Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

ACC 2024 Congress

Catch up on all the top stories and latest evidence in cardiology research with our ACC 2024 Congress hub page.
ADVANCED SEARCH
Log in
Top
Current Oncology Reports
Published in: Current Oncology Reports 5/2020

01-05-2020 | Cytostatic Therapy | Palliative Medicine (A Jatoi, Section Editor)

The Physical Consequences of Chemotherapy-Induced Peripheral Neuropathy

Authors: Cindy S. Tofthagen, Andrea L. Cheville, Charles L. Loprinzi

Published in: Current Oncology Reports | Issue 5/2020

Login to get access

Abstract

Purpose of Review

Chemotherapy-induced peripheral neuropathy (CIPN) is a common side effect of numerous chemotherapy drugs. CIPN negatively impacts function and quality of life during and after treatment. We will provide a review of the data describing the physical consequences of CIPN and discuss the possible long term impact on emotional well-being and quality of life.

Recent Findings

CIPN negatively affects physical function and many aspects of quality of life. Exercise interventions are likely to reduce the risk of falls associated with CIPN.

Summary

There remains a need for evidence-based interventions focused on improving symptoms, function, and quality of life in persons with CIPN.
Literature
1.
Tofthagen C, Visovsky C, Dominic S, McMillan S. Neuropathic symptoms, physical and emotional well-being, and quality of life at the end of life. Support Care Cancer. 2019.
2.
• McCrary JM, Goldstein D, Trinh T, Timmins HC, Li T, Menant J, et al. Balance deficits and functional disability in cancer survivors exposed to neurotoxic cancer treatments. J Natl Compr Cancer Netw. 2019;17(8):949–55 Reports on numerous functional and balance deficits and proposes a risk based screening model for identifying persons at risk of falls and functional decline.CrossRef
3.
Ventzel L, Jensen AB, Jensen AR, Jensen TS, Finnerup NB. Chemotherapy-induced pain and neuropathy: a prospective study in patients treated with adjuvant oxaliplatin or docetaxel. Pain. 2016;157(3):560–8.PubMedCrossRef
4.
Mols F, Beijers T, Vreugdenhil G, van de Poll-Franse L. Chemotherapy-induced peripheral neuropathy and its association with quality of life: a systematic review. Support Care Cancer. 2014;22(8):2261–9.PubMedCrossRef
5.
Tofthagen C, Kip KE, Passmore D, Loy I, Berry DL. Usability and acceptability of a web-based program for chemotherapy-induced peripheral neuropathy. Comput Inform Nurs. 2016;34(7):322–9.PubMedCrossRef
6.
Kim JH, Dougherty PM, Abdi S. Basic science and clinical management of painful and non-painful chemotherapy-related neuropathy. Gynecol Oncol. 2015;136(3):453–9.PubMedPubMedCentralCrossRef
7.
8.
Almadrones LA, Arcot R. Patient guide to peripheral neuropathy. Oncol Nurs Forum. 1999;26(8):1359–60.PubMed
9.
Bao T, Basal C, Seluzicki C, Li SQ, Seidman AD, Mao JJ. Long-term chemotherapy-induced peripheral neuropathy among breast cancer survivors: prevalence, risk factors, and fall risk. Breast Cancer Res Treat. 2016;159(2):327–33.PubMedPubMedCentralCrossRef
10.
Gewandter JS, Fan L, Magnuson A, Mustian K, Peppone L, Heckler C, et al. Falls and functional impairments in cancer survivors with chemotherapy-induced peripheral neuropathy (CIPN): a University of Rochester CCOP study. Support Care Cancer. 2013;21(7):2059–66.PubMedPubMedCentralCrossRef
11.
Tofthagen C, Overcash J, Kip K. Falls in persons with chemotherapy-induced peripheral neuropathy. Support Care Cancer. 2012;20(3):583–9.PubMedCrossRef
12.
• Winters-Stone KM, Horak F, Jacobs PG, Trubowitz P, Dieckmann NF, Stoyles S, et al. Falls, functioning, and disability among women with persistent symptoms of chemotherapy-induced peripheral neuropathy. J Clin Oncol. 2017;35(23):2604–12 A comparison of functional outcomes in long term breast cancer survivors. Demonstrates sustained functional deficits related to CIPN.PubMedPubMedCentralCrossRef
13.
Tofthagen C. Surviving chemotherapy for colon cancer and living with the consequences. J Palliat Med. 2010;13(11):1389–91.PubMedCrossRef
14.
Tofthagen C. Patient perceptions associated with chemotherapy-induced peripheral neuropathy. Clin J Oncol Nurs. 2010;14(3):E22–8.PubMedCrossRef
