Treatment Side Effects - Peripheral Neuropathy

Some patients with lung cancer experience peripheral neuropathy, damage to the nerves. The peripheral nerves carry information from the brain to parts of the body and from those parts of the body back to the brain. The effects of peripheral neuropathy vary, depending on which nerves are affected: the sensory, motor, or autonomic.¹

Anatomy of nerves

The sensory nerves detect pain, heat, cold and pressure. Patients experiencing peripheral neuropathy to sensory nerves may have symptoms of:

• Tingling or numbness in hands, arms, feet, and/or legs, sometimes called “pins and needles” sensations
• Difficulty detecting heat or cold
• Inability to feel pain in the extremities
• Shooting pains or burning feeling, especially in the fingers or toes
• Hearing loss^1,2

Motor nerves communicate to the muscles to regulate movement. Patients with peripheral neuropathy to motor nerves may experience:

• Weakness
• Achy muscles
• Loss of balance
• Difficulty walking
• Frequent tripping or falling
• Difficulty with fine motor skills, like using buttons or picking up small objects
• Muscle twitching or cramping
• Muscle wasting
• Difficulty swallowing or breathing (if the chest or throat muscles are affected) ^1,2

Autonomic nerves control bodily functions like heart rate, temperature, digestion, blood pressure, and urination. Patients who have peripheral neuropathy that affects autonomic nerves may experience:

• Low blood pressure, causing dizziness or faint feelings
• Digestion problems, like constipation or diarrhea
• Sexual difficulties
• Sweating too much or too little
• Difficulty with urination, like leaking or trouble emptying the bladder ^1,2

What causes peripheral neuropathy?

There are multiple causes for peripheral neuropathy. If a cancerous tumor is pressing on or growing into nerves, the tumor itself can cause neuropathy. Some chemotherapy drugs also can cause peripheral neuropathy as a side effect of treatment. Besides cancer and its treatment, peripheral neuropathy can also be caused by other health conditions, including diabetes, hypothyroidism, rheumatoid arthritis, AIDS, and carpel tunnel syndrome. Other medications, such as some used for cardiovascular disease, may also cause peripheral neuropathy.^2,3

Managing peripheral neuropathy

Any patient undergoing treatment for lung cancer should report side effects such as peripheral neuropathy to their health care team. Early treatment is the best way to limit the damage, reduce pain and control these symptoms.¹

Treating peripheral neuropathy will depend on what is causing it. If the neuropathy is related to chemotherapy, doctors may reduce the dosage or change the chemotherapy agents. For pain associated with neuropathy, patients may be prescribed pain medications. Additional strategies to manage peripheral neuropathy include:

• Getting regular exercise to maintain circulation
• If the neuropathy is caused by diabetes, managing the diabetes with proper diet and medication to control blood sugar
• Limit alcohol use
• Protect your hands and feet from injury, wearing shoes and using caution with sharp utensils
• Avoid using heating pads and hot water bottles
• Prevent falls by removing throw rugs and using bathmats in showers or tubs
• Try acupuncture, massage, physical therapy, or yoga^1,2

Because peripheral neuropathy is caused by damage to the nerves, it is difficult to predict how long symptoms will last. Some people experience partial recovery, while others may have continued symptoms.²