Signs and symptoms of neuropathy include numbness, pain, burning, tingling or loss of feeling in your hands or feet. Symptoms might feel mild or severe, and can vary from person to person. If you have neuropathy, you could:
- Feel sharp or shooting pain that comes or goes
- Have persistent pain that interferes with your day-to-day life
- Feel pins-and-needles, itching or weakness
- Have trouble picking up tiny objects
- Feel more sensitive to cold or heat
- Hear ringing in your ears
- Have trouble with balance, or perhaps trip while walking
- Be constipated or have other troubles with bowel movements, your bladder or digestion
If you notice signs of neuropathy, it’s important to talk with your providers. You may think these signs are related to your cancer treatment, but other health issues, such as diabetes, can also cause neuropathy. Nerve pain can also be due to surgery or radiation used in cancer treatment or from tumors pressing on nerves.
It can be helpful to keep a log of what your symptoms feel like and when you experience them. That information may help your providers pinpoint the cause.
Keep a journal, noting when and where you have symptoms, what they feel like, how intense they are and what makes the symptoms worse. Write down which symptoms you have and how long you’ve had them. Rate them on a scale of 1 (not at all uncomfortable) to 10 (the most uncomfortable you have ever been).
Note where you have the symptoms, and if they come and go or are persistent. Be as specific as possible, and let your team know how much neuropathy impacts your life. Take the journal with you when you talk with healthcare providers.
Your doctor may tell you about the risk of neuropathy when you discuss your treatment options. Because chemotherapy medicines travel throughout the body, they can reach the peripheral nerves and damage them. Your doctor may even use the term “chemotherapy-induced peripheral neuropathy,” or CIPN.
Certain chemotherapy medicines are more commonly linked to neuropathy:
- Platinums like carboplatin (Paraplatin) and cisplatin (Platinol)
- Taxanes, such as paclitaxel (Taxol) and docetaxel (Taxotere)
- Other non-taxane microtubule inhibitors, like eribulin (Halaven) and vinorelbine (Navelbine)
Just taking these medicines does not mean you will develop neuropathy. Higher doses and longer treatment increase the risk, as well as having other risk factors. These include a personal history of diabetes or an autoimmune disease, or drinking too much alcohol.
Research has shown that having neuropathy does not predict disease outcomes such as long-term survival or cancer recurrence. It might seem logical to assume that side effects such as neuropathy are a sign that chemotherapy is working against the cancer cells, but research has not found evidence to support that idea.
Neuropathy can start during breast cancer treatment or soon after. The symptoms often begin to surface and then go away completely after you finish treatment.
Neuropathy can either be short-term or long-lasting. In some cases, neuropathy can remain long after treatment is over.
If the neuropathy is caused by chemotherapy, your doctor may decide to switch you to a different chemotherapy medicine, use smaller doses or change the timing of your treatments. In some cases, you and your doctor may decide to take a break from treatment to try to give some relief from symptoms and to prevent long-term nerve damage.
Your doctor may also suggest treatment for the pain or discomfort caused by neuropathy. These may include:
- Pain medicines, either over-the-counter product or by prescription
- Steroids for initial relief from symptoms
- Creams and lotions that have a numbing effect
- In some cases, antidepressants or anti-seizure medicines for nerve-related pain
You can also change some things in your daily life to reduct pain from neuropathy, such as:
- Avoid tight-fitting clothes
- Wear comfortable shoes, or talk to your doctor about special therapeutic shoes
- Care for your feet to prevent sores. Check your feet every day and keep them clean
- Keep your hands and feet warm
- If you have numbness and tingling in your hands, be careful using scissors and knives
- If the problem is in your legs and feet, use hand rails to help with balance
- Avoid standing or walking for long periods
- Clear clutter and loose rugs in your home to avoid falling
Researchers are looking into other possible remedies and researching ways to prevent neuropathy from occurring in the first place. If your problems are more severe and interfere with your physical abilities, you may be referred to a physical therapist or occupational therapist to help you regain strength and function.