On a hot summer day, an ice-cold lemonade or popsicle sounds like perfection to many. But if you are on certain chemo regimens and suffering from cold sensitivity, that cold treat can seem like your worst enemy.
COLD SENSITIVITY AND CIPN
Many colorectal cancer (CRC) patients are treated with a combination of drugs referred to as FOLFOX, which includes oxaliplatin, folinic acid, and fluorouracil. Oxaliplatin, specifically, is notorious for increasing a person’s sensitivity to cold. It causes numbness, tingling, and muscle spasms, which are made worse by exposure to cold temperature and coming into contact with cold objects.
The most striking side effect, however, is due to a short-term nerve damage that occurs in the mouth and throat, making it difficult to eat or drink anything cold in the days after treatment. Additionally, FOLFOX often leads to chemotherapy induced peripheral neuropathy (CIPN). CIPN is a progressive and sometimes irreversible condition of the hands and feet. Patients often describe it as feeling numb, tingling, and painful, and it also leads to a sensitivity to cold.
“When I went through 12 rounds of Folfox, I had bad cold sensitivity when I would swallow anything cold (shards of ice sensation).” Andrea Deacon, Stage IV, colon cancer
ICE MAY HELP!
For decades, patients have lived through these uncomfortable side effects as just par for the course of cancer treatment. However recently, patients have been spreading the word about the benefits of using ice to help. Though it seems counterintuitive, studies suggest it just might be working.
An April 2019 study published in the Journal of the National Comprehensive Cancer Network, showed that gastrointestinal cancer patients who kept ice chips in their mouth during their oxaliplatin infusion (called “icing” by some) developed less cold sensitivity in their mouths compared to patients who did not keep ice in their mouths during treatment. The benefit of this is that those patients could eat and drink with less discomfort.
“Currently I’m on CapOx, 5th round, and I’m icing. Huge difference with the past! Now I can drink cold beverages.” Rene Wooten Roach, Stage IV, rectal cancer survivor
PATIENTS GIVE A REAL-WORLD EXAMPLE
Through anecdotal experiences, patients in an exclusive online Facebook community named Colontown also began experimenting with their own icing protocol and reported successful outcomes.
Results of their study will be presented at virtual ASCO 2020. According to their conclusions, “this real-world example highlights the role of educated patient advocates on social media. Working with these groups directly can provide insights for the medical community on measures patients can do to prevent chemotherapy-associated side effects.”
“It is exciting to see something so simple as chewing on ice during a FOLFOX infusion make a big impact on a CRC patient’s quality of life during chemotherapy. Before this, we did everything we could to avoid anything cold. Now, some patients leave their infusion center and go get ice cream! I am most excited to see the long term effects that icing might have on reducing CIPN. This shows the power of patients in an educated social media setting.”
– Dr. Dana Cardinas, retired podiatrist, CRC Stage 3C survivor
The Effects of Using Coldness During Treatment is Nothing New
The idea of cooling specific body parts during cancer treatment is not totally new to the cancer landscape. A study from 2017 showed that women with breast cancer receiving chemotherapy with a taxane, anthracycline, or both, who underwent scalp cooling were significantly more likely to have less than 50% hair loss compared with no scalp cooling.
Another study with breast cancer patients used cryotherapy during treatment to affect CIPN. In this study, patients who were treated with a paclitaxel or a paclitaxel-containing regimen wore a frozen sock on one foot and a frozen glove on one hand for an hour and a half, which included the duration of the treatment infusion. The study endpoint assessed the changes in tactile sensitivity from a pretreatment baseline, comparing the hand and foot that were using the frozen glove and sock to the hand and foot that did not. While the study group was small, fewer than 40 people, the study showed that cryotherapy is useful for preventing both the objective and subjective symptoms of CIPN and resultant dysfunction.
Research is growing in this area to ensure patients have the highest quality of life during treatment. Do you have experience with using ice during chemo? Comment below!