Chemotherapy-Induced Peripheral Neuropathy

THE MANAGEMENT OF

CHEMOTHERAPY-INDUCED PERIPHERAL NEUROPATHY

31st May, 2020

 

It’s a sad fact of life that at some point in our lives, we or someone we know will be touched by cancer. Last year (2019) 145,000 new cases were diagnosed and that number is set to rise to 150,000 this year [1]. Depending on the type of cancer, its severity, location and other factors, treatment options can vary somewhat. However generally, chemotherapy is the main form of treatment.

What is CIPN?

There are many different chemotherapy drugs, all of which aim to attack cancer cells. However, in doing so, they also affect healthy cells which can then cause a number of side effects. The most common side effects we hear about are hair loss, nausea, vomiting, pain and fatigue. However another common side effect is Chemotherapy-Induced Peripheral Neuropathy (CIPN). This is where the structure and function of motor, sensory and autonomic neurons are damaged which can cause loss of all sensory modalities, impaired balance or coordination, early loss/reduction of deep reflexes, pain, numbness, burning and/or tingling [2]. If severe, the symptoms can lead to a dose reduction and/or early discontinuation of chemotherapy [3], which as you can imagine can have a huge impact on the outcome of treatment. CIPN can also severely impair quality of life, including dysfunction of daily activities, social well being, work integration and physical impairments including pain [4].

What Can Be Done About It?

Unfortunately for these cancer patients, there hasn’t been any success in managing these potentially debilitating symptoms, and research into CIPD intervention is relatively minimal [5]. However, there has been a growing interest in Acupuncture as a form of treatment for CIPD, as its impact has been demonstrated in many recent studies in the treatment of musculoskeletal diseases, lower back pain, morning sickness and headaches. Not only this but Acupuncture has also been shown to be effective in the treatment of many cancer symptoms caused by chemotherapy or radiotherapy, such as nausea, vomiting, cancer pain, hot flashes and fatigue [6].

How Can Acupuncture Help?

The way I approach treating CIPD is similar to how I approach any condition. I ask lots of questions about your symptoms – where the pain is, what type of pain it is, what triggers it, what gives relief. Then I ask about other areas of your health such as digestion, sleep, energy levels, emotional health, bowel movements and more. Based on the answers you give, I get a good picture of how your body is working, what may be causing/contributing to the problem, and where it may need improving. With cancer patients there is the added strain on the body of the cancer itself, plus the chemotherapy/radiation, so my treatment always includes Acupuncture points to strengthen your energy in general, as well as circulate more blood flow and reduce inflammation. Acupuncture is gentle, effective and does not introduce any foreign material into the body, which is why many cancer doctors recommend it to their patients, as it does not interfere with any cancer medication.

Getting Back to the Research

A study of Korean breast cancer patients showed that Acupuncture significantly reduced the symptoms of CIPN, as well as improving their quality of life. Not only this but the benefits were still felt 4 weeks after treatment ceased [7].

In a study of chemotherapy patients undertaking an 8 week course of Acupuncture, pain intensity, quality of life and sensory and neurological symptoms were significantly better in the Acupuncture group compared to the control group [8].

And in a systematic review of literature which looked at five different studies, it was concluded that the use of Acupuncture appears to be associated with an improvement in the symptoms of CIPN and has no side effects [9].

While Acupuncture cannot treat the cancer itself, it is an amazing therapy to help with the many issues associated with chemotherapy. Cancer takes an incredible physical and emotional toll on a person, and I think anything that can be done to ease that strain is definitely worth the time and energy. If you or someone you love is going through chemotherapy and struggling with the side effects, anything I can do to make life that little bit easier would be my pleasure. If you have any questions please contact me, or you can make a booking at Park Orchards or Mt Evelyn.

[1] “Facts and Figures”, Cancer Council. www.cancer.org.au (accessed April 5, 2020).

[2] A. F. Baviera, K. Olson et al., “Acupuncture in adults with Chemotherapy-Induced Peripheral Neuropathy: a systematic review,” Rev. Latino-Am. Enfermagem. 2019;27:e3126.

[3] R. M. Speck, M. D. Sammel, J. T. Farrar et al., “Impact of chemotherapy-induced peripheral neuropathy on treatment delivery in non-metastatic breast cancer,” Journal of Oncology Practice, vol. 9, no. 5, pp. e234-e240, 2013.

[4] A. Molassiotis, L. K. P. Suen et al., “A Randomized Assessor-Blinded Wait-List Controlled Trial to Assess the Effectiveness of Acupuncture in the Management of Chemotherapy-Induced Peripheral Neuropathy,” Integrative Cancer Therapies, vol. 18: 1-2, 2019.

[5] A. Molassiotis, L. K. P. Suen et al., “A Randomized Assessor-Blinded Wait-List Controlled Trial to Assess the Effectiveness of Acupuncture in the Management of Chemotherapy-Induced Peripheral Neuropathy,” Integrative Cancer Therapies, vol. 18: 1-2, 2019.

[6] A. F. Baviera, K. Olson et al., “Acupuncture in adults with Chemotherapy-Induced Peripheral Neuropathy: a systematic review,” Rev. Latino-Am. Enfermagem. 2019;27:e3126.

[7] Y. J. Jeong, M. A. Kwak et al., “Acupuncture for the Treatment of Taxane-Induced Peripheral Neuropathy in Breast Cancer Patients: A Pilot Trial,” Evidence-Based Complementary Medicine and Alternative Medicine, vol. 2018, article ID 5367014.

[8] A. Molassiotis, L. K. P. Suen et al., “A Randomized Assessor-Blinded Wait-List Controlled Trial to Assess the Effectiveness of Acupuncture in the Management of Chemotherapy-Induced Peripheral Neuropathy,” Integrative Cancer Therapies, vol. 18: 1-2, 2019.

[9] A. F. Baviera, K. Olson et al., “Acupuncture in adults with Chemotherapy-Induced Peripheral Neuropathy: a systematic review,” Rev. Latino-Am. Enfermagem. 2019;27:e3126.