15.
• Zajaczkowska R, Kocot-Kepska M, Leppert W, Wrzosek A, Mika J, Wordliczek J. Mechanisms of chemotherapy-induced peripheral neuropathy. Int J Mol Sci. 2019;20(6). Literature review focusing on mechanistic research findings in CIPN. Recommended for anyone who wants to increase their understanding of how each class of neurotoxic agents cause CIPN.PubMedCentralCrossRef
16.
Park JH, Chae J, Roh K, Kil EJ, Lee M, Auh CK, et al. Oxaliplatin-induced peripheral neuropathy via TRPA1 stimulation in mice dorsal root ganglion is correlated with aluminum accumulation. PLoS One. 2015;10(4):e0124875.PubMedPubMedCentralCrossRef
17.
Di Cesare Mannelli L, Zanardelli M, Failli P, Ghelardini C. Oxaliplatin-induced neuropathy: oxidative stress as pathological mechanism. Protective effect of silibinin. J Pain. 2012;13(3):276–84.PubMedCrossRef
18.
Liu F, Huang J, Liu Z. Vincristine impairs microtubules and causes neurotoxicity in cerebral organoids. Neuroscience. 2019;404:530–40.PubMedCrossRef
19.
Cairns BE, Arendt-Nielsen L, Sacerdote P. Perspectives in pain research 2014: Neuroinflammation and glial cell activation: the cause of transition from acute to chronic pain? Scand J Pain. 2015;6(1):3–6.PubMedCrossRef
20.
Zheng H, Xiao G, Bennett G. Mitotoxicity and bortezomib-induced chronic painful peripheral neuropathy. Exp Neurol. 2012;238(2):225–34.PubMedCrossRef
21.
Molassiotis A, Cheng HL, Leung KT, Li YC, Wong KH, Au JSK, et al. Risk factors for chemotherapy-induced peripheral neuropathy in patients receiving taxane- and platinum-based chemotherapy. Brain Behav. 2019;9(6):e01312.PubMedPubMedCentralCrossRef
22.
Wong ML, Cooper BA, Paul SM, Abrams G, Topp K, Kober KM, et al. Age-related differences in patient-reported and objective measures of chemotherapy-induced peripheral neuropathy among cancer survivors. Support Care Cancer. 2019;27(10):3905–12.PubMedCrossRef
23.
• Petrovchich I, Kober KM, Wagner L, Paul SM, Abrams G, Chesney MA, et al. Deleterious effects of higher body mass index on subjective and objective measures of chemotherapy-induced peripheral neuropathy in cancer survivors. J Pain Symptom Manag. 2019;58(2):252–63. Demonstrates relationships between higher BMI and increased pain, more postural instability among cancer survivors with CIPN.PubMedCrossRef
24.
Chan A, Hertz DL, Morales M, Adams EJ, Gordon S, Tan CJ, et al. Biological predictors of chemotherapy-induced peripheral neuropathy (CIPN): MASCC neurological complications working group overview. Support Care Cancer. 2019;27(10):3729–37.PubMedCrossRef
25.
Chauvenet AR, Shashi V, Selsky C, Morgan E, Kurtzberg J, Bell B. Vincristine-induced neuropathy as the initial presentation of charcot-marie-tooth disease in acute lymphoblastic leukemia: a pediatric oncology group study. J Pediatr Hematol Oncol. 2003;25(4):316–20.PubMedCrossRef
26.
Sy A, Cheng J, Cooper R, Mueller L. Heterozygosity for CMT type 4 predicts a severe vincristine-induced polyneuropathy phenotype: a case report and review of literature. J Pediatr Hematol Oncol. 2019;41(1):e41–e3.PubMedCrossRef
27.
Vincenzi B, Frezza AM, Schiavon G, Spoto C, Silvestris N, Addeo R, et al. Identification of clinical predictive factors of oxaliplatin-induced chronic peripheral neuropathy in colorectal cancer patients treated with adjuvant Folfox IV. Support Care Cancer. 2013;21(5):1313–9.PubMedCrossRef
28.
Hershman DL, Lacchetti C, Dworkin RH, Lavoie Smith EM, Bleeker J, Cavaletti G, et al. Prevention and management of chemotherapy-induced peripheral neuropathy in survivors of adult cancers: American Society of Clinical Oncology clinical practice guideline. J Clin Oncol. 2014;32(18):1941–67.PubMedCrossRef
29.
• Smith EM, Pang H, Ye C, Cirrincione C, Fleishman S, Paskett ED, et al. Predictors of duloxetine response in patients with oxaliplatin-induced painful chemotherapy-induced peripheral neuropathy (CIPN): a secondary analysis of randomised controlled trial - CALGB/alliance 170601. Eur J Cancer Care. 2017;26(2). Demonstrates increased reponse to duloxetine among persons with higher emotional well-being.CrossRef
30.
Nho JH, Reul Kim S, Nam JH. Symptom clustering and quality of life in patients with ovarian cancer undergoing chemotherapy. Eur J Oncol Nurs. 2017;30:8–14.PubMedCrossRef
