Neuropathy Continued After Treatment

Most treatment side effects have a rough end date. Neuropathy often does not. Chemotherapy finished months ago. Your scans are stable. And your feet still feel wrapped in a layer of something. This page is about that stage. How long it lasts. What helps once treatment is over. And how to live safely with the version that stays.

The National Cancer Institute describes peripheral neuropathy as damage to the peripheral nerves. Those nerves carry information from the brain to other parts of the body. Which symptoms persist depends on which nerves were hit.

Sensory damage leaves tingling, numbness, or a pins-and-needles feeling in the feet and hands. It can also leave you unable to feel hot or cold, or unable to feel pain, such as from a cut or sore on your foot.

Motor damage leaves weak or achy muscles. That may make you lose your balance or trip easily. It can also cause muscle twitching, cramping, or wasting, and trouble swallowing or breathing.

Autonomic damage affects the nerves you do not control. It causes digestive changes, dizziness from low blood pressure, sexual problems, sweating problems, and urination problems.

The honest answer from the sources is a range, not a timeline. The American Cancer Society states that peripheral neuropathy can last for weeks, months, or even years after cancer treatment is done.

Neither NCI nor ACS publishes a recovery curve. There is no percentage of people better at six months. There is no expected point of full resolution. A confident date goes beyond what either organization claims.

MedlinePlus addresses permanence directly. If a medical condition can be found and treated, your outlook may be excellent. But sometimes nerve damage can be permanent, even if the cause is treated. Some nerve problems do not interfere with daily life. Others get worse quickly, and may lead to long-term, severe symptoms and problems.

Your risk is not random. ACS notes that the risk of chemotherapy-induced peripheral neuropathy depends on the type of chemotherapy and the dose given. The risk also rises with each cycle. ACS names the highest-risk chemotherapy drugs: the platinum compounds, the taxanes, and plant alkaloids. It also names immunomodulators such as thalidomide, and proteasome inhibitors such as bortezomib.

Some widely discussed measures are preventive. They belong to the infusion chair, not to the year after. ACS describes cold therapy, which means cooling your hands and feet during chemo infusions. It also describes compression therapy, which means wearing tight gloves to squeeze the fingertips during infusions. Then it says plainly that more research is needed to prove these methods are effective. ACS also notes that exercise might lower your risk, at least twice a week, including strength, balance, and general movement exercises. Raise all of this before or during treatment, not after.

For symptoms that have persisted, ACS lists several options. Topical lidocaine patches and capsaicin cream. Antidepressant medicines used at lower doses. Antiseizure medications. Opioids for severe pain. It also lists electrical nerve stimulation, physical or occupational therapy, relaxation therapy, and acupuncture. NCI's guidance is to ask about pain medicine, and about integrative medicine practices such as acupuncture, massage, physical therapy, and yoga. These are described as ways to control pain and manage symptoms.

Two things are within your control. ACS advises avoiding alcohol, because it can make your symptoms worse. And if you have diabetes, controlling your blood sugar helps prevent more damage to nerves. ACS also notes that most pain medicines work best if you take them before the pain gets bad.

If sensation does not fully return, the risk shifts. It is no longer discomfort. It is injuries you cannot feel. ACS advises looking at your feet once a day for injuries or open sores. Always wear shoes that cover your whole foot, even at home. Be very careful with knives, scissors, and box cutters. Wear gloves to clean, work outdoors, or do repairs. Set water heaters between 105 and 120°F, and use oven gloves. Use night-lights or flashlights when getting up in the dark.

NCI adds fall prevention. Move rugs out of your path. Put rails on the walls. Put bathmats in the shower or tub. Wear sturdy shoes with soft soles. Use potholders in the kitchen. Check your arms, legs, and feet for cuts or scratches every day. And ask for help with difficult tasks.

MedlinePlus advises contacting your provider whenever you have symptoms of nerve damage, because early treatment improves the odds of controlling them and preventing more. Here is how the timing usually breaks down.

• Call 911 or go to an emergency department if swallowing or breathing turns difficult. Both sit on NCI's motor nerve list, and neither is a wait-until-Monday problem.
• Call your care team the same day if you discover a cut, blister, or open sore on a foot you cannot feel, especially if the skin nearby is red, hot, or smells wrong. MedlinePlus lists skin sores among the serious complications of nerve damage, and notes that a few cases end in amputation.
• Call your care team within a day or two if tingling, weakness, or pain in your hands or feet is new, spreading, or clearly worse than last month, or if you have started tripping. ACS says unusual tingling, weakness, or pain warrants prompt medical care, and that worsening symptoms should always reach your cancer team.

Finishing treatment does not close the door on getting this addressed. It is reasonable to raise ongoing neuropathy at a follow-up appointment years later.

• National Cancer Institute — Nerve Problems (Peripheral Neuropathy) and Cancer Treatment: https://www.cancer.gov/about-cancer/treatment/side-effects/nerve-problems
• MedlinePlus (NIH) — Peripheral Neuropathy: https://medlineplus.gov/ency/article/000593.htm
• American Cancer Society — Peripheral Neuropathy: https://www.cancer.org/cancer/managing-cancer/side-effects/pain/peripheral-neuropathy.html
• American Cancer Society — What to Do for Peripheral Neuropathy: https://www.cancer.org/content/dam/cancer-org/cancer-control/en/booklets-flyers/getting-help-for-peripheral-neuropathy.pdf