I'm afraid of this side effect because of my already damaged nerves and muscle weakness in both of my legs and hips.Managing Numbness and Tingling (Peripheral Neuropathy)Numbness and tingling in your hands and feet is a condition called peripheral neuropathy. Peripheral neuropathy can be a side effect associated with certain chemotherapy drugs. It is caused by damage to the nerves that transmit signals between the extremities and the central nervous system (CNS).
These nerves include those that transmit sensation from the extremities to the CNS or those that carry signals for muscle movement from the CNS to the extremities.
Depending on the type of nerve damage, an individual with peripheral neuropathy may fully recover without residual effects or may partially recover but have long-term problems in his or her ability to feel or move.
If severely affected, it is possible to develop atrophy (muscle deterioration) and chronic muscular weakness.
Causes of Peripheral Neuropathy
There are many possible causes of numbness and tingling. Some of the more common include:
* Certain chemotherapy drugs
* Diabetes
* Uremia (too much urea in the blood due to kidney problems)
* Severe malnutrition
* Trauma, such as broken or dislocated bones
* Cancer
* Certain medicines or toxic substances
Symptoms of Peripheral Neuropathy
In addition to numbness and tingling, other symptoms of peripheral neuropathy include:
* Weakness
* Pain in the arms, hands, legs and/or feet
* Abnormal sensations, including:
o Burning
o Tickling
o Pricking
o Tingling (also known as paresthesia)
Areas of the body most commonly affected by peripheral neuropathy are the fingers and toes. Symptoms usually start at the end of the extremity and gradually move upward.
Bowel function may also be compromised, causing or worsening constipation and eventually causing blockage of the intestines.
Sometimes side effects signal a serious problem. Find out when to call your doctor about chemotherapy side effects.
Treating Peripheral Neuropathy
The treatment for peripheral neuropathy caused by chemotherapy is to stop the treatment or change to a different drug that does not cause damage to the nerves. If immediate steps are not taken when symptoms start, peripheral neuropathy can become a long-term problem.
Recovery from peripheral neuropathy is usually slow, but steps can be taken to encourage regeneration of the damaged nerves. Approaches include:
* Acupuncture which is believed to relieve pain associated with peripheral neuropathy in certain cases. Ask your doctor for more details and the name of a licensed acupuncturist.
* Massage which increases blood flow and may provide pain relief associated with peripheral neuropathy.
* Physical therapy which uses range-of-motion and stretching exercises that may help strengthen muscles that are weak and improve other symptoms of peripheral neuropathy.
* Transcutaneous nerve stimulation (TENS) which uses a special device that transmits electrical impulses through electrodes attached to your skin. TENS has been shown to provide pain relief29 and may promote nerve regeneration.30
And this from the sores I'd get in my mouth. Everyone I talk to gets them.Managing Mouth SoresMouth sores are a common side effect of certain chemotherapy drugs as well as radiation to the head.
Chemotherapy and radiation therapy kill rapidly dividing cells, such as cancer cells. However, the gastrointestinal (GI) tract, including the mouth and the throat, is made up of cells that divide rapidly.
For this reason, the GI tract is particularly susceptible to damage from chemotherapy and radiation treatment. Chemotherapy- or radiation-induced damage to the cells lining the mouth, throat, and gastrointestinal tract is called mucositis. This side effect of cancer treatment can significantly affect quality of life and may cause delays in treatment.
While side effects can cause delays in treatment, it's important to stick to a treatment schedule for best results. Find out more about chemotherapy cycles and schedules.
Diagnosing Mouth Sores
Symptoms of mouth sores commonly occur 3 to 10 days following treatment with chemotherapy. You may experience a burning sensation followed by ulcers, and your mouth may appear red (inflammation) with sores (ulcerations). You may also experience discomfort and pain.
* Mouth sores can make chewing and swallowing difficult, interfering with your nutrition and food intake, resulting in weight loss.
* Your speech may also be compromised.
* Because the lining of your mouth also serves to protect you against infection, mouth sores make you more susceptible to bacterial, fungal, or viral infections in the mouth.
* Ultimately, mouth sores can become severe enough that it is necessary to reduce your chemotherapy dose or delay your treatment in order to allow your mouth to heal.
Treatment That Makes Mouth Sores Worse
While mouth sores can occur with any treatment for cancer, oral mucositis is more severe if you receive the following:
* High-dose chemotherapy or radiation with stem cell transplants
* Radiation for head and neck cancer
* Combined chemotherapy and radiation therapy
The technique used to administer radiation may also impact the severity and duration of mouth sores. The following radiation techniques tend to produce less severe mouth sores:
* Hyperfractionated radiation involves lower doses administered more frequently, resulting in less severe mouth sores.
* Intensity-modulated radiation therapy (IMRT) spares normal tissues, reducing mouth sores, while still delivering the full radiation dose or even an increased dose to the cancer.
Your doctor may suggest combining chemotherapy with radiation therapy. Find out more about how cancer is treated with radiation therapy.
