Reducing Symptoms of Chemotherapy-Induced Neuropathy
Chemotherapy is a long and painful treatment process for individuals suffering from cancer. One of the most common side effects associated with chemotherapy is peripheral neuropathy, a tingling / numbness to the feet. The overall incidence of chemotherapy induced peripheral neuropathy (CIPN) ranges from 30%–80% in patients treated for cancer, depending on the chemotherapy regimens used and the duration of treatment
With the focus primarily on direct cancer therapy, the priority of CIPN and associated symptoms is typically low until the cancer is in remission.
As patients begin to resume their normal routines the effects of the chemotherapy-induced neuropathy can start to interfere with daily activities. Below are a few simply tips that can help reduce the symptoms of CIPN.
What is CIPN?
Neuropathy is a type of nerve damage that can cause one of many unusual sensations, such as tingling, numbness, and other feelings. These feelings are most often noticed in the hands and feet of the patients.
The main belief why neuropathy happens is because chemotherapy is meant to destroy cancer cells, but it also cannot help but damage healthy cells, too due to chemotherapy toxicity. When chemotherapy affects the movement and feeling in the hands and feet, they consider it chemotherapy-induced peripheral neuropathy, or CIPN, for short.
How to Prevent & Treat CIPN
The best way to outright prevent CIPN is to simply choose a chemotherapy drug that is not as likely to cause it. This, however, is not always a guarantee, as treatments for cancer are known to be “diagnosis-specific”. Some of the most common chemotherapies that cause neuropathy include vinca alkaloids (vincristine), cisplatin, paclitaxel, and the podophyllotoxins (etoposide and tenoposide). Other drugs used to treat cancer such as thalidomide and interferon also can cause peripheral neuropathy. This means the most helpful drugs can also have the most severe side effects.
Although there is no guarantee for reversal of CIPN symptoms there is some promising research with nerve protective medications and vitamin supplementations which demonstrates reversal of the symptoms. Below are just a few of the top worth exploring.
The novel therapeutic option of the inhibition of HDAC6 has been proposed to protect against neurological disorders by facilitating distribution of mitochondria throughout the neuronal network. In a recent study it was demonstrated that just 11 doses of inhibition of HDAC6 treatment improved mitochondrial bioenergetics and contents in the tibial nerves of cisplatin-treated mice. Or in other words reduced CIPN symptoms!
There is sure to more soon on the advanced of FDA approved medications for the reversal CIPN.
Studies have proven that taking vitamins and other supplements can help alleviate symptoms of CIPN and even stimulate new nerve growth. Some of the big players in this area are L-methyl-folate, acteyl-l-carnitine and R-lipoic acid.
One study on acetyl-l-carnitine demonstrated a reduction in painful symptoms after just 10 days of treatment with the efficacy persisting for 3 weeks after the supplements were stopped. Suggested dose is 100 mg/kg by mouth or also intravenously.
For dosing and suggested vitamin supplementation it is suggested to speak to your medical professional.
CBD Oil and Creams
Cannabis has been used in medicine for thousands of years prior to achieving its current illicit substance status. Cannabinoids, the active components of Cannabis sativa, mimic the effects of the endogenous cannabinoids, activating specific cannabinoid receptors, particularly CB1 found predominantly in the central nervous system.
Topical CBD Creams have been shown to be of benefit in the treatment of peripheral neuropathy, suggesting an important role in the prevention and management of CIPN. One such brand is Theramu not only contains the beneficial CBDs but also the strong anti-oxidant emu oil
Textured Sensory Insoles
There are wearables that are designed to bring stability to movement patterns when neuropathy causes numbness in the feet. These products include insoles, compression socks and gloves.
Naboso Insoles , are designed to stimulate the nerves on the bottom of the feet. These insoles do a wonderful job of alleviating foot pain and fatigue in addition to restoring necessary foot function to help you stay active despite having CIPN.
A new treatment for CIPN has made the rounds in recent years known as low-level laser therapy. With this therapy, infrared light is used in the affected areas of your body to enhance the repair of tissue and improve the health and function of the nerves within.
Systems such as the Mito Red Light now makes this treatment options something that can be done at the convenience of your own home.
Additional Treatment Options
There are many forms of alternative medicine that patients find to be beneficial in CIPN. These include acupuncture, chiropractic, reflexology, among others. We encourage you to try these remedies to cope with stress, which is a very common symptom when being diagnosed with cancer and being treated with chemotherapy. However, it is not backed by research that these alternative medicines can treat additional symptoms of CIPN.
CIPN is on the rise but not a condition that is without potential hope in the reversal or reduction of the symptoms. We suggest viewing the above options as lifestyle changes that requite consistency and patience. The future of research for CIPN is bright and hopefully soon the risks of nerve toxicity can be prevented during the initial chemotherapy treatments.
