Vincristine (part of CHOP)

Symptoms of PN may occur in individuals who clear this drug too slowly,
leading to increased concentrations of the drug in the blood.

Please report PN symptoms to your oncologist when they occur.

Cisplatin (Platinol®)

Carboplatin (Paraplatin®)

Oxaliplatin (Eloxatin®)
 

Velcade - Bortezomib-Induced Peripheral Neuropathy (BIPN)

Incidence and severity of bortezomib-induced PN BIPN was first reported in phase I trials.24 ... Among patients who developed PN, a full resolution or an improvement of the PN was reported in most of the patients during follow-up (in 51% of the patients with grade ≥2 PN, and in 71% of the patients with grade 3, 4 PN or with PN resulting in treatment discontinuation).

The median time to improvement or resolution of the PN was 47 (range, 1–529) days. Among patients without PN in the SUMMIT/CREST trials, 41 were included in the extension of the SUMMIT trial: only 5 (12%) of these patients presented PN after the additional courses of bortezomib. In spite of a prolonged treatment, most of the patients who had presented a PN in the SUMMIT/CREST trials did not report an aggravation of the PN, demonstrating that prolonged exposure to bortezomib does not increase the incidence or severity of the PN.14

Source: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2817035/

Balance problems

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

Electric shock sensation

Numbness, loss of sensation

Scab-like sensation when something touches their fingers or toes

Trouble swallowing

Severe cases: 

touching the affected area can feel like touching an open wound

Severe pain and altered feedback in the nervous system may even interfere with walking

NEW: Neuropathic Pain - Med News Today: (company press release)
KRN5500 Demonstrated Significant Decrease In The Intensity
Of Neuropathic Pain In Patients With Cancer

Physical Therapy to Improve Functionality in Peripheral Neuropathy Patients
James Nussbaum, Ph.D., M.S.P.T., C.S.C.S., E.M.T.
http://bit.ly/iNxy6X 
 

Chemotherapy-induced Peripheral Neuropathy Fact Sheet http://bit.ly/jyDcfb 

“Spotlight on Physical Therapy and Chemotherapy Induced Peripheral Neuropathy

“Three studies have examined progressive resistive exercise, aerobic exercise, and stretching exercises in the treatment of peripheral neuropathy. All three found significant improvements in outcomes such as stance, functional reach, and peroneal motor conduction velocity (Balducci et al., 2006; Lindeman et al., 1995; Richardson et al., 2001). A Cochrane review examined the role of exercise for individuals with peripheral neuropathy from etiologies other than chemotherapy. The study found that exercise increased function, muscle strength, endurance, quality of life and return to work. Strengthening exercises were found to reverse the losses in muscle strength related to peripheral neuropathy.”
 

Antioxidants such as alpha lipoic acid to prevent PN?

"Because it is a powerful antioxidant, there are concerns that lipoic acid could make radiation therapy or chemotherapy less effective. While this concern is based largely on theories of how cancer treatments work, it is supported by some recent studies. For this reason, people being treated for cancer should speak with their doctors before taking this supplement." cancer.org

http://www.lymphomation.org/CAM-A-E.htm#lipoic
 
So far there is no evidence from controlled clinical trials to show therapeutic or protective effects of alpha-lipoic acid. Clinical studies of sufficient size are required to determine the risks and potential benefits of any intervention, particularly when the effects are modest or small.

Report your symptoms so the treatment dose can be adjusted.

Please do not self-treat with vitamins, for which there is no clinical evidence.

Vitamin B for treating peripheral neuropathy - no evidence of meaningful benefit ncbi.nlm.nih.gov/pubmed/18646107

Randomized and quasi-randomized trials where vitamin B was compared with placebo or another treatment in generalized peripheral neuropathy.

AUTHORS' CONCLUSIONS: There are only limited data in randomised trials testing the efficacy of vitamin B for treating peripheral neuropathy and the evidence is insufficient to determine whether vitamin B is beneficial or harmful. One small trial in alcoholic peripheral neuropathy reported slightly greater improvement in vibration perception threshold with oral benfotiamine for eight weeks than placebo. In another small study, a higher dose of oral vitamin B complex for four weeks was more efficacious than a lower dose in reducing symptoms and signs. Vitamin B administered by various routes for two to eight weeks was less efficacious than alpha-lipoic acid, cilostazol or cytidine triphosphate in short-term improvement of clinical and nerve conduction study outcomes. Vitamin B is generally well-tolerated.

Find Board Certified Neurologist application.abpn.com

The American Board of Psychiatry and Neurology, Inc. (ABPN) is a not-for-profit corporation dedicated to serving the public interest and the professions of psychiatry and neurology  by promoting excellence in practice through certification and maintenance of certification  processes. The ABPN is a Member Board of the American Board of Medical Specialties (ABMS).

ClinicalTrials.gov  studies for chemo-related peripheral neuropathy

Nerve Growth Factor: 

New Treatment Shows Promise for Peripheral Neuropathy
Excerpted from an article by Matt Chappel, ACT UP/Golden Gate  PDF 

Neurologychannel.com

Chronic pain treatments work better together eurekalert.org 

"When given both an anti-seizure drug (gabapentin) and an antidepressant (nortriptyline), patients suffering from neuropathic pain caused by nerve damage or disease experienced less pain than when they took one or the other individually, reports Ian Gilron"

What are the symptoms of chemo-induced PN? cancer.org

Chemotherapy-induced Peripheral Neuropathy Fact Sheet  cancersupportivecare.com

Numbness & Tingling chemocare.com

The Houston Peripheral Neuropathy Support Group  winoverpn.com

About Neuropathy neurologychannel 

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

Patient Guide prepared by MSKCC  PDF 

Venlafaxine Helpful in Painful Polyneuropathy CME News Author: Laurie Barclay, MD
CME Author: Bernard M. Sklar, MD, MS  Medscape (free login req.)

Chronic pain treatments work better together, says anesthesiologist eurekalert.org 

"When given both an anti-seizure drug (gabapentin) and an antidepressant (nortriptyline), patients suffering from neuropathic pain caused by nerve damage or disease experienced less pain than when they took one or the other individually, reports Ian Gilron"

Toxic neuropathy in patients with pre-existing neuropathy.
Neurology. 2003 Jan 28;60(2):337-40. PMID: 12552058  PubMed

Burning mouth syndrome (BMS) ("which has features of a neuropathy"): double blind controlled study of alpha-lipoic acid (thioctic acid) therapy. J Oral Pathol Med. 2002 May;31(5):267-9. PMID: 12110042  PubMed

Oxidative stress and diabetic neuropathy: pathophysiological mechanisms and treatment perspectives. Diabetes Metab Res Rev. 2002 May-Jun;18(3):176-84. PMID: 12112935  PubMed

Insulin-like growth factor I reverses experimental diabetic autonomic neuropathy. Am J Pathol. 1999 Nov;155(5):1651-60. PMID: 10550321  PubMed 

Caution: Insulin-like growth factor induces the survival and proliferation of myeloma cells through an interleukin-6-independent transduction pathway. Br  J Haematol. 2000 Nov;111(2):626-34. PMID: 11122111 PubMed