Other Factors That Make Mouth Sores Worse
A number of other factors contribute to the severity of mouth sores, including:
* Poor oral and dental health prior to treatment
* Kidney disease
* Age—younger children or older adults
* Smoking and the use of chewing tobacco during episodes of mucositis
* Harsh foods and alcohol
* Concomitant disease (disease occurring at the same time), such as diabetes or AIDS
Preventing and Treating Mouth Sores
Treatment for mouth sores generally consists of good oral care, mouthwashes, and cryotherapy (sucking on ice chips).
Oral Care
Good oral care helps prevent mouth sores:
* Rinse your mouth with a saltwater solution 2 or 3 times per day.
* Brush your teeth 2 or 3 times per day with a soft toothbrush.
Mouthwashes
A mouthwash of salt and soda may relieve mouth sores as well as medicated mouthwashes and is less expensive.28
Cryotherapy (Ice Chips)
You can relieve mouth pain by sucking ice chips when the chemotherapy drug is most concentrated in the body.
This technique, called cryotherapy, works by decreasing blood flow to the cells in the mouth, reducing exposure to the drug and decreasing the risk of developing mouth sores.
I'm afraid of my Shingles getting worse too.This is just one woman's experience with Shingles.Yes I did contract shingles during my chemo treatment, not once, not twice, not three times but FOUR outbreaks of shingles. It would no more than clear up and bam! I would get it again.
More importantly though is the permanent pain I have been left with because of the shingles. It has taken visits to my oncologist, my neurologist, my internist and an orthopedic surgeon... and my own in-depth research to determine that the chronic pain I live with is a result of the shingles contracted during chemo.
The pain is constant; I am on a very strong pain medication and nerve medication and will probably remain on both the rest of my life.
At first, they thought it was just temporary pain and would diminish over time. After 2 years it showed no signs of decreasing and they had to tackle the problem. They even tried to pin it on a mental well being sort of thing. I knew I was not imagining the pain. They tried to tell me I had arthritis, but the pain is not just in my joints. It is from my waist down to my toes; in my hips and legs. And, it is a burning/wet/cold, highly sensitized pain..
My oncologist FINALLY figured it out when she went back to other patients' records (I badgered all of my doctors for over 2 years...until someone came up with an answer!)
And my eyes of course. I already have baby cataracts and I have Glaucoma. So what is all that Chemo going to do?? It is so scary.
Chemotherapy and Glaucoma
Glaucoma is a serious eye condition that damages the optic nerve and eventually leads to blindness. There are two types of the condition -- open-angle and closed-angle. Open-angle glaucoma is the most prevalent form and results in the gradual loss of vision over time. Closed-angle glaucoma occurs much more rapidly.
One factor that leads to glaucoma is the inability of the eye to drain ocular fluid. Chemotherapy may lead to complications with this drainage system. The first symptom of glaucoma is often a feeling of increased pressure in the eye. Loss of side vision is also an early indicator. However, these symptoms manifest long after glaucoma has set in, often resulting in irreparable damage. Therefore, it is recommended that chemotherapy patients have their eyes checked for early signs of the disease at least once a year following treatment.
Unfortunately, there is no cure for glaucoma. However, treatment is available to minimize or slow the onset of the effects of the condition. Surgery or eye drops are common treatment options.
Other Eye Problems Associated With Chemotherapy
Less severe eye problems that may result from chemotherapy include photophobia, dry eyes and watery eyes. Photophobia is a condition that results in sensitivity to light. Oftentimes, the sensitivity causes pain and requires patients to wear sunglasses outside. Medications associated to photophobia include:
- Cytarabine (Ara-C®)
- Fluorouracil
- Isotretinoin
- Tretinoin
Dry eye syndrome results from the inability to produce adequate tears. Eye drops may be prescribed to help improve lubrication and reduce itchiness. Medications associated with dry eyes include:
- Isotretinoin (Vesanoid®)
- Tretinoin (Accutane®)
Some chemotherapy patients experience the opposite of dry eye syndrome. Watery eyes result from an overproduction of tears and may be a sign of a sinus infection. The condition has been linked to the following drugs:
- Capecitabine
- Cytarabine
- Doxorubicin (Adriamycin®)
- Fluorouracil
Chemotherapy-Induced Cataracts
Cataracts are one of the most prevalent eye problems associated with chemotherapy. Though painless, the condition results in degenerative vision over time. This is due to the buildup of cloudy material in the lens of the eye, which blocks the passage of light to the retina.
Symptoms of cataracts typically begin to show 18 to 24 months after chemotherapy and may include blurred vision, sensitivity to bright lights (such as car headlights) and increased nearsightedness. Cataracts sometimes develop in both eyes, but often only manifest in one. For patients that experience severe loss of vision, cataract surgery is available that may significantly restore vision.
Studies show that as many as 80 percent of patients who undergo total body irradiation (TBI) will develop cataracts. Patients who have received high doses of steroids are at greater risk for contracting cataracts. The following drugs have also been linked to the formation of cataracts:
- Bexarotene
- Dexamethasone
- Hydrocortisone
- Methylprednisone
- Prednisone
- Tamoxifen (Nolvadex®)
Now you know why I don't want Chemo. I'll take my chances. Rather than be left with worse eyes and worse muscles and risk of a bad infection because of mouth sores.I am not that strong as I have led people to believe all my life....
