Chemotherapy-Induced Peripheral Neuropathy
Peripheral neuropathy is usually described as numbness, tingling, pain, prickling or burning that occurs in the hands or feet. In some cases, patients may experience weakness, difficulty with walking/movements or even loss of reflexes.
Peripheral neuropathy occurs from injury to the peripheral nervous system, as a result of one or more of the following:
Toxic exposure (ex. chemotherapy)
Nutrient deficiency (ex. B12 deficiency)
Mechanical injury (ex. car accident)
Metabolic disorders (ex. diabetes)
Infection (ex. Lyme disease)
*Note: Some patients may have more than one cause or risk factor. For example, an untreated vitamin B12 deficiency may be a risk factor for worse neuropathy from chemotherapy. In this case, both the low B12 and chemotherapy could contribute to symptoms.
CHEMOTHERAPY RELATED PERIPHERAL NEUROPATHY
Chemotherapy Induced Peripheral Neuropathy = “CIPN”
Which chemotherapy drugs can cause CIPN?
Platinum-based chemotherapy (Cisplatin, Oxaliplatin, Carboplatin)
Taxane chemotherapies (Taxol, Paclitaxel, Docetaxel)
Vinca alkaloid chemotherapies ( ex. Vinblastine, Vinorelbine, Vincristine)
Lenalidomide
Bortezomib
Others…
CIPN will depend on the chemotherapy drug used, the dose given, the delivery method and the capacity of an individual’s nervous system to cope with the nerve-damaging effects of the drug. For some patients, CIPN can significantly disrupt quality of life, work and selfcare. CIPN can be disabling and limit or affect cancer treatment. In some cases, the oncologist may even need to change or completely discontinue the chemotherapy treatment.
Enter the power of integrative and naturopathic medicine! There are some excellent options for natural medicine support, to reduce the risk, incidence or severity of CIPN. Well placed, these therapies can be synergistic and compatible with a person’s chemotherapy regimen. For example, in a randomized double-blind placebo-controlled study, patients with breast cancer, on treatment with taxane therapy, were given integrative medicine support in the form of omega-3 fatty acids. The group receiving the omega-3 fatty acids, showed a decrease in paclitaxel-associated CIPN. Other studies suggest that omega-3 fatty acids may support inhibition of tumor blood vessel growth, tumor cell invasion, and metastasis (spread to other locations in the body), as well as improve survival and progression-free survival in breast cancer cases. This example highlights the goal of choosing naturopathic therapies for a patient, that are supportive of successful outcomes with their prescribed chemotherapy while still protecting and supporting quality of life.
I try to engage in a proactive and preventative approach with my patients, before they even start a neuropathy-inducing chemotherapy drug. However, if a patient is already experiencing CIPN, there are evidence-supported natural medicines and therapies that can be used to enhance recovery and restore nerve health.
Some of these evidence-supported natural medicines, that I may consider with my patients, include:
ACUPUNCTURE
MASSAGE
L-GLUTAMINE
ACETYL-L-CARNITINE
GLUTATHIONE
FISH OIL
B-VITAMINS
COLD LASER THERAPY
MANY OTHERS including herbal medicine, nutritional factors/practices, physical therapy, topical applications and biofeedback.
HOW DO I KNOW WHICH ONE IS RIGHT FOR ME?
What is most important is to select natural medicines that are compatible with a patient’s treatment (chemotherapy drug(s)). Of course, the therapy should also be appropriate with a patient’s medical history, symptoms, nutritional health, medications, allergies and personal comfort level. In other words, there is no one size fits all. I recommend seeking the help of a naturopathic doctor who is experienced in working with cancer patients. You need safe, effective and individualized recommendations, including proper dosing!
A well-prescribed natural medicine program can effectively reduce side effects, support outcomes and improve quality of life. If you are a loved one is struggling with chemotherapy-related side effects, I’d love to help you navigate some natural medicine solutions though an intelligent naturopathic support plan.
In Good Health,
Dr. Jessica Moore, ND
Call Tandem Clinic at 604 670 0590 or schedule online here
References:
JAMA Oncol. 2019;5(5):750.
The Oncologist 2019;24:1–9
Integr Cancer Ther. 2017 Sep;16(3):258-262
Oncologist. 2007 Mar;12(3):312-9.
Exp Ther Med. 2016 Dec;12(6):4017-4024.
J Clin Oncol. 2002 Aug 15;20(16):3478-83.
BMC Cancer. 2012; 12: 355.
Asian Pac J Cancer Prev. 2019;20(3):911-916.
J Clin Oncol 2016 Dec; 27 (15)
J Clin Oncol 2017 Jan; 30 (15): 9019-9019.1`
