Nerve damage (peripheral neuropathy)

If you are experiencing tingling, burning or pain in your hands and feet, muscle weakness, numbness or sensitivity in your limbs, then you may have some nerve damage (peripheral neuropathy). 

The information on this page will help you to find out more about peripheral neuropathy, and ways to manage it, during and after cancer treatment.

Peripheral neuropathy explained

Cancer and its treatments can cause a number of side effects. A side effect that you may not expect is nerve damage. It doesn’t happen for everyone, but is an issue to be aware of.

Peripheral nerves are nearer the surface of our skin, and send messages to the central nervous system. They tell us if our feet are cold, or we touch something hot, for example.

Peripheral neuropathy happens when these nerves are damaged or injured,

There can be several causes of cancer-related peripheral neuropathy. Causes include some chemotherapy treatments. Radiotherapy and surgery can sometimes cause nerve damage too.

Occasionally, the cancer itself may be pressing on a peripheral nerve.

Symptoms

Symptoms include numbness, loss of sensation or tingling in the part of the body affected.

With some chemotherapy treatments, you may notice this particularly in your hands and feet. Sometimes your digestive system may be affected causing constipation.

Others report hearing loss. Your health care team will know of the side effects with certain drugs and advise you if this is something to look out for.

Other symptoms may include difficulty with fine movements, like trying to fasten buttons, problems with walking or extra sensitivity - clothing and shoes can feel uncomfortable.

Sometimes the heat or the cold, eating or drinking can trigger temporary symptoms.

The key is to tell your doctor or specialist nurse know about any new symptoms you’re experiencing. Occasionally nerve damage may develop or worsen later on, but generally it happens during or soon after treatment.

Whilst peripheral neuropathy is usually only a temporary side effect, for some people the damage is permanent.

Managing peripheral neuropathy

There are things that you can do to manage the symptoms, particularly if you’re aware of the cause. Here are some suggestions to help cope day to day with the nerve damage.

• Tell the healthcare team of any symptoms you may be experiencing. It may be that the treatment can be reduced - or sometimes stopped, to prevent further damage.
• Keep your hands and feet warm: Wear gloves and warm clothing when out and about can help.  Avoid walking round the house in bare feet. 
• Try and exercise daily:  It helps to exercise your muscles and maintain your balance.
• Wearing well fitting shoes with padded insoles can help your feet feel more comfortable.
• Mind-body exercises such as Tai chi can help. (Ask at your nearest Maggie’s centre about our relaxation, exercise, yoga and Tai Chi sessions.)
• Be aware of safety at home: You may not feel extreme heat and cold, so test the water temperature when running taps/shower/bath. Heat pads and hot water bottles should be used with caution too.
• Ask about medication which may help relieve pain and tingling. Medication doesn’t cure the neuropathy but can ease the symptoms.
• Ask about non-drug pain relief too. Some people find acupuncture and massage helps. Others gain benefit from using a TENS machine (Transcutaneous electronic nerve stimulation). 
• Try and eat a balanced diet, and avoid alcohol. Vitamin B and folate supplements may help although the evidence is sparse. Always check with your medical team before taking any supplements as they may interfere with treatment.
• You may not realise that you need to contact the Drivers and Vehicle Licensing Authority (DVLA) and let them know  you have peripheral neuropathy. The DVLA can inform you of any restrictions on your right to drive.  You can find more information on DVLA website.
• Talk with others about how you feel. Nerve damage can feel less isolating if you meet others who understand what you’re going through. Drop into your local Maggie’s centre for emotional and practical support.

When to seek further help

Nerve damage can affect you physically and emotionally. On top of everything else you are going through, you may find you’re feeling low in mood or anxious. If you’re finding that you’re feeling withdrawn, tearful, and depressed, let your GP and healthcare team, as help is available.

If the symptoms are causing problems with mobility you may need additional support with aids around the home, etc. It may be tempting to try and manage, but ask your GP or hospital team for a referral for home assessment, if things are getting difficult.

What now?

Have a look at our blogs and links on this page to find out more about coping with peripheral neuropathy.  

Talk with others about what you are experiencing. It can help to hear that what you’re feeling is not unusual, and help you feel less alone. 

Call into your local Maggie’s centre to talk to our cancer support specialists and connect with others in a similar position to yourself.