Women who survived cancer experience chemotherapy-induced neuropathy years after treatment

Nearly half of women showed symptoms of chemotherapy-induced peripheral neuropathy years after treatment, according to a secondary analysis of cancer survivors.

“Aggressive treatments for cancer have improved survival but often cause serious long-term effects on daily life that last for many years,” Kerri M. Winters-Stone, PhD, research professor in the school of nursing at Oregon Health & Science University, and colleagues wrote.

Cancer treatment can lead to peripheral neuropathy, which can influence physical function, fall risk and quality of life.

“Tailoring rehabilitation strategies to best prevent the disability and falls associated with chemotherapy-induced peripheral neuropathy could improve patient safety and enhance survivorship care plans for those receiving neurotoxic chemotherapies,” Stone and colleagues wrote.

The researchers carried out a secondary analysis of 512 women (mean age, 62 years) who had survived cancer (mean time since diagnosis, 4.1 years). Winters-Stone and colleagues compared women who self-reported symptoms of chemotherapy-induced peripheral neuropathy with those who did not in several areas, including falls in the past year, self-reported physical function and disabilities, maximal leg strength, timed chair stand, physical function battery and gait characteristics.

Forty-seven percent of patients still reported symptoms of chemotherapy-induced peripheral neuropathy at a mean of 6 years after treatment.

Those with chemotherapy-induced neuropathy had worse self-reported and objectively measured function than those who did not, except for base of support during a normal walk and maximal leg strength. They also had a slower gait than those with no neuropathy, and took more — although slower and shorter — steps (P < .05 for all). Women with neuropathy also demonstrated a 1.8-times greater likelihood to fall, and self-reported significantly more disabilities (P < .0001).

Researchers found a linear association between increased severity of symptoms and worse function, increased fall risk and increased disability (P < .05 for all).

“Our findings suggest that a high proportion of women treated with chemotherapy for a variety of cancers may experience persistent symptoms of chemotherapy-induced peripheral neuropathy many years after their treatment ends and that these women have abnormal gait patterns and more functional deficits, patient-reported disability and falls compared with women with no symptoms,” the researchers wrote.

Strength and balance training rehabilitation serves as a “reasonable initial recommendation” for such patients because it has been shown to prevent disability and falls in individuals with neurologic conditions, according to the researchers.

“However, our data suggests that the etiology of disability and falls associated with chemotherapy-induced peripheral neuropathy symptoms may be unique; thus, efforts to define, implement and evaluate the efficacy and cost effectiveness of specific prevention strategies for persons with chemotherapy-induced peripheral neuropathy are urgently needed.” – by Andy Polhamus

Disclosure: Winters-Stone reports no relevant financial disclosures. Please see the study for a full list of all other researchers’ relevant financial disclosures.