Cryotherapy May Help Prevent Neuropathy Caused by Taxol Chemotherapy

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Neuropathy is the general term for pain caused by damage to the nerves of the peripheral nervous system. Your peripheral nervous system is made up of the many nerves that bring signals from the brain and spinal cord to other (peripheral) parts of the body, such as the hands and feet. Damage to those nerves can affect the way the body sends signals to muscles, joints, skin, and internal organs. This can cause pain, numbness, loss of sensation, and other symptoms.

For people diagnosed with breast cancer, the most common cause of peripheral neuropathy is chemotherapy, especially platinum and taxane chemotherapy medicines. Chemotherapy medicines travel throughout the body, where they can damage the nerves.

Taxane chemotherapy medicines include Taxol (chemical name: paclitaxel), Taxotere (chemical name: docetaxel), and Abraxane (chemical name: nab-paclitaxel). Platinum chemotherapy medicines include carboplatin.

A small study suggests that wearing frozen gloves and socks for 90 minutes after Taxol chemotherapy can help control neuropathy symptoms.

Doctors call therapies that use extreme cold as a treatment cryotherapy.

The research was published online on Oct. 12, 2017 by the Journal of the National Cancer Institute. Read “Effects of Cryotherapy on Objective and Subjective Symptoms of Paclitaxel-Induced Neuropathy: Prospective Self-Controlled Trial.”

In the study, 36 people diagnosed with breast cancer who were being treated with weekly Taxol infusions for 12 weeks wore frozen gloves and socks on their dominant hand and foot from 15 minutes before the Taxol infusion to 15 minutes after the infusion was complete for a total of 90 minutes. The frozen gloves were replaced after the first 45 minutes.

The researchers compared neuropathy symptoms in the hand and foot that wore the frozen garments to symptoms in the hand and foot that didn’t wear the frozen garments.

To compare neuropathy symptoms, the researchers measured the participants' sensitivity to touch, temperature, and vibration, as well as their dexterity before the study started and then again after the 12-week chemotherapy regimen was completed.

None of the people dropped out of the study because they couldn’t tolerate wearing the frozen gloves and socks.

The researchers found that the hands and feet that wore the frozen gloves and socks had less loss of sensitivity to touch and temperature than the hands and feet that didn’t wear the frozen garments:

  • 27.8% of the hands that wore the frozen gloves lost some sensitivity to touch
  • 80.6% of the hands that didn’t wear the frozen gloves lost some sensitivity to touch
  • 25.0% of the feet that wore the frozen socks lost some sensitivity to touch
  • 63.9% of the feet that didn’t wear the frozen socks lost some sensitivity to touch
  • 8.8% of the hands that wore the frozen gloves lost some sensitivity to warmth
  • 32.4% of the hands that didn’t wear the frozen gloves lost some sensitivity to warmth
  • 33.4% of the feet that wore the frozen socks lost some sensitivity to warmth
  • 57.6% of the feet that didn’t wear the frozen socks lost some sensitivity to warmth

These differences were statistically significant, which means that it was likely due to the frozen glove and sock treatment and not just because of chance.

The hands that didn’t wear the frozen gloves also took more time to perform the test that measured dexterity compared to the hands that wore the frozen gloves.

"We conclude that cryotherapy is a simple, safe, and effective strategy for the prevention of chemotherapy-induced peripheral neuropathy in patients with cancer undergoing paclitaxel treatment," the researchers wrote. "Cryotherapy could support the delivery of optimal chemotherapy by preventing a dose delay or reduction, as well as inhibiting the deterioration of quality of life in cancer patients during and after treatment."

In an editorial that was published with the study, Breastcancer.org Professional Advisory Board member Dawn Hershman, M.D., of the Herbert Irving Comprehensive Cancer Center at Columbia University, said that despite the success of study, it remains unclear whether cryotherapy also would benefit people being treated with platinum chemotherapy medicines.

"If the results are confirmed, cryotherapy has the advantage of a limited side effect profile, is low-cost, and it appears to prevent components of neuropathy other than [just] neuropathic pain," Hershman wrote. "Ultimately a better understanding of the biologic mechanisms causing chemotherapy-induced peripheral neuropathy will improve our ability to effectively prevent and treat all components of this toxicity."

If you’ve been diagnosed with breast cancer and taxane chemotherapy is in your treatment plan, you may want to talk to your doctor about this study and whether wearing frozen socks and mittens during your infusion might make sense for you. While the results haven’t been confirmed, the side effects of wearing frozen gloves and socks during chemotherapy are minimal and may help. You also may have to be prepared to bring your own frozen garments because it’s not clear how many treatment centers offer this option.

For more information, visit the Breastcancer.org Neuropathy page.


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