Peripheral Neuropathy After Childhood Cancer


Some chemotherapy drugs can cause damage to the nerves outside the brain or spinal cord, called peripheral neuropathy. This damage makes the hands or feet hurt, tingle, and feel weak or numb. Here's what you need to know to help manage peripheral neuropathy.

Am I at Risk?

The following chemotherapy drugs increase risk for peripheral neuropathy, especially if you received them in higher doses or if you were treated with more than one of them:

  • vincristine,
  • vinblastine,
  • cisplatin, and
  • carboplatin.
  • Other factors that increase risk include:
    • surgery,
    • sudden and rapid weight loss,
    • diabetes, and
    • prior nerve disease.
    • Pressure on nerves over time from artificial limbs, wheelchairs, or crutches can also add to nerve damage.

What Are the Symptoms?

Most often, symptoms of peripheral neuropathy start during cancer treatment. Once treatment is over, symptoms may get better. But some survivors have them for months or years.

Symptoms include:

  • burning, tingling, or prickling feeling usually in the hands or feet
  • numbness or sensitivity to pain or temperature
  • extreme sensitivity to touch
  • sharp shooting pain
  • poor balance or coordination
  • loss of reflexes
  • muscle weakness
  • noticeable changes in the way you walk

Muscle weakness may begin around the arch of the foot and in the palm of the hand. It may be hard to grip things or perform tasks like writing, buttoning clothes, or tying shoes. You also may tend to drag your feet or lift them high to keep them from dragging.

What If I Have Peripheral Neuropathy?

The goal of treatment is to help manage symptoms because none can cure or reverse nerve damage.

Rehabilitation Services;

Physical therapy employs exercises to help you improve strength, balance, and coordination. Occupational therapy helps improve hand/eye coordination and other skills needed for daily life.

Orthotic Devices 

Orthotic devices can improve support for feet or ankles. Arch supports or splints help keep your arch from flattening and can improve walking. Splints called ankle-foot-orthoses may be suggested to prevent the ankle from moving too much from side to side and to support the foot when walking.

Pain Management 

Your doctor may prescribe medicine to control pain, tingling, and burning. Elastic stockings, warm packs, or exercise may also help with discomfort, as well as helping to improve your ability to move around on your own.

Other tips to manage discomfort include:

Avoid shoes that are too tight or too loose. Both can worsen pain and may not provide enough support. Instead, wear sneakers or shoes that fit well, provide support, and are flexible.

Be sensitive to temperature. Many people report that neuropathy feels worse in hot weather or when their feet are heavily covered.

Keep feet uncovered in bed. Friction between your toes and bed sheets can cause discomfort.

Use massage. Massaging your hands and feet, or having someone else massage them, can be very soothing and relaxing. It can increase blood flow and boost the body’s chemicals that help control pain (endorphins).

Try cool soaks. Soaking painful hands and feet in cool water can sometimes relieve pain enough to let you fall asleep or to wait until pain medicine starts to work.

Where Can I Find More Information?

You can find more information about peripheral neuropathy from the Neuropathy Association (www.neuropathy.org).

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