31.
Knoerl R, Chornoby Z, Smith EML. Estimating the frequency, severity, and clustering of SPADE symptoms in chronic painful chemotherapy-induced peripheral neuropathy. Pain Manag Nurs. 2018;19(4):354–65.PubMedCrossRef
32.
Bakitas MA. Background noise: the experience of chemotherapy-induced peripheral neuropathy. Nurs Res. 2007;56(5):323–31.PubMedCrossRef
33.
Postma TJ, Aaronson NK, Heimans JJ, Muller MJ, Hildebrand JG, Delattre JY, et al. The development of an EORTC quality of life questionnaire to assess chemotherapy-induced peripheral neuropathy: the QLQ-CIPN20. Eur J Cancer (Oxf Engl). 2005;41(8):1135–9.CrossRef
34.
Yeo F, Ng CC, Loh KWJ, Molassiotis A, Cheng HL, Au JSK, et al. Minimal clinically important difference of the EORTC QLQ-CIPN20 for worsening peripheral neuropathy in patients receiving neurotoxic chemotherapy. Support Care Cancer. 2019;27(12):4753–62.PubMedCrossRef
35.
• Tabata A, Kanai M, Horimatsu T, Tsuboyama T, Matsushima K, Kato T. Changes in upper extremity function, ADL, and HRQoL in colorectal cancer patients after the first chemotherapy cycle with oxaliplatin: a prospective single-center observational study. Support Care Cancer. 2018;26(7):2397–405 Identified reduced sensation in the hands after a single cycle of oxaliplatin. Highlights the need for early intervention.PubMedPubMedCentralCrossRef
36.
Monfort SM, Pan X, Patrick R, Ramaswamy B, Wesolowski R, Naughton MJ, et al. Gait, balance, and patient-reported outcomes during taxane-based chemotherapy in early-stage breast cancer patients. Breast Cancer Res Treat. 2017;164(1):69–77.PubMedPubMedCentralCrossRef
37.
Zanville NR, Nudelman KN, Smith DJ, Von Ah D, McDonald BC, Champion VL, et al. Evaluating the impact of chemotherapy-induced peripheral neuropathy symptoms (CIPN-sx) on perceived ability to work in breast cancer survivors during the first year post-treatment. Support Care Cancer. 2016;24(11):4779–89.PubMedPubMedCentralCrossRef
38.
Stubblefield MD, McNeely ML, Alfano CM, Mayer DK. A prospective surveillance model for physical rehabilitation of women with breast cancer: chemotherapy-induced peripheral neuropathy. Cancer. 2012;118(8 Suppl):2250–60.PubMedCrossRef
39.
Stubblefield MD. The underutilization of rehabilitation to treat physical impairments in breast cancer survivors. PM R. 2017;9(9s2):S317–s23.PubMedCrossRef
40.
Cheville AL, Dose AM, Basford JR, Rhudy LM. Insights into the reluctance of patients with late-stage cancer to adopt exercise as a means to reduce their symptoms and improve their function. J Pain Symptom Manag. 2012;44(1):84–94.CrossRef
41.
Cheville AL, Troxel AB, Basford JR, Kornblith AB. Prevalence and treatment patterns of physical impairments in patients with metastatic breast cancer. J Clin Oncol. 2008;26(16):2621–9.PubMedPubMedCentralCrossRef
42.
Kolb NA, Smith AG, Singleton JR, Beck SL, Stoddard GJ, Brown S, et al. The association of chemotherapy-induced peripheral neuropathy symptoms and the risk of falling. JAMA Neurol. 2016;73(7):860–6.PubMedPubMedCentralCrossRef
43.
Komatsu H, Yagasaki K, Komatsu Y, Yamauchi H, Yamauchi T, Shimokawa T, et al. Falls and functional impairments in breast cancer patients with chemotherapy-induced peripheral neuropathy. Asia Pac J Oncol Nurs. 2019;6(3):253–60.PubMedPubMedCentralCrossRef
44.
Kneis S, Wehrle A, Muller J, Maurer C, Ihorst G, Gollhofer A, et al. It's never too late - balance and endurance training improves functional performance, quality of life, and alleviates neuropathic symptoms in cancer survivors suffering from chemotherapy-induced peripheral neuropathy: results of a randomized controlled trial. BMC Cancer. 2019;19(1):414.PubMedPubMedCentralCrossRef
45.
Schwenk M, Grewal GS, Holloway D, Muchna A, Garland L, Najafi B. Interactive sensor-based balance training in older cancer patients with chemotherapy-induced peripheral neuropathy: a randomized controlled trial. Gerontology. 2016;62(5):553–63.PubMedCrossRef
46.
Vollmers PL, Mundhenke C, Maass N, Bauerschlag D, Kratzenstein S, Rocken C, et al. Evaluation of the effects of sensorimotor exercise on physical and psychological parameters in breast cancer patients undergoing neurotoxic chemotherapy. J Cancer Res Clin Oncol. 2018;144(9):1785–92.PubMedCrossRef
