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Peripheral neuropathy (PN) is a condition caused by damage to the peripheral nervous system. It can cause pain, tingling, numbness, or sensitivity, often in the hands or feet.
The nerves running throughout your body make up the peripheral nervous system. These nerves send signals between the central nervous system (the brain and spinal cord) and all other parts of the body.
There are three main types of peripheral nerves:
Peripheral neuropathy can affect any of these nerves. The type of symptoms it might cause will depend on the type of nerves damaged.
Peripheral neuropathy can feel like:
Some of the most common causes of peripheral neuropathy are medicines used to treat cancer. When this happens, it is called chemotherapy-induced peripheral neuropathy (CIPN). The risk of CIPN depends on the type of chemotherapy and dose given, and increases with each cycle of chemotherapy. CIPN can make it hard to get around and do things you used to do.
Peripheral neuropathy can cause severe pain and can affect things like the way you walk, write, button your shirt, or pick up coins. Peripheral neuropathy can last for weeks, months, or even years after treatment is done. If it gets worse, it can also cause changes in your heart rate and blood pressure, falls, trouble breathing, and not being able to move on your own. It’s important to let your cancer care team know if your symptoms get worse.
Peripheral neuropathy also can be caused by things other than chemotherapy, such as:
It’s important to know what’s causing peripheral neuropathy so that the right treatment can be given. The information on this page is about peripheral neuropathy (PN) as a side effect of chemotherapy.
Certain cancer medicines are more likely to cause CIPN. Some of the more common ones include:
If you’re not sure if a cancer treatment you’re getting might cause CIPN, ask your cancer care team.
There are some therapies that have been used to prevent or limit the effects of peripheral neuropathy caused by chemotherapy, but more research is needed to prove they are effective.
During chemo infusions, some experts recommend:
These therapies may help by reducing circulation in the hands and feet while chemo is being given, which may lower the amount of chemo drugs reaching these areas. More research is needed to prove these methods are effective and to determine the best ways to apply cold or compression.
Exercising at least twice a week, including strength, balance, and general movement exercises, might also lower your risk for neuropathy. Exercise may improve circulation to support nerve health and help keep you stronger and healthier during treatment. But again, more research is needed to understand how exercise might help prevent CIPN.
These methods can be used alone or together. Ask your cancer care team about options that might be best for you.
During treatment, your cancer care team will ask you about your symptoms and watch you to see if the PN is getting worse. Your team may need to delay your treatment, use smaller doses of the chemo drugs, or stop treatment with the drug that is causing the PN until your symptoms get better. These actions must be started right away to prevent long-term damage that might get worse over time.
Peripheral neuropathy isn’t always preventable, but there are ways to help to manage your symptoms. Treatment can often help ease symptoms of PN. Sometimes these symptoms go away shortly after treatment is done, but sometimes they last much longer. Severe PN may lessen over time but may not go away completely.
Treatment focuses on relieving the discomfort that can come with PN. Some of the medicines used include:
Sometimes more than one type of treatment is needed. Tell your cancer care team if medicine used to treat PN is not working so that something else can be tried. Other non-medical treatments can be tried to ease nerve pain and its effect on you.
There are some things you can do to better manage the symptoms of PN, such as:
If you have peripheral neuropathy, the loss of sensation or balance might put you at a higher risk of injury. Here are some things you can do to stay safe:
Here are some questions you might want to ask your cancer care team:
It’s important to work closely with your cancer care team to manage peripheral neuropathy.
Talk to your cancer care team:
Remember that only you decide if you want to get, or keep getting, a certain treatment.
The American Cancer Society medical and editorial content team
Our team is made up of doctors and oncology certified nurses with deep knowledge of cancer care as well as editors and translators with extensive experience in medical writing.
American Society of Clinical Oncology (ASCO). Nerve problems or peripheral neuropathy. Accessed cancer.net. Content is no longer available.
Chow R, Novosel M, So OW, Bellampalli S, Xiang J, Boldt G, Winquist E, Lock M, Lustberg M, Prsic E. Duloxetine for prevention and treatment of chemotherapy-induced peripheral neuropathy (CIPN): systematic review and meta-analysis. BMJ Supportive & Palliative Care. 2023 Mar;13(1):27-34. https://doi.org/10.1136/spcare-2022-003815
Desforges AD, Hebert CM, Spence AL, et al. Treatment and diagnosis of chemotherapy-induced peripheral neuropathy: an update. Biomed & Pharmacother. 2022;147:112671. Accessed November 17, 2023 at https://doi.org/10.1016/j.biopha.2022.112671
Kanda K, Ishida K, Kyota A, Ishihara C, Fujimoto K, Hosokawa M, Mochizuki R. Randomized clinical trial quantifying the effectiveness of a self-monitoring intervention in cancer patients with peripheral neuropathy: A quantitative study. Asia Pac J Oncol Nurs. 2023;10(4):100198. Accessed November 17, 2023 at https://doi.org/10.1016/j.apjon.2023.100198
Li T, Park SB, Battaglini E, King MT, Kiernan MC, Goldstein D, Rutherford C. Assessing chemotherapy-induced peripheral neuropathy with patient reported outcome measures: a systematic review of measurement properties and considerations for future use. Qual Life Res. 2022;31(11):3091-107. Accessed November 17, 2023 at https://doi.org/10.1007/s11136-022-03154-7
Loprinzi CL. Prevention and treatment of chemotherapy-induced peripheral neuropathy. In: Vora SR, ed. Uptodate. UpToDate; 2023. Accessed July 26, 2024. https://www.uptodate.com/contents/prevention-and-treatment-of-chemotherapy-induced-peripheral-neuropathy
National Cancer Care Center Network (NCCN). Adult Cancer Pain. Version 2.2023. Accessed November 16, 2023 at https://www.nccn.org/professionals/physician_gls/pdf/pain.pdf.
Last Revised: August 6, 2024
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