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While chemo-induced neuropathy is a common side effect, it is treatable and typically goes away after chemotherapy has finished.

Hair loss is one of the most well-known side effects of chemotherapy. But the lifesaving cancer treatment can have a host of other side effects, including tingling or numbness in the hands and feet.

What is peripheral neuropathy?

Sometimes referred to as “chemo hands” or “chemo feet,” these sensations or loss of feeling are known as peripheral neuropathy from chemo. Chemotherapy drugs can damage the peripheral nerves — those outside the brain and spinal cord that control sensations or movements of your arms, legs, hands and feet.

Interference with the nerves’ normal functioning leads to a variety of symptoms, ranging from mild to severe. They can begin during chemotherapy or several months after treatment has finished and include:

  • Tingling or numbness, similar to a “pins and needles” sensation
  • Burning or shooting pain
  • Muscle weakness
  • Loss of coordination and balance

“Symptoms typically start in the fingers and toes and move up through the hands, feet, arms and legs, and they can greatly affect your qualify of life,” says Jenn Lemon, RN, Geisinger registered nurse manager in hematology-oncology. “You might struggle to hold a fork, type or button a shirt. For numbness in the legs, you might have trouble walking, especially on stairs or uneven sidewalks, or have balance issues that can increase risk of injury.”

Is peripheral neuropathy from chemo permanent?

Luckily, peripheral neuropathy from chemo is often temporary, as nerves damaged by chemotherapy can repair themselves over time.

Though most people’s symptoms improve or go away completely after treatment, some have lingering neuropathy. Symptom duration can vary dramatically by person, ranging from a few weeks to several months — in rare cases persisting long-term.

So talk to your oncologist right away about any side effects during chemo treatment. Catching symptoms early can make it easier to manage them and keep them from worsening.

“Damage to the nerves depends on the type of chemotherapy drugs used, dosage and length of use,” says Ms. Lemon. “Your oncologist may choose to prescribe lower doses over a longer period of time to help minimize damage or even stop treatment until your symptoms improve.”

Treatment options for chemo-induced neuropathy

The main goal of treatment is to relieve symptoms, with medication being the primary option. Your oncologist may prescribe antidepressants or anti-seizure medications to relieve pain by blocking abnormal electrical signals in the brain. Patches or topical numbing creams are other options that you can apply directly to the painful area. Short-term use of steroids can also help. 

What’s more, physical therapy and occupational therapy can improve strength and flexibility to address neuropathy-caused limitations in daily activities. Exercises like yoga and tai chi can be beneficial for maintaining or restoring your balance.

“While more research is needed, some studies have indicated complementary therapies — such as acupuncture, medical massage and electrical nerve stimulation — have been shown to ease nerve pain,” says Ms. Lemon. “Every situation is different, and symptoms can vary greatly from mild to severe, so it may take some time to find the approach or combination that works best for you.”

She also points to healthy lifestyle habits to preserve nerve health and minimize the impact of chemo-induced neuropathy. Incorporating lifestyle changes like regular exercise, a balanced diet, and avoiding alcohol and tobacco, which can limit blood flow, could alleviate symptoms.

Reducing risk of injury

Because neuropathy diminishes sensation, it’s essential to take precautions to prevent injury.

Ms. Lemon recommends:

  • Always wear socks and shoes that cover your whole foot, even at home.
  • Use a walker or cane for extra support if you tend to stumble. Consider installing handrails in hallways and bathrooms.
  • Protect your hands and feet from extreme temperatures, such as wearing gloves in cold weather and checking bath water with a thermometer. Or start with cold running water and gradually shift to warmer.

“Be sure to check your hands and feet regularly for cuts or infections,” advises Ms. Lemon. “Neuropathy can affect wound healing and lead to serious complications. If open sores develop, contact your doctor right away.”

Can chemo-induced neuropathy be prevented?

While it may not be possible to entirely prevent chemo-induced neuropathy, you can take steps to minimize your risk.

Before starting chemotherapy, discuss potential side effects with your care team. They may suggest alternative medications or adjust your dosage to lower the risk of chemo-related neuropathy. Certain classes of chemotherapy drugs used to treat common types of cancer, like breast, colon, lung and prostate cancer, are more likely to cause nerve damage than others.

If treatment adjustments aren’t possible, you can ask your oncologist about putting ice on your hands and feet during infusion. There’s some evidence that shows icing can help keep certain chemotherapy medications from penetrating the small nerves of the extremities, minimizing damage.

“The best thing you can do is talk to your oncologist about various treatments and strategies at the first sign of symptoms,” says Ms. Lemon. “Treating symptoms early, before they become too severe, can reduce the effects of chemo-induced neuropathy.”

Next steps:

Learn about cancer care at Geisinger
What is an oncology pharmacist?
How breast cancer treatment affects your health

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