47.
Zimmer P, Trebing S, Timmers-Trebing U, Schenk A, Paust R, Bloch W, et al. Eight-week, multimodal exercise counteracts a progress of chemotherapy-induced peripheral neuropathy and improves balance and strength in metastasized colorectal cancer patients: a randomized controlled trial. Support Care Cancer. 2018;26(2):615–24.PubMedCrossRef
48.
Sherrington C, Fairhall NJ, Wallbank GK, Tiedemann A, Michaleff ZA, Howard K, et al. Exercise for preventing falls in older people living in the community. Cochrane Database Syst Rev. 2019;1:Cd012424.PubMed
49.
Hermanns M, Haas BK, Rath L, Murley B, Arce-Esquivel AA, Ballard JE, et al. Impact of tai chi on peripheral neuropathy revisited: a mixed-methods study. Gerontol Geriatr Med. 2018;4:2333721418819532.PubMedPubMedCentralCrossRef
50.
Duregon F, Vendramin B, Bullo V, Gobbo S, Cugusi L, Di Blasio A, et al. Effects of exercise on cancer patients suffering chemotherapy-induced peripheral neuropathy undergoing treatment: a systematic review. Crit Rev Oncol Hematol. 2018;121:90–100.PubMedCrossRef
51.
Fernandes J, Kumar S. Effect of lower limb closed kinematic chain exercises on balance in patients with chemotherapy-induced peripheral neuropathy: a pilot study. Int J Rehabil Res. 2016;39(4):368–71.PubMedCrossRef
52.
Mizrahi D, Broderick C, Friedlander M, Ryan M, Harrison M, Pumpa K, et al. An exercise intervention during chemotherapy for women with recurrent ovarian cancer: a feasibility study. Int J Gynecol Cancer. 2015;25(6):985–92.PubMedCrossRef
53.
Streckmann F, Kneis S, Leifert JA, Baumann FT, Kleber M, Ihorst G, et al. Exercise program improves therapy-related side-effects and quality of life in lymphoma patients undergoing therapy. Ann Oncol. 2014;25(2):493–9.PubMedCrossRef
54.
Wonders KY, Whisler G, Loy H, Holt B, Bohachek K, Wise R. Ten weeks of home-based exercise attenuates symptoms of chemotherapy-induced peripheral neuropathy in breast cancer patients. Health Psychol Res. 2013;1(3):e28.PubMedPubMedCentralCrossRef
55.
Prinsloo S, Novy D, Driver L, Lyle R, Ramondetta L, Eng C, et al. Randomized controlled trial of neurofeedback on chemotherapy-induced peripheral neuropathy: a pilot study. Cancer. 2017;123(11):1989–97.PubMedPubMedCentralCrossRef
56.
Streckmann F, Lehmann HC, Balke M, Schenk A, Oberste M, Heller A, et al. Sensorimotor training and whole-body vibration training have the potential to reduce motor and sensory symptoms of chemotherapy-induced peripheral neuropathy-a randomized controlled pilot trial. Support Care Cancer. 2019;27(7):2471–8.PubMedCrossRef
57.
Tofthagen C, Donovan KA, Morgan MA, Shibata D, Yeh Y. Oxaliplatin-induced peripheral neuropathy’s effects on health-related quality of life of colorectal cancer survivors. Support care cancer. 2013;21(12):3307–13.PubMedPubMedCentralCrossRef
58.
Greenwald MK, Ruterbusch JJ, Beebe-Dimmer JL, Simon MS, Albrecht TL, Schwartz AG. Risk of incident claims for chemotherapy-induced peripheral neuropathy among women with breast cancer in a Medicare population. Cancer. 2019;125(2):269–77.PubMedCrossRef
59.
Ezendam NP, Pijlman B, Bhugwandass C, Pruijt JF, Mols F, Vos MC, et al. Chemotherapy-induced peripheral neuropathy and its impact on health-related quality of life among ovarian cancer survivors: results from the population-based PROFILES registry. Gynecol Oncol. 2014;135(3):510–7.PubMedCrossRef
60.
Shah A, Hoffman EM, Mauermann ML, Loprinzi CL, Windebank AJ, Klein CJ, et al. Incidence and disease burden of chemotherapy-induced peripheral neuropathy in a population-based cohort. J Neurol Neurosurg Psychiatry. 2018;89(6):636–41.PubMedPubMedCentralCrossRef
61.
Tofthagen C, Visovsky C, Eckelman E, Clatterbuck B, Leggatt M, Buck H. Starting a nurse-led clinic for patients with peripheral neuropathy. Nursing. 2018;48(8):39–42.PubMedCrossRef
Metadata
Title
The Physical Consequences of Chemotherapy-Induced Peripheral Neuropathy
Authors
Cindy S. Tofthagen
Andrea L. Cheville
Charles L. Loprinzi
Publication date
01-05-2020
Publisher
Springer US
Published in
Current Oncology Reports / Issue 5/2020
Print ISSN: 1523-3790
Electronic ISSN: 1534-6269
DOI
https://doi.org/10.1007/s11912-020-00903-0