Herbs, Botanicals & Other Products: FAQs
Do you offer alternative treatments for cancer?
Alternative treatments are those used instead of mainstream therapies. They are unproven, expensive and unsafe. We do not offer alternative medicine in this hospital.
What is complementary medicine?
Complementary medicine includes therapies that are used as adjuncts to mainstream cancer care. They are supportive measures that control symptoms, enhance well-being, and contribute to overall patient care. Their benefits are usually supported by clinical studies and they are generally inexpensive. Complementary therapies include acupuncture, massage, music, and mind-body therapies such as meditation.
Does healthcare insurance pay for Integrative Medicine therapies?
It depends on the coverage of your policy. Many insurance companies recognize the benefits and cost-effectiveness of complementary therapies and offer coverage to include them. Some hospitals provide these therapies free of charge as part of the overall inpatient care.
Spending on most complementary therapies is considered a medical expense and may also be eligible for a healthcare flexible spending account.
Dietary Supplements for Cancer Prevention
What are free radicals? Do they cause cancers?
Free radicals are chemicals that have unpaired electrons. They are present in the environment and are also generated in the body through normal metabolism. Free radicals are highly active and are thought to interact with DNA causing cell damage and cancer.
What are antioxidants?
Antioxidants are substances that can inhibit the process of oxidation associated with free radicals. Many foods and dietary supplements, such as vitamin C and pycnogenol, have antioxidant effects.
Can antioxidants be used to prevent cancers?
Some believe a diet rich in antioxidants helps prevent cancer. However, there is no conclusive evidence that antioxidant supplements can reduce cancer incidence. Moreover, high intake of certain antioxidants is associated with increased cancer risk.
Should I use a daily multivitamin to prevent cancer?
Studies of multivitamin use for cancer prevention have yielded mixed results. Most found that multivitamins have little or no effect in reducing the overall risk of cancer. And some studies suggest that multivitamin supplementation may actually increase the risk of certain cancers. But according to a recent study from the Physicians’ Health Study published in the Journal of the American Medical Association, multivitamins can lower cancer incidence in male cancer survivors. Because of variation in the populations studied and the formulations of multivitamins used, the benefits of a daily multivitamin for general cancer prevention remain unclear.
Dietary Supplements During Cancer Treatment
Are there any herbs that can be used to treat cancer?
Many chemotherapeutic drugs used in cancer treatment are derived from plants. They are developed after rigorous clinical trials for safety and efficacy. Only a few oral herbal supplements, like turmeric, and some medicinal mushrooms have been tested this way. However, even those that showed promising results in lab studies may not have the same effects in humans. In addition, the optimal dosages are often not determined. More studies are needed before they can be recommended for general use.
Can I use herbs or supplements safely during chemotherapy?
Most herbs and dietary supplements have not been studied together with chemotherapy drugs and their interactions remain unclear. Many oncologists advise their patients to avoid these products during chemotherapy.
How do herbs interact with chemotherapy drugs?
Herbs can interact with chemotherapy drugs through different mechanisms. Some herbs can interfere with the metabolism of the drugs, making them less effective. Other herbs may potentiate the adverse effects, such as bleeding, of chemotherapy drugs.
While undergoing cancer therapy, do I have to avoid spices and herbs in cooking?
Culinary herbs used in small quantities for flavoring are generally safe. However, consuming large amounts for prolonged period of time may have adverse effects. For example, there are reports of post-operative hemorrhage associated with use of garlic.
Dietary Supplements to Alleviate Side Effects of Cancer Treatment
Can I take antioxidants to prevent the side effects of cancer therapies?
There are prescription drugs that act as antioxidants to help protect against the adverse effects of cancer therapies. The precise mechanism and the side effects of these drugs have been thoroughly examined. However, very few antioxidant dietary supplements have been studied for their safety and usefulness. Current information about the use of these products is confusing. Some think they help kill cancer cells or protect healthy cells from the damage caused by chemotherapy drugs or radiation therapy. But antioxidant supplements may also make these treatments less effective. Until more is known, it is wise to avoid them during chemotherapy.
I heard some herbal formulas can be used to treat the side effects of chemotherapy. Is that true?
Herbs like Astragalus have immunomodulating effects. They have been studied in humans and have been shown to help reduce some of the adverse reactions induced by chemotherapy. However, they are not appropriate for all patients and larger clinical trials are needed to confirm their safety and efficacy.
I have peripheral neuropathy following chemotherapy. Is there a natural treatment to relieve my symptoms?
