Neuropathy means nerve pain. Nerve pain is a common side effect of chemotherapy treatment for ovarian cancer. It’s estimated that about 30 to 40% of patients who receive chemotherapy, develop some type of nerve pain, and it’s the most common reason people decide to stop treatment.
Chemotherapy-induced peripheral neuropathy (CIPN) usually begins in the hands and feet. Symptoms are described as tingling, numbness, hypersensitivity, burning pain, and shooting pain. Sensitivity to changing temperature is also reported. Neuropathy usually begins in the hands and feet, then slowly progresses up the limbs.
CIPN makes daily activities more difficult. For example, trying to count change, tie shoe laces, or do any type of detailed activity with the fingers may no longer be possible. This can have long term effects on one’s quality of life, and one’s ability to earn money.
If nerve pain starts while actively taking chemotherapy medicine, the treatment can be reduced to a lower dose, or temporarily stopped. Pain usually goes away within a few weeks, although for some it can become a life-long issue. The other consideration is how aggressive the cancer is, and if it’s worth coping with the nerve pain in order to get the most out of treatment. This is an important discussion for a patient to have directly with her cancer doctor.
Other treatments used to help reduce nerve pain include physical therapy, medications such as steroids, pain meds, and medications that work directly on the nervous system. Complementary therapies such as massage and acupuncture, may also be tried.
Studies have shown that a type of anti-depressant which blocks the re-uptake of serotonin/norepinephrine, such as duloxetine and venlafaxine, may help. There is also a compound made of a muscle relaxant, an antidepressant, and an analgesic which is rubbed into the skin. The three primary drugs that make up this compound are baclofen, amitriptyline and ketamine. A specialist in managing pain can help determine which medications are most helpful.
Chemotherapy Drugs Associated with CIPN
A number of chemotherapeutic agents are known to increase risk of CIPN, these include:
- Platinum compounds (cisplatin, carboplatin, oxaliplatin)
- Taxanes (docetaxel, paclitaxel)
- Epothilones (ixabepilone)
Long Term Assistance
Women with ovarian cancer have a number of treatment options available. Research shows that using at least 2 different chemotherapy drugs at the same time has the best chance of killing cancer cells. The side effects, however, can cause complications such as peripheral neuropathy that may require long term follow on treatments, and symptom management.
Greg Vigna MD, JD is a practicing rehabilitation physician and certified Life Care Planner. He understands both the benefits and risks of chemotherapy treatment for ovarian cancer. Dr. Vigna is available to review your case for free, and determine if you may be eligible for compensation from manufacturers of talc-based baby powder, to treat your ovarian cancer and its complications.