Neuropathy & Nerve Changes


Neuropathy is common among those receiving chemotherapy. You might feel a numbness or tingling in your hands and feet, a loss of sensation, shooting pain, a loss of balance, aching muscles, problems with finger dexterity and forgetfulness.

A unique symptom that many colorectal cancer patients experience with neuropathy is an extreme sensitivity to cold. The good news is that neuropathy often goes away when treatment ends. But, sometimes this type of nerve damage can linger.

Oxaliplatin, a drug used in the FOLFOX chemotherapy treatment, is known to cause acute or chronic nerve damage. While acute neuropathy can be managed by avoiding cold things, chronic or peripheral neuropathy gets worse with cumulative doses of oxaliplatin. It tends to fade after treatment with the drug ends, but it may take 18 months to 2 years to go away completely.

Acute & Chronic Neuropathy

Acute oxaliplatin-induced neuropathy

Often begins shortly after an infusion of oxaliplatin and gets better within a few days. It is triggered by eating, drinking, or touching something cold or breathing cold air. Some patients experience sharp pain in their mouth or jaw when they take a bite of cold food. Others may feel like their throat is closing and they cannot breathe, although breathing isn’t really affected.

Chronic peripheral neuropathy

The risk of a longer-lasting sensory neuropathy in your hands and feet increases as the amount of oxaliplatin increases in your body. Some patients start with feeling pins and needles, others may go on to have numbness and find it difficult to do small tasks with their fingers. In some cases, neuropathy can cause pain and difficulty with daily life, including walking. It is very important to let your doctor know if symptoms last beyond a few days after treatment. Use a notebook to track how you feel and let your doctor know if neuropathy gets worse.

Tips to manage neuropathy

  • Use gloves and warm socks (buy some BLUE gloves, socks & scarves in the Fight CRC store!)
  • Wear scarves or face masks outdoors in cold weather if you must go outside
  • Avoid eating or drinking cold or even cool foods.
  • Eat food that is room temperature
  • Avoid excessive air-conditioning
  • Take care to use handrails and avoid clutter that may cause you to stumble or trip
  • Consult with a physical therapist to strengthen muscles or build balance
  • Keep your doctor informed about your neuropathy symptoms
  • It helps to be prepared for your first oxaliplatin treatments by wearing gloves, a shawl or blanket, warm socks, and avoiding cold foods/drinks.

Content medically-reviewed by members of the Fight Colorectal Cancer Medical Advisory Board, February 2014

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