Cancer has a major impact on society in the United States and across the world. Pain with cancer usually starts in the hands and/or feet and creeps up the arms and legs. Sometimes it feels like a tingling or numbness. Other times, it’s more of a shooting and/or burning pain or sensitivity to temperature. It can include sharp, stabbing pain, and it can make it difficult to perform normal day-to-day tasks like buttoning a shirt, sorting coins in a purse, or walking. An estimated 30 to 40 percent of cancer patients treated with chemotherapy experience these symptoms, a condition called chemotherapy-induced peripheral neuropathy (CIPN).

CIPN is one of the most common reasons that cancer patients stop their treatment early.  For some people, the symptoms can be mitigated by lowering the dose of chemotherapy or temporarily stopping it, which diminishes the pain within a few weeks. But, for other patients, the symptoms last beyond their chemotherapy for months, years, or even indefinitely.

“Peripheral neuropathy can be an incredibly debilitating side effect,” explained Dr. Ann O’Mara, head of NCI’s Palliative Care Program in the Division of Cancer Prevention. “We can’t predict who will come down with it or to what degree they will get it. So there are a lot of questions around this issue, in terms of preventing and treating it.

  • PAIN: tingling, burning, weakness or numbness in the hands and/or feet
  • Loss of balance
  • Clumsiness
  • Difficulty picking up objects and buttoning clothing
  • Walking problems
  • Jaw pain
  • Hearing loss
  • Stomach pain
  • Constipation

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Medication. Although medication cannot reverse the neuropathy, it may relieve the pain. However, it does not relieve the numbness. The most common medications to treat neuropathic pain are anticonvulsants and antidepressants.

Over-the-counter pain medications may be recommended for mild pain, or prescription nonsteroidal anti-inflammatory drugs or very strong painkillers (analgesics) may be prescribed for severe pain.

Topical treatments, such as lidocaine patches and creams, can also help control pain.

Better nutrition. Eating a diet rich in B vitamins (including B1 and B12), folic acid, and antioxidants may help manage neuropathy. You should also eat a balanced diet and avoid alcohol.

Physical therapy. Physical therapy can keep muscles strong and improve coordination and balance. Therapists can often recommend assistive devices that may allow you to more easily complete your usual daily activities. Regular exercise may also help reduce pain.

Complementary medicine. Massage, acupuncture, and relaxation techniques may help decrease pain and reduce mental stress.

Transcutaneous electrical nerve stimulation (TENS). TENS is a small electrical device that transmits a gentle current into areas of pain through wires attached to the skin with electrodes. Nerves are stimulated to release endorphins, the body’s natural painkillers.

Additional tips include placing stress mats for feet in your home and work environment and wearing shoes with a rocker bottom sole.

Depending on your symptoms, these tips may help you avoid injury in your home if you have sensory or motor difficulties:

  • Keep all rooms, hallways, and stairways well lit.
  • Install handrails on both sides of stairways.
  • Remove small area rugs and any other clutter that could cause you to trip or slip.
  • Install grab bars in the shower or handgrips in the tub, and lay down skid-free mats.
  • Use a thermometer to check that any water you bathe in or use is below 110 degrees Fahrenheit, or set your water heater accordingly.
  • Clean up any spilled water or liquids immediately.
  • Use non-breakable dishes.
  • Use potholders while cooking and rubber gloves when washing dishes.
  • If you drive, make sure you can fully feel the gas and brake pedals and the steering wheel and that you can quickly move your foot from the gas pedal to the brake pedal.
  • If prescribed, use a cane or walker when moving from one room to the other.

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