Life After Cancer: Peripheral Neuropathy

The peripheral nervous system is the term for all the nerves outside the brain and spinal cord (central nervous system or CNS). The peripheral nerves carry information back and forth between the CNS and the rest of the body. Peripheral neuropathy means damage to these nerves. It's a common problem caused by cancer treatment. Peripheral neuropathy can cause pain, numbness, tingling, and other problems around the body.

Peripheral neuropathy may last for only a short time after cancer treatment. Or it can get better as nerves heal over time. For some people, it can last months or years. It can depend on how much chemotherapy you had and the type you had. It can also depend on where the tumor was, and the type of radiation or surgery that was done. It can also depend on whether you have certain other health conditions such as diabetes or thyroid problems. It also matters if you have family members with peripheral neuropathy. Long-term peripheral neuropathy needs to be managed.

What causes peripheral neuropathy after cancer?

Sometimes tumors press on and damage nerves. Surgery or radiation therapy may cause nerve damage that leads to peripheral neuropathy. But the most common cause is chemotherapy. Many kinds of chemo medicines can cause damage nerves, especially at high doses. Ask your healthcare team if the chemo medicines you took affect your risk of peripheral neuropathy.                                    

Symptoms of peripheral neuropathy after cancer

The symptoms can vary depending on which nerves are damaged. The most common symptoms include:

  • Tingling

  • Prickly pain

  • Sharp, stabbing pain

  • Burning feeling

  • Numbness

  • Weakness

  • Changes in organ function. For example, you may have constipation if the nerves that control your bowels were damaged.

Symptoms often start in your fingers and toes and then move into your hands and feet. They may then move up into your ankles, legs, and arms. The symptoms may feel worse when you touch something, or wear gloves or shoes.

Over time, other symptoms may include:

  • More sensitivity to cold, heat, and touch

  • Trouble sensing heat and cold

  • Tingling, burning, or both, or even pain

  • Trouble using your fingers, such as problems texting or buttoning a shirt

  • Arms and leg that feel heavy or weak

  • Tripping, stumbling, or balance problems

  • Numbness that makes it hard to tell if you are hurt

  • Trouble swallowing

  • Trouble urinating

  • Slow bowels

  • Muscle weakness

  • Low blood pressure

  • Trouble walking

  • Constipation

  • Trouble breathing

  • Sexual problems

Treatment for peripheral neuropathy

Peripheral neuropathy can't be cured, but treatment is done to help relieve pain. Treatment may include medicines that can lessen nerve pain, such as:

  • Medicine in a patch or cream to put on your skin

  • Antidepressant medicine

  • Anti-seizure medicine

  • Opioid medicine such as codeine or morphine for severe pain

Other kinds of treatment include:

  • Transcutaneous electric nerve stimulation (TENS). This is a type of therapy that uses mild electric currents to help relieve some kinds of pain. You can buy a TENS unit at a drugstore, but talk with your healthcare provider first.

  • Acupuncture. This type of therapy uses very thin needles placed in certain areas of the skin. The needles are left in for up to 30 minutes and then removed. This can help relieve pain all over the body. Check with your healthcare provider to be sure it's safe for you to do this and to find a trained acupuncture therapist.

  • Hypnotherapy. A trained therapist can help you reach a state of relaxation that helps relieve pain.

  • Guided imagery. This type of therapy helps you create images in your mind to help lessen feelings of pain. You can do it at home or work. Many books and websites have instructions for how to do guided imagery.

  • Physical therapy. For this treatment, you work with a trained therapist to make parts of your body stronger.

  • Occupational therapy. This type of therapy focuses on how to do help you do activities of daily living. These include bathing, dressing, cooking, and other tasks.

Living with peripheral neuropathy

If you have peripheral neuropathy, you will need to take good care of yourself. For example:

  • Don't drink alcohol. It can worsen nerve damage.

  • Watch your blood sugar. If you have diabetes, make sure your blood sugar is under control. High blood sugar can make nerve damage worse.

  • Avoid hot or cold temperatures. Take lukewarm baths and showers. Dress for the weather to prevent heat or cold from affecting your symptoms. Wear gloves in cold weather.

  • Manage constipation. Eat high-fiber foods, drink lots of water, and get exercise. Talk with your healthcare provider if you think you need laxatives.

Nerve damage means you are less likely to feel injury, and may take longer to recover from it. You will need to take extra steps to protect yourself from injury. For example:

  • Check your feet daily for injury. Don't walk around barefoot. Make sure to wear shoes that fit well. Check for blisters, cuts, or other problems every day.

  • Make sure your home is safe. Put non-slip pads under rugs. Lower the setting on your hot water heater to help prevent burns.

  • Prevent falls. Use a walker or cane if needed for balance. Put hand rails and non-skid mats in the tub or shower.

  • Be careful with sharp things. Wear gloves to protect your hands when you clean, garden, or cook.

  • Make sure you are safe to drive. Check that you can fully feel the pedals and steering wheel. Make sure you can apply enough pressure on the brakes, and can make quick movements when steering if needed.

Working with your healthcare providers

Make sure to talk with your healthcare team if you need help. Tell them if symptoms get worse or if you have new symptoms. Also let them know if you're having trouble with daily tasks.