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Tips for Managing Chemotherapy-Induced Peripheral Neuropathy

CIPN (Chemotherapy-induced peripheral neuropathy) showcases loss of sensations and pains in the hands and feet. This disorder interferes with cancer treatment and tends to further worsen the quality of life of a patient. It is a result of almost all neurotoxic drugs used during chemotherapy. Neuropathy is a pervasive problem and can impact patients affected by any type of cancer.

Why does CIPN occur?

The exact cause of CIPN is still not known, even though scientists have tried to point towards a few pertinent factors. CIPN may occur as a result of one or more of the following factors:

Susceptibility of a patient to CIPN 

Overall genetic makeup

Duration and amount of chemotherapy

The onset and duration of this disorder varies among individuals. While some people are affected by the first dose of chemotherapy, there are others who do not face problems even till late in the treatment. Other than this, there are individuals who experience Chemotherapy-induced peripheral neuropathy even after the completion of chemotherapy.

Management of CIPN

Drugs are the predominant form of managing CIPN right now. Patients are given anticonvulsants, antidepressants, and/or analgesics. A topical numbing drug known as lidocaine is also used for moderate pain, while opioids help to control extreme pain. However, each of the following may have side effects on patients and are also not very effective. 

One of the non pharmaceutical ways of managing CIPN is through Neuromodulation, which means training one’s brain to perform an action different from what it is used to, with the help of stimulation and feedback. Types of neuromodulation are as follows:

Neurofeedback- Behavior is modified by reinforcing positive consequences of the desired behavior. Once the brain realizes it can earn a reward by changing its function in a site, it will repeat the same. 

Scrambler therapy- This therapy prevents damaged nerve information from being sent to the brain, as a result of which the perfection of pain is much lesser than actual. The benefits of this therapy have been found to last for a number of months. 

Repetitive Transcranial Magnetic Stimulation- This has been effective for several chronic pain syndromes, including epilepsy and CIPN. Targeted magnetic pulses send electrical currents to the motor art of the brain for it to change its activity. However, no studies for CIPN have yet been made.   

Physical therapy- This is highly effective for managing the loss of sensation in the limbs. It also helps in regaining strength and in increasing safety. Easy exercises such as swimming can be undertaken. 

Occupational therapy- Patients can regain their motor skills such as using scissors and tying shoelaces with the help of this therapy

Prevention

The most effective tip to prevent the incidence of CIPN is to be completely aware of one’s symptoms and report any kind of concerns to the doctor as soon as possible. A moderate use of Duloxetine has been recommended for prevention, although the drug’s effectiveness hasn’t been proved yet.  The MRC sum score as told by Kleyweg and associates, along with the motor subset of NIS [23,24,28] are the outcome measures for peripheral neuropathy.