence seems to show that different platinum-based chemotherapies have different toxicities. Of the three most often used: carboplatin, oxaliplatin and cisplatin, it is cisplatin that has the greatest effect on the peripheral nerves.  

    There is research currently looking into the mechanism for CIPN as well as preventive measures, but although I looked through the research papers, I couldn’t find evidence that suffering from peripheral neuropathy as a late-onset side effect made the recovery longer or slower.

    Most people find that their symptoms gradually improve with time as the nerves slowly recover. This may take several months or more.

    Unfortunately for some people, the nerve damage will be permanent. In this situation, however, many people find that their symptoms become less troublesome over time, as they adapt and find ways of coping with the changes.

    As well as the information on managing the symptoms outlined in the link above, you may be interested to know that the European Society for Medical Oncology (ESMO) guidelines suggest a drug called duloxetine (Cymbalta). It has shown to be beneficial in reducing the symptoms of peripheral neuropathy. You might consider speaking to your GP about this.

    Also, do discuss your symptoms with your hospital cancer team as there may be support treatments they can offer such as physiotherapy.

    I hope this information is useful. Please don’t hesitate to get back in contact by email, webchat or phone, if you need further information or support.

    The Macmillan Support Line offers practical, clinical, financial and emotional support. You can call us free from landlines and from most mobile phone networks on 0808 808 00 00, 7 days a week, 8am – 8pm.

     

    Best wishes, Helen

    Cancer Information Nurse Specialist 

     

    Ref HM/AM

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