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• • neuropathy from paclitaxel appears in some patients after the first dose and tends to increase with prolonged treatment
  • sensory loss from docetaxel occurs in up to 50% of patients.
  • docetaxel is not as neurotoxic as paclitaxel and patients may experience spontaneous recovery when treatment is discontinued
  • in general, patients may experience improvement in symptoms from neuropathy over a long period of time
  • when combined with platinum-based drugs, a high percentage of patients develop sensorimotor neuropathy.

• Platinum-based drugs (e.g., cisplatin, oxaliplatin, or carboplatin)

  • highly associated with small fiber sensory neuropathy (numbness, paresthesia)
  • large fiber nerves may be affected
  • up to 60% of patients receiving platinum-based medications suffer from peripheral neuropathy
  • oxaliplatin is associated with dysesthesia caused by contact with anything cold and muscle contractions
  • symptoms may persist or progress for several months beyond the treatment period
  • the neuropathic side effects of these drugs can be a factor in limiting the dosage given for treatment

• Interferons - these drugs boost the immune system and are used to treat certain types of cancers. Interferons have been reported to cause peripheral neuropathy in some patients.

• Thalidomide - this drug causes neuropathy which results in sensory more than motor neuropathy. Its effects on the nervous system are long lasting and while some patients recover slowly, others do not recover at all.

Other neuropathic symptoms associated with cancer chemotherapy include:

• Burning
• Painful numbness
• Allodynia (pain due to a stimulus which does not usually cause pain, e.g., light touch)
• Acroparesthesia (tingling/numbness in legs); this is often the earliest and most persistent symptom.
• Muscle weakness
• Hypoflexia (diminished muscle reflexes)

• Autonomic symptoms such as:

  • postural hypotension - drop of blood pressure with postural or positional change; it is one of the most common manifestations of autonomic involvement
  • cardiac irregularities
  • bladder/bowel dysfunction

Recovering from chemotherapy-related peripheral neuropathy can be very slow and sometimes symptoms may be even more intense during the recovery period. Regenerating nerves can cause cramping and paresthesia that are severe and significantly interfere with daily activities. Patients who had previous neuropathy are at highest risk for developing chemotherapy-related peripheral neuropathy. As cancer treatment evolves with the use of higher doses of drugs and combinations of increasingly potent drugs, the number of cases of chemotherapy-related peripheral neuropathy is expected to increase.

To read more about chemotherapy-related peripheral neuropathy, please click on the following link: http://www.medifocus.com/abstracts.php?gid=NR021&ID=18367040