Cold Weather’s Coming. . . and Oxaliplatin Difficulties

There was frost on the grass this morning when I let the little dog out.  A hard freeze is predicted for the next few nights, a sign that winter and its ice and snow isn’t far off.

Cold is a special problem for people who are getting Eloxatin® (oxaliplatin) for colon and rectal cancer.  Almost all patients on FOLFOX will experience acute neuropathy within a few hours of each oxaliplatin infusion.  This is acute, short-term, and ends within few days.

About a third will go on to a chronic peripheral neuropathy that begins as oxaliplatin doses accumulate.  Most patients will experience some tingling and numbness in their hands and feet.  A very few will have pain and difficulty walking.

Chronic neuropathy usually fades in the months after treatment ends, but may linger as long as a year or 18 months.  It remains a long-term problem for a small percentage of patients.

As cold weather approaches, you need to take care if you are on FOLFOX treatment or have peripheral neuropathy left over from previous treatment.

Protection from the Cold

Acute Neuropathy

During your oxaliplatin infusion and for the next few days

  • Avoid cold drinks, very cold food, or frozen treats like ice cream.  They will cause sudden pain in your mouth and throat that is intense and may provoke frightening spasms.
  • Don’t suck on ice during treatment to prevent 5-FU mouth sores.  Avoid ice altogether.
  • Use pot holders or gloves to remove items from the freezer or ask for help.
  • Wear mittens and warm socks to treatment and ask for a blanket.
  • For a few days after treatment, stay inside where it is warm.
  • If you must be outside, wear mittens, warm socks, and boots.  Cover your mouth with a scarf to avoid breathing cold air,
  • If you suddenly feel spasms in your throat, relax.  You are able to breathe.  Breathe slowly and deeply in through your nose and exhaling through pursed lips.  This will help you relax until the spasm eases.

Chronic peripheral neuropathy

  • Keep hands and feet warm and dry with mittens and socks.
  • Talk to your doctor about your symptoms and consider lowering the oxaliplatin dose or discontinuing it altogether.

Safety First

When your hands and feet are tingling or numb, you need to take special care to avoid cuts, burns, and falls.  Serious neuropathy may affect your balance, and when you can’t feel your feet you can easily fall.

  • If you can, avoid using knives and sharp tools.  Ask for help in the kitchen and with chores that require tools that might slip.
  • Turn down the thermostat on your hot water heater so that your won’t burn yourself washing your hands, doing dishes, or taking a shower.
  • Always use hot pads or oven gloves handling hot dishes or pans.  Ask for help if they feel heavy or hard to hold.
  • Always wear shoes — indoors and outside.
  • Get rid of scatter rugs and obstacles that you might trip over in the house.
  • Be sure that there are railings on both sides of staircases and walk slowly on stairs.  Don’t carry baskets or bundles up and down stairs.
  • Consider installing bars in the bathroom or use a shower seat.
  • If you have serious problems walking or keeping your balance, ask your doctor for a referral for a home visit from an occupational therapist who can help you with home safety.

Slow down, sit down, and ask for help.

Allergic Reactions

Oxaliplatin can cause an allergic reaction that is different from the reaction to cold.  Allergic reactions can occur even after several successful treatments so,

If you experience any of the following symptoms, ask for help from the oncology nurse and your doctor immediately.

  • You feel like your throat is closing up.
  • You have shortness of breath.
  • Your face gets red and feels hot.
  • You get a rash.
  • Your lips or tongue swell.
  • You have a sudden cough.
  • You get dizzy, sweat, or have chest pain.

There is more information about coping with oxaliplatin-induced neuropathy in the Fight Colorectal Cancer patient information section.

Disclosure: Fight Colorectal Cancer has accepted funding from sanofi-aventis for projects and educational programs from in the form of unrestricted educational grants. Fight CRC has ultimate authority over website content.



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