Neuropathy During Chemotherapy: What to Ask

Neuropathy during chemotherapy usually means peripheral neuropathy: damage to nerves outside the brain and spinal cord. It can cause tingling, numbness, burning pain, weakness, or balance problems. Some chemotherapy drugs are more likely than others to cause it. Ask your team whether yours is one of them.

Sensory nerve damage causes tingling, numbness, or a pins-and-needles feeling. It usually starts in the feet and hands. It can also reduce your ability to sense temperature or pain, which raises injury risk. Motor nerve damage causes muscle weakness, balance problems, or twitching. In severe cases, it can affect swallowing or breathing. Autonomic nerve damage affects functions you don't control directly, like digestion, blood pressure, or bladder control.

Report new symptoms as soon as you notice them, even if mild. Getting nerve problems diagnosed and treated early is the best way to control them. Your team may compare symptoms cycle by cycle. That helps catch a worsening trend before it becomes severe. Waiting until symptoms are severe makes them harder to manage and can mean permanent damage in some cases.

Numb feet and hands raise your risk of injury without you noticing it right away. Check your feet daily for cuts or blisters you might not feel. Use potholders and test water temperature before touching hot surfaces, since you may not sense a burn starting. Move slowly when standing, and modify your home to reduce fall risk if balance is affected.

Nerve symptoms can sometimes lead your team to lower your chemotherapy dose. They may change your schedule too, to prevent permanent damage. This is a normal, protective adjustment, not a sign your treatment is failing. Physical or occupational therapy can also help with strength, balance, and daily function.

• Call 911 or go to an emergency department if you suddenly have trouble breathing or swallowing, or a limb becomes suddenly weak or paralyzed.
• Call 911 or go to an emergency department if you fall and hit your head, or you faint.
• Call your care team the same day if you notice new or fast-worsening numbness, tingling, burning pain, or weakness in your hands or feet.
• Call your care team straight away, at any hour, if your temperature reaches 100.4°F (38°C) or higher while you are on chemotherapy. CDC treats a fever during chemotherapy as a medical emergency. If you cannot reach them quickly, go to an emergency department and say at the desk that you are having chemotherapy.
• Call 911 or go to an emergency department if you suddenly cannot pass urine or lose control of your bladder or bowels. Together with leg weakness or back pain this can mean pressure on the spinal cord, which is treated within hours, not days.
• Call your care team the same day if you find a cut, blister, or burn on a numb foot or hand that looks infected, or you feel faint every time you stand up.
• Call your care team within a day or two if numbness is making you stumble, drop things, or feel unsteady on stairs.

• Is my chemotherapy drug known to cause neuropathy?
• Which symptoms should I report before my next treatment cycle?
• Could neuropathy change my dose or schedule, and how would I know?
• What can I do to reduce my risk of falls or burns?
• Will these nerve symptoms improve after treatment ends?

• National Cancer Institute — Nerve Problems (Peripheral Neuropathy) and Cancer Treatment
• American Cancer Society — Peripheral Neuropathy
• CDC — Watch Out for Fever (Preventing Infections in Cancer Patients)