Peripheral Neuropathy

One of the possible side effects of chemotherapy treatments for mesothelioma is peripheral neuropathy, which patients often describe as pain, numbness or a tingling or burning sensation. Peripheral neuropathy occurs when one nerve or several nerves outside the brain or spinal column become damaged. Some chemotherapy drugs (e.g., cisplatin, which is normally used in combination with Alimta) may cause this symptom, or it may be related to other conditions not associated with the cancer, such as diabetes or shingles. In mesothelioma patients, peripheral neuropathy may also be caused by tumor pressing on or invading a nerve. It is up to your doctor to determine the cause of this symptom so it can be treated accordingly.

Some common symptoms of peripheral neuropathy include:

Pain.
Weakness.
Loss of feeling in a particular area.
Loss of reflex responses.
Tingling sensation in the hands or feet, or in other parts of the body.
Burning sensation along a nerve route in the body.
Sharp or shooting pain.
Exaggerated pain caused by something that would not normally cause pain.

Neuropathy brought on by chemotherapy may be temporary or may become chronic, depending on a patient's age, the individual amount of each dose of chemotherapy received, the total amount of chemotherapy received and the combination of different drugs received. Those who already have neuropathy due to other medical conditions, are at greater risk of more severe neuropathy when they receive chemotherapy drugs known to create possible nerve damage.

The doctor's aim in treating neuropathy is to reduce pain. Some treatments may include:

Antidepressant medications in doses often less than those typically used to treat depression.
Anticonvulsants used either alone or in combination with antidepressant medications.
Steroid medications.
Local anesthetics such as patches or creams which may be applied directly to the painful area.
Opioids, such as oxycodone, which are available in a variety of forms.
Non-drug treatments such as acupuncture, biofeedback or relaxation therapy.

It may also be helpful to work with a pain management specialist, particularly if symptoms persist, however, there are also some things you can do on your own to help manage symptoms:

Avoid alcohol. Even a small amount of alcohol can damage nerves that have been exposed to chemotherapy.
Stay ahead of your pain. Take any medications prescribed by your doctor early in the day before symptoms become severe.
If neuropathy is affecting your feet, sit down whenever possible and ask about the best types of shoes to wear. Check your feet regularly for any open sores which you may not be able to feel.
If you have diabetes, keep your blood sugar levels under control. High levels can damage nerves, particularly during chemotherapy.

If you are receiving chemotherapy treatment, and you start having pain you think may be related to neuropathy, be sure to discuss this symptom with members of your health care team. It will be helpful if you can describe:

The intensity of the pain (i.e., mild, moderate or severe).
What the pain feels like (i.e., sharp, stabbing, tingling, burning, dull, aching).
How the intensity of the pain changes throughout the day or night, or with activity.
How the pain affects your daily activities.
How much relief you are getting with any prescribed medications or other treatments.

As mentioned above, it is always important for your doctor to evaluate symptoms of this nature. As with all medical conditions, all possible causes will be taken into consideration, and the likelihood of one versus another will be weighed. Finding the correct cause will result in the correct treatment.

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