Keeping Cool: Can Ice Keep Side Effects at Bay?


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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.


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


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


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.”

Dana Cardinas headshot

"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!

11 thoughts on “Keeping Cool: Can Ice Keep Side Effects at Bay?

  1. Thank you for sharing such important things. I think this is one of the right things to do. I am very inspired by such strong personalities who continue to fight no matter what. I would never have thought that the sensitivity to cold could be increased or decreased in any way, although this is a common practice. But I ran into this after my father was diagnosed with cancer. After the treatment, he developed a great sensitivity to cold, I even envy him a little.

  2. I am going to begin my chemotherapy for CRC in two weeks. I want to “ice”. I haven’t found out how you do this? I can eat ice chips but do I buy the gel pack socks and hand gloves?
    Has the American Society for Clinical Oncology begun any clinical trials?

    1. Hi Kathy,

      Here is the protocol developed by members of the COLONTOWN group, Live Wire:

      1. Start icing prior to starting oxaliplatin infusion
      a. Request a 10 minute warning prior to starting oxaliplatin to allow time to get your cold
      packs applied.
      2. Apply icing protocol to hands, feet, and by mouth (orally).
      3. Hands and Feet Icing
      a. Rest the hands and feet directly on the cold packs or secure with tape or ace type
      bandages. Socks and thin gloves can be worn during icing or you can wrap the cold packs
      in cloth.
      b. Types of cold packs.
       Small bags of ice – have replacement ice ready, as your body heat will melt the ice fairly
       Freezer packs (gel or blue ice) – might need replacements if they start to get warm
       Commercial cold therapy mittens and socks
       Frozen water bottles
      c. Wrists and Ankles
       If cold sensitivity is present in the hands and feet, icing of the wrists and ankles can be
      used as an alternative.
      4. Oral Icing
      a. Find a cold substance that you can consume during infusion by sucking on it or chewing it.
      b. Types of cold substances
       Ice chips
       Frozen ice treats like Popsicles
       Slushy type drinks
       Ice water
      c. You may experience some slurring of words as your mouth and tongue become numb
      5. If the iced areas become too cold, take a short break. You can stop icing at any time if the cold
      becomes intolerable
      6. Continue icing for about 20 minutes after the oxaliplatin infusion has ended
      7. Feel free to cover the non-icing portions of your body with a blanket during the icing protocol. Do
      not let your body get so cold that you begin to shiver.

      To my knowledge, there have been several clinical trials testing the efficacy of icing for oxaliplatin induced cold sensitivity (

  3. I have completed my chemo treatment last Dec. 2020 and 2nd colon surgery due to colostomy reversal last Jan. 12, 2021. To date, i have numbness and tingling of hands and feet as side effect. Hope anyone can suggest treatment.

  4. Yes! I was on capox in the summer of 2019 and I had to fight with a major cancer hospital to allow me to do this. It was even less acceptable than it is now. But I won. And it worked. Totally.

  5. Hi, everyone; thank you for sharing this. My brother recently began his colon cancer related chemotherapy regimen, and I shared this with him. When he asked about taking the ice chips today during his chemo session, he was told that he couldn’t have them due to the medication being administered to help prevent mouth sores. Frankly, ice chips seem pretty innocuous to me; has anyone else been told this or knows what the adverse interaction might be about? Thanks so much!

  6. I learned about icing from Colontown. I have been icing since chemo #1 of 12. This week was #11 for me. No true neuropathy. Only very mild finger tip sensitivity but not enough to keep me from touch cold or hot. Due to taste issues, icing mouth is a little more challenging but I still try to do some and even with that (and a lysine supplement), oral symptoms are less of an issue and improve (not resolve) faster. My oncologist didn’t suggest this. I learned about on my own thanks to Colontown (Livewire group). I just showed up with my supplies on chemo #1. Nurse seemed skeptical but happy that it has been working!

  7. It works. Plain and simple.
    Fellow chemo patients:

    Ice your hands, feet and mouth/throat during your infusion!
    If it gets too cold, take a quick break, and then start again.
    I do it every time and am preventing cold sensitivity…I can immediately grab frozen foods, and swallow ice cream.
    It is ridiculous to me that oncologists not only don’t recommend this practice, but often dismiss it as useless. It makes me angry!

    Stage IV colon cancer survivor.

  8. I had cold sensitivity during treatment. I was usually able to eat a Wendy’s frosty, which was something I craved during treatment 4-5 days after a treatment. I couldn’t even go into the frozen foods section of the grocery store because my hands and legs would cramp. Today I am 8 months post treatment and my hands have mild neuropathy but it is significantly more severe in my feet. My friend who was undergoing chemo for ovarian cancer would ice her hands and feet during her treatments.

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