Several nutritional supplements, such as glutamine, glutathione, vitamin Bs, vitamin E and alpha-lipoic acid, have been tested as treatments for peripheral neuropathy. Early clinical trials indicate that glutamine may reduce the incidence and severity of chemotherapy-induced peripheral neuropathy. Preliminary studies show that acupuncture can reduce pain and improve nerve function and sensation, and can help relieve peripheral neuropathy associated with chemotherapy. But larger studies are needed to confirm these effects.
Are there any herbs that can help my hair grow back?
Hair loss is a common adverse effect from chemotherapy. Most patients’ hair will grow back after discontinuing treatment. Currently, there is no evidence that herbs can help regrow hair.
What is good for “dry mouth”?
Many patients may experience xerostomia (dry mouth) after surgery or radiation therapy for head and neck cancer. Prescription drugs can be used to help relieve this symptom but they are often associated with other side effects. Currently, there is convincing evidence that acupuncture can be used to address this symptom safely and effectively. Patients can consult with a qualified practitioner for more information.
What are phytoestrogens?
These are herbs that have estrogen-like activities. A few popular examples include soy, red clover, flaxseed, and dong quai.
I have estrogen-receptor positive breast cancer. Can I take soy products?
The use of soy products by patients with hormone sensitive cancer remains controversial.
Animal studies show that constituents in soy may stimulate the growth of breast cancer cells and increase risk of metastasis. They can also work against tamoxifen, a drug used for estrogen-dependent breast cancer. However, epidemiological data suggest that soy foods help reduce breast cancer risk and have a positive effect on breast cancer survivors. Soy foods also have other health benefits as they are naturally rich in protein and low in fat. Until more is known, many experts agree that moderate consumption of soy foods is acceptable but concentrated soy supplements should be avoided.
Do botanicals interfere with the metabolism of drugs?
Yes, many botanicals interfere with the way a drug is processed in the body: Increased metabolism of a drug reduces its concentration in the blood and may reduce its effectiveness; decreased metabolism of a drug increases its concentration in the blood and can lead to toxicity or increased side effects.
I am taking an anticoagulant drug. Why are there so many dietary restrictions?
Anticoagulant drugs, such as warfarin, have a very narrow therapeutic range. They can cause adverse effects and are prone to interact with other drugs and dietary supplements. Herbs like ginger, garlic, turmeric can interfere with anticoagulants increasing the risk of bleeding. Certain vegetables rich in vitamin K can decrease the therapeutic effects of warfarin.
How do I know if an herb or a vitamin can interact with chemotherapy drugs or other prescription drugs?
Talk to your physician or pharmacist before taking dietary supplements.
How does acupuncture work?
In Traditional Chinese Medicine, acupuncture is thought to treat diseases by promoting flow of energy (Qi) in meridians that are believed to connect various organs in the body. Modern research indicates that acupuncture can modulate the secretion of neurochemicals, such as beta-endorphin and serotonin, to help relieve pain. Studies also suggest that patient-practitioner interaction plays a role in acupuncture’s therapeutic effects. Research is underway to determine the mechanisms underlying acupuncture’s effects.
Can acupuncture be used to treat cancer?
There is no scientific evidence to show that acupuncture can be used to treat cancer or to shrink tumors. But several studies indicate acupuncture’s usefulness in alleviating symptoms associated with cancer and its treatments.
What is acupuncture good for?
Acupuncture can be used to control several symptoms associated with cancer treatment, such as pain, anxiety, nausea, dry mouth, and hot flashes. There is preliminary evidence indicating the benefits of acupuncture for neuropathy.
Is it safe to receive acupuncture during cancer treatment?
Acupuncture can be performed safely during cancer treatment. However, patients who are on anticoagulants or are susceptible to infections should use acupuncture with caution. It is important to consult with an oncology-trained acupuncturist for evaluation before beginning treatment.
Can I receive acupuncture if I have lymphedema?
Due to risk of infections, patients are often advised to avoid needles on limbs that are prone to lymphedema. This extends to the use of acupuncture needles. However, most acupuncturists use disposable needles and clean needle technique which greatly reduce the risk of infection. Furthermore, emerging data from recent studies indicate that acupuncture treatment is safe and helps reduce symptoms of lymphedema. We are currently conducting a study to confirm the safety and efficacy of acupuncture for lymphedema. Patients with lymphedema should first consult with a physician and seek treatment from trained acupuncturists.
Do I need a doctor’s referral for an acupuncture treatment?
In New York and in many other states, acupuncturists are considered as independent healthcare providers. You don’t need a doctor’s referral to get an acupuncture treatment. However, it is important to consult with your physician for a proper diagnosis and evaluation. Your doctor and acupuncturist can work together to provide you the best care.