Chemotherapy Induced Peripheral Neuropathy (CIPN)
Peripheral neuropathy is a set of symptoms caused by damage to the nerves that are away from the brain and spinal cord. These distant nerves are called peripheral nerves. They carry sensations (feeling) to the brain and control the movement of our arms and legs. They also control the bladder and bowel. Some of the chemotherapy and other drugs used to treat cancer can damage peripheral nerves. When this happens it is called chemotherapy-induced peripheral neuropathy (CIPN). This can be a disabling side effect of cancer treatment.
The symptoms of chemotherapy induced peripheral neuropathy depend on the type of chemotherapy and which nerve fibers are affected.
Pain (which may be there all the time or come and go, like shooting or stabbing pain)
Tingling (“pins and needles” feeling) or electric/shock-like pain
Loss of feeling (which can be numbness or just less ability to sense pressure, touch, heat, or cold)
Trouble using your fingers to pick up or hold things; dropping things
Trouble with tripping or stumbling while walking
Being more sensitive to cold or heat
Being more sensitive to touch or pressure
Trouble passing urine
Blood pressure changes
Decreased or no reflexes
CIPN can cause severe pain and can affect your ability to do things like walk, write, button your shirt, or pick up coins. If it gets very bad, it can cause more serious problems like changes in your heart rate and blood pressure, dangerous falls, trouble breathing, paralysis, or organ failure.
What you can do to help with your CIPN
Avoid things that seem to make your CIPN worse, such as hot or cold temperatures, or snug clothes or shoes.
Give yourself extra time to do things. Ask friends for help with tasks you find hard to do.
Don’t drink alcohol. It can cause nerve damage on its own, and might make CIPN worse.
If you have diabetes, control your blood sugar. High blood sugar levels can damage nerves.
If you have neuropathy in your hands, be very careful when using knives, scissors, box cutters, and other sharp objects. Use them only when you can give your full attention to your task.
Protect your hands by wearing gloves when you clean, work outdoors, or do repairs.
If the neuropathy is in your feet, sit down as much as possible, even while brushing your teeth or cooking.
Take care of your feet. Look at them once a day to see if you have any injuries or open sores. Always wear shoes that cover your whole foot when walking, even at home. Talk to your doctor about shoes or special inserts that can help protect your feet.
Be sure that you have ways to support yourself if you have problems with stumbling while walking. Hand rails in hallways and bathrooms may help you keep your balance. A walker or cane can give you extra support.
Use night lights or flashlights when getting up in the dark.
Protect yourself from heat injuries. Set hot water heaters between 105° to 120°F to reduce scalding risk while washing your hands. Use oven gloves and hot pads when handling hot dishes, racks, or pans. Check bath water with a thermometer.
Keep your hands and feet warm and well covered in cold weather. For example, consider keeping a pair of gloves in your car. Avoid extreme temperatures.
If constipation is a problem, follow your doctor’s recommendations about laxatives and exercise. Drink plenty of water and eat fruits, vegetables, and whole grains to get enough fiber.
Neurofeedback for CIPN
Certain types of brain waves are associated with pain. Intense pain is linked with increased beta brain wave activity and decreased alpha wave activity, while strong pain relief has been associated with the opposite. By reducing the perception of pain in the brain, chronic pain can be reduced provided there is not a continuing injury. Neurofeedback training for chronic pain involves enhancing alpha wave activity, decreasing beta activity and altering other brain wave patterns associated with pain and relief. The training is used to treat arthritis, back pain, cancer-related pain, complex regional plan, fibromyalgia, muscle pain, migraine headaches and trigeminal neuralgia.
Study of the Efficacy of Neurofeedback Training on Chemotherapy-Induced Neuropathy Receives 2018 FNAN Award
In the study that received this year’s award, cancer survivors at the University of Texas’ MD Anderson Cancer Center – mostly female, with a mean age of 62.5 years, and at least a grade three neuropathy rating - were randomly divided into two groups: 30 individuals who received neurofeedback training and 32 individuals who served as a wait-list control. Pre and post measures for both groups included the Brief Pain Inventory (BPI) measure and other secondary measures of pain severity. Quantitative electroencephalogram (qEEG) data was also collected. Each patient in the neurofeedback group received twenty sessions of training based on their own qEEG pattern. One hundred percent of the participants completed the program. After treatment, the neurofeedback group showed significantly greater improvement than controls in their BPI worst-pain item (on a 10-point scale, 2.43 for neurofeedback versus 0.09 for controls). Similar improvements were also seen in the secondary measures.