Peripheral Neuropathy & Mesothelioma
Peripheral neuropathy is a disorder of the nerves that carry information from the brain and spinal cord to the body. It can be caused by a number of chemotherapy agents, in which case it is called CIPN – chemotherapy induced peripheral neuropathy. It usually affects the nerves going to the arms and legs.
Symptoms of CIPN related to nerves that cause sensation include a feeling of pins and needles or tingling, numbness, pain, burning, increased pain with exposure to different temperatures (especially cold) or increased sensitivity to pressure. If sensation is lost in the feet, balance can be a problem, and you may find yourself tripping.
CIPN affecting the nerves that control the muscles include weakness and loss of muscle mass. If CIPN is affecting the arms and legs, it usually starts at the point farthest away from the spinal cord – the hands and feet – and it is often the same on both sides. This can be called a stocking/glove distribution.
When CIPN is more advanced and affecting nerves closer to the center of the body, you can have trouble swallowing, difficulty urinating, constipation, and even changes in your blood pressure.
There are some chemotherapy medicines that are more likely to cause CIPN than others. They include the platin drugs often used to treat mesothelioma, including cisplatin, carboplatin, and oxaplatin. Vinorelbine and vinblastine are part of a another group causing this problem.
If you have any of the symptoms described, you must tell your doctor immediately. Your chemotherapy may need to be stopped, or the dosage lowered. Much of the time, CIPN lasts only a short time and goes away after treatment is stopped. However, it can go on longer. Severe CIPN is more likely to last, which is why your doctor needs to know about your symptoms early on.
Doctors are trying to help lower the chances of patients getting CIPN by giving chemotherapy agents more slowly, or over more days. They are also looking for substances that may reduce the risk, for example, vitamin E, calcium and magnesium. There are also ways to treat it, with pain medicine, local patches of numbing medicine, steroids, and other classes of medication.
There are other medical problems that cause peripheral neuropathy, such as diabetes. It is important for you to make sure all your other medical conditions are being treated.
Dr. Kaplan