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TOPIC SEARCH treatment for:  Vincristine-specific | Neuropathy 

Peripheral neuropathy (PN) is experienced as the loss of feeling in limbs and extremities. PN is probably caused when damage occurs to the myelin sheath, the "insulation" covering the nerve endings. PN is also caused by other conditions, such as HIV, and diabetes. 

Peripheral Neuropathy can be prevented or its progression slowed. By recognizing the early signs and symptoms, you can get prompt diagnosis, adjustment of cancer treatment, and treatment for the condition.

Symptoms: (will depend on severity)

	Electric shock sensation
	Strange plastic or scab-like sensation when something touches  their fingers or toes
	Severe cases:  touching the affected area can feel like touching an open wound
	Deep soreness or shooting pains in the muscles of the legs and lower arms that may come and go, but always affect the same general area
	Severe pain and altered feedback in the nervous system may even interfere with walking
	Numbness, loss of sensation

NOTE: Please consult a pain specialist when experiencing severe levels of pain. 
See neuropathy.org  to help locate a specialist in your area.

Vincristine (a cancer drug): raised level of serum alkaline phosphatase may predict severe neurotoxicity

Can severe vincristine neurotoxicity be prevented? Cancer Chemother Pharmacol. 1982;8(2):211-4. PMID: 6125275 | Related articles

Resources: 

	ClinicalTrials.gov  studies for chemo-related peripheral neuropathy
	About Neuropathy neurologychannel
	Acupuncture as therapy?  acupuncturetoday.com
	Differential diagnosis of symptoms  thebody  Relates symptoms and clinical features to types of neuropathy.
	Find a doctor who specializes in Neuropathy  neuropathy.org
	Management of Sensory Neuropathy  thebody
	Nerve Growth Factor New Treatment Shows Promise for Peripheral Neuropathy Excerpted from an article by Matt Chappel, ACT UP/Golden Gate  PDF
	Patient Guide prepared by MSKCC  PDF | PDF-Help
	Treating Neuropathy  neurologychannel.com
	Understanding Peripheral Neuropathy in patients with Cancer, ons.org  PDF | PDF-Help
	Venlafaxine Helpful in Painful Polyneuropathy CME News Author: Laurie Barclay, MD CME Author: Bernard M. Sklar, MD, MS  Medscape (free login req.)
	Vitamins as therapy for neuropathy?  aids.org

Personal Story  

"My neuropathy was serious enough that I lost muscle strength in my hips as well as legs and, at its worst I was dragging one leg when (barely) walking and could not sit in a chair without falling into it. Even my lips and the tip of my nose were numb -- and often still are. My onc sent me to both an acupuncturist and neurologist (the neurologist also recommended the acupuncture).  

The acupuncture got me moving again and I had several months of physical therapy to recover the muscle strength. I started taking 50 mgs of amitriptyline when the problem started and take it to this day. As to whether it helps the neuropathy I cannot say, but I always have a good night's sleep which is a benefit.  I have a couple of friends who have painful neuropathy in their feet, tho extensive testing can find no cause. Neither has found relief from any medication on the market.  

I would recommend to anyone who starts experiencing numbness during chemo to report it to their onc immediately, in case their dosage of Vincristine could be reduced. Mine was not as I was receiving less that the specified maximum for my body weight. The neuropathy is certainly something I can live with and more than a fair tradeoff for eight plus years of remission. I should add that most neuropathy from Vincristine resolves on its own so one shouldn't panic when it first appears. It is caused by the burning off of the myelin sheath which is the "insulation" covering the nerve endings.  This usually repairs itself within six months but if the damage is severe it may not." - Sally nhl-info (Texas)

UPDATE: Oct 2003

I returned to my neurologist last month - ten years after he treated me for peripheral neuropathy resulting from the Vincristine in my chemo. I am actually stronger now than when he last saw me and there has been no progression of the neuropathy. He explained that the off and on increases in numbness/tingling/aching are easily explained by the happenings in my life at this time - good stuff, not bad. He suggested that if I would lead a boring lifestyle it might help - no way. Stress and fatigue also contribute.

I am continuing on 50 mgs nightly of amitriptyline and he also suggested that I take Vitamin B50 each day. This is something that wasn't suggested ten years ago so I suppose it is a somewhat new idea. After a month on it I think there is a slight decrease in my symptoms and, as it's safe and cheap, wanted to pass the idea on to my fellow sufferers.  ~ Sally

UPDATE: Nov 2004

Back in October I reported that I had been reevaluated by my neurologist for peripheral neuropathy resulting from Vincristine in my chemo completed in 1994. He suggested that I try taking Vitamin B50 which I reported to the group at the time.

At the end of two months, as I was about to finish off the sixty tablet bottle, I noticed a profound improvement which has continued for the past 2-3 weeks. I called my neurologist today and he said that it was indeed possible to have such dramatic results. Whether this will last, of course, remains to be seen and he said not every one responds in this way. But, for those of you suffering from this discomfort, I'd say it's a cheap and easy remedy to try.

Sally
Dx 10-93, CVP, CR since 3/94

A cautionary note: It's reported that mega-doses of vitamin b-6 (pyridoxine) can cause sensory neuropathy, so best to consult an informed neurologist before practicing medicine on oneself.