Other articles of this Issue 5/2020

Current Oncology Reports 5/2020 Go to the issue

Hot Topic

COVID-19 and Cancer: a Comprehensive Review

Lymphomas (MR Smith, Section Editor)

Hairy Cell Leukaemia

Neuro-oncology (Y Umemura, Section Editor)

Developing Real-world Evidence-Ready Datasets: Time for Clinician Engagement

Lymphomas (MR Smith, Section Editor)

Therapy of Peripheral T Cell Lymphoma: Focus on Nodal Subtypes

Correction

Correction to: Targeting and Therapeutic Monitoring of H3K27M-Mutant Glioma

Correction

Correction to: The Present and Future of Liquid Biopsies in Non-Small Cell Lung Cancer: Combining Four Biosources for Diagnosis, Prognosis, Prediction, and Disease Monitoring
Webinar | 19-02-2024 | 17:30 (CET)

Keynote webinar | Spotlight on antibody–drug conjugates in cancer

Watch now

Antibody–drug conjugates (ADCs) are novel agents that have shown promise across multiple tumor types. Explore the current landscape of ADCs in breast and lung cancer with our experts, and gain insights into the mechanism of action, key clinical trials data, existing challenges, and future directions.

Dr. Véronique Diéras
Prof. Fabrice Barlesi
Developed by: Springer Medicine
Image Credits