Numbness, tingling, and sometimes pain in your fingers and toes is called peripheral neuropathy. It is caused by damage to the nerves from some cancer treatments or medical conditions. 

Nerves are the highway of the body that carries information between your body, brain, and spinal cord.  When these nerves are damaged, it can cause a pins-and-needles feeling, numbness, or weakness in your hands or feet. 

What causes Peripheral Neuropathy? 

1. The cancer itself, if a tumor is close to a nerve   

2. Cancer treatments:  

   • Certain chemotherapies and other drugs that treat cancer can cause damage to nerves and result in neuropathy  

   • Radiation therapy: if the field, or location, of radiation includes nerves, may cause neuropathy  

   • Surgery: Completely removing a tumor may cause manipulation or direct damage to nerves leading to neuropathy 

   • Note: If you already have experienced this side effect from prior cancer treatment, you may be at a higher risk for this getting worse during subsequent treatments associated with a risk for peripheral neuropathy 

3. Other common non-cancer health conditions are also known to cause peripheral neuropathy: 

   • Diabetes 

   • Alcoholism 

   • Peripheral vascular disease 

   • Severe malnutrition 

Symptoms 

The way that peripheral neuropathy feels in your body may vary depending on the cause and which nerves are damaged.   

 The most common symptoms you might feel:  

• Gradual onset of numbness or tingling, like the feeling of pins and needles, in your hands or feet (or both); this may spread upwards in the shape of a sock or glove  

• Burning sensation in your hands or feet 

• Being less sensitive to touch, such as not stepping on something with bare feet and not feeling it 

• Have a hard time picking things up or buttoning clothes 

• Not knowing where a body part is without looking 

• Tripping  

• Weakness, leg cramping, or pain in hands or feet 

For some people, these symptoms are temporary and resolve after treatment is finished. For others, these symptoms may last much longer or become permanent. It is important to tell your doctor when you start having symptoms and to discuss the risks for long-term symptoms. 

What you can do at home to improve the symptoms & prevent injuries 

1. Avoid any extreme temperature changes 

• If you are receiving oxaliplatin, you may experience a discomfort to cold, for example swallowing cold items and or touching cold things. You will want to avoid these for the first 4-5 days after treatment.  

2. Massage affected areas.  

3. Apply lotions or creams to the areas of discomfort.  

• Consider capsaicin cream which may provide some relief when used regularly. Of note, this can cause a burning feeling when first applied which goes away with regular use.  

4. Exercise regularly if approved by your doctor (e.g., 20-30 minutes most days of the week).  

• Including walking, strength training with light weights, and resistance training such as squats and lunges 

5. Practice relaxation techniques such as deep breathing, meditation, or guided imagery 

6. Take care to protect yourself from injuries 

• Keep hands and feet clean and dry 

• Inspect skin for cuts, abrasions, or burns daily, especially on your hands and toes.  

• Do not walk around on bare feet. Wear thick socks and soft soled shoes. 

• Wear warm clothing in cold weather.  Protect feet and hands from extreme cold. 

• Use care when washing dishes or taking a bath or shower. Use warm to lukewarm water (avoid extremely hot temperatures). 

• Use potholders when cooking. 

• Use gloves when washing dishes or gardening. 

7. Closely monitor and write down what your symptoms are so you can share this with your doctor 

What your doctor might recommend 

Depending on your cancer treatment and your symptoms, your doctor may prescribe a medicine to reduce the pain or discomfort, such as duloxetine, gabapentin, or pregabalin. Your doctor may also decide to decrease the dose or change your cancer treatment if your symptoms are too severe. 

Other treatments to discuss with your oncologist 

• Physical therapy: uses range of motion exercises, stretching, and massage 

• Occupational therapy: focuses on improving your ability to do daily activities such as buttoning clothing,  

• Acupuncture 

• Electric nerve stimulation uses low electrical impulses to reduce or block pain signals from traveling to the brain

When to Contact Your Doctor, Health Care Provider, or Iris Oncology Nurse  

• Any new numbness, tingling, and or discomfort in hands or feet.  

• Difficulty buttoning buttons 

• Difficulty walking 

• If you still have pain after trying a treatment from your doctor 

 Questions for your doctor  

• Does my cancer treatment put me at risk for nerve damage?  

• When does nerve damage from my treatment usually start?  

• What symptoms will I experience? Where in my body? 

• How long can I expect these symptoms to last?  

• What medicines can I take to treat symptoms?  

• Are there other non-medicine strategies you recommend that might help? 

• Should I track my symptoms?  

• When should I report my symptoms to you or the team?