Dr. Mackenzi Pergolotti, Ph.D., OTR/L is an Assistant Professor at Colorado State University, she answers a few questions as we learn more about the ins and outs of CIPN.
Chemotherapy Induced Peripheral Neuropathy (CIPN) is described as a group of symptoms related to nerves and muscles that are a result from nerve damage caused by cancer treatment. The most common symptom of CIPN is numbness and tingling felt in the hands and feet, but symptoms are different for everyone.
Q: Are some people more at risk than others to develop CIPN during treatment for CRC?
There are a few genetic risk factors to predispose someone for CIPN. Clinical risk factors include older age, previous neuropathy or diabetes, or smoking, and sensory changes during chemotherapy.
Q: What types of doctors should patients/survivors seek out for treatment of CIPN?
First talk with your medical oncologist to determine how severe it is and if your cancer treatment needs to be adjusted. Then, consult with rehabilitation professionals. An occupational therapist will be able to help you return to the activities you may be having difficulty with, such as buttoning shirts, opening jars, or being able to type or paint.
An occupational therapist in collaboration with a physical therapist can help determine your risk of falling, or if you have already fallen, figure out ways to decrease your risk in the future. Physical therapy can help you develop a plan for staying active and maintaining balance.
Q: What are some questions to ask your provider before treatment/after treatment?
Ask for a referral to rehabilitation if you are having any difficulties with neuropathy, but also if you are having trouble with fatigue, endurance, cognitive tasks (multitasking, concentration, attention, word finding or memory), medication management or participating in life. We are there to help through treatment and throughout survivorship.
I also suggest asking your provider about what they recommend for physical activity throughout your treatment and into survivorship.
Lastly, I would ask what are the symptoms you need to be most concerned about, and even contact them if you begin to have those symptoms. Having your questions written down and take notes so you can remember afterwards what your provider suggests. Or, as I often do for my own medical appointments, take someone with you to the appointment to help remember questions and answers provided.
Q: What do you recommend a patient/survivor do if the treatments don’t work?
Sometimes, time itself can help heal, but don’t give up. Keep asking for help and be your own advocate. I would suggest trying integrative medicine, acupuncture or massage. I also recommend meditation and mindfulness training. These techniques have scientific evidence suggesting they can be effective in helping with chronic symptoms such as pain and can decrease anxiety.
Tips, Tricks and Advice
Some patients have noted that some feel-good, self-care rituals have helped them with CIPN management. These include:
- Taking a arm bath
- Exercise (like walking, strength training, balance exercises)
- Massages and foot rubs
- Putting feet up
Managing CIPN is important, as neglecting the side effect could, in fact, lead to falls and other injury. For tips that could help minimize those risks, download our Side Effects Mini Magazine.