Peripheral Neuropathy
Peripheral neuropathy (often just called neuropathy) is damage to one or more nerves of the peripheral nervous system that causes pain, numbness, tingling, or muscle weakness in the affected area.
Your peripheral nervous system is made up of the many nerves that bring signals to and from the brain and spinal cord to other — or peripheral — parts of the body, such as the hands, feet, arms, and legs.
Damage to those nerves can lead to troubling symptoms, like burning pain, loss of sensation, and a “pins and needles” feeling in the hands, arms, feet, or legs.
The nerves to the bowel, bladder, or other internal organs can also be affected.
The symptoms can range from mild to severe and can interfere with daily activities and functioning.
People with breast cancer can develop neuropathy as a side effect of certain chemotherapy medicines and other treatments. Damage to the nerves can also result from metastatic breast cancer.
Some people may experience neuropathy for just a few weeks during treatment, while others may have symptoms for months, years, or indefinitely.
If you’re experiencing neuropathy symptoms during or after breast cancer treatment, tell your healthcare team as soon as possible. Strategies to treat neuropathy and prevent it from worsening are often more effective when started earlier.
Symptoms of neuropathy
People can have peripheral neuropathy symptoms on one or both sides of their body. The most common symptoms include:
pain, tingling, burning, numbness, or weakness in the hands, arms, feet, and legs
sudden, sharp, stabbing, or shocking pain sensations
loss of touch sensation
clumsiness
trouble using hands to pick up objects or fasten clothing
balance problems, difficulty walking, and falls
changes in sensitivity to temperature
problems urinating
dizziness from low blood pressure
Causes of neuropathy
Neuropathy can be a side effect of several treatments for breast cancer, as well as a symptom of metastatic breast cancer. It can also stem from causes unrelated to breast cancer and its treatments, such as diabetes, excessive alcohol consumption, and infections that affect the nerves. Some people have neuropathy from multiple causes.
For people undergoing breast cancer treatment, the most common cause of neuropathy is chemotherapy. Chemotherapy medicines travel throughout the body, where they can cause damage to the nerves.
Doctors call this type of neuropathy chemotherapy-induced peripheral neuropathy (CIPN).
Certain chemotherapy medicines used to treat breast cancer are more likely to cause neuropathy than others. These include:
Neuropathy can start during or immediately after treatment and usually stabilizes or may improve in the weeks after treatment ends. However, with certain chemo medicines (carboplain, Navelbine, and vincristine), it can start during treatment and progress for several months afterwards.
Several other breast cancer treatments besides chemo may cause peripheral neuropathy, like the immunotherapy drug called Tecentriq (chemical name: atezolizumab).
Many targeted therapy medicines may also cause neuropathy. They include:
Ogivri (chemical name: trastuzumab-dkst), biosimilar to Herceptin
Additionally, surgery and radiation therapy may cause damage to nerves in the chest and underarm areas, which can lead to neuropathy symptoms such as pain, numbness, tingling, and/or increased sensitivity in those areas.
If a metastatic tumor grows onto or along the nerves — such as the nerves around the lymph nodes in the armpit or the nerves connected to the brain or spinal cord — it can disrupt signals to the peripheral nervous system, causing neuropathy. Specific symptoms depend on which nerves are affected.
People with metastatic breast cancer may be at greater risk of having neuropathy than people with early-stage breast cancer because they usually receive treatment over longer periods of time and may also receive higher doses of certain medicines that can cause neuropathy.
Risk factors for chemo-induced neuropathy
Risk factors that can make you more likely to develop neuropathy or have more severe or long-lasting neuropathy as a side effect of chemotherapy include:
being age 65 or older
having had neuropathy before starting breast cancer treatment
receiving chemo in the past (particularly Taxol)
being overweight or obese
having had a mastectomy
having had a higher number of lymph nodes containing cancer cells
having metastatic breast cancer
having certain vitamin deficiencies
being Black/having African ancestry (especially with Taxane chemotherapies such as Taxol)
having certain gene mutations that predispose you to chemo-induced neuropathy (for example, variants in the EPHA5, CYP3A4, ABCB1 genes)
having diabetes
Preventing chemo-induced neuropathy
Before you start chemo, you may want to ask your oncologist some of these questions:
How likely are the chemotherapy medicines or other treatments I receive to cause neuropathy?
Do I have any factors that would put me at a higher risk for developing neuropathy? What can I do to lower my risk?
What are the symptoms that could indicate I’m starting to develop neuropathy?
These are several strategies that can help prevent neuropathy or keep it from worsening:
icing your hands and feet during every chemo infusion by wearing frozen socks and gloves
wearing tight-fitting gloves and socks, known as compression therapy
doing certain exercises and staying physically active during and after chemo treatment
changing your chemotherapy treatment if you’re starting to develop neuropathy symptoms — this could include, for example, lowering the dose, switching to a different chemo medicine, changing your chemo schedule, or stopping chemo
It’s important to tell your oncologist as soon as possible if you’re having neuropathy symptoms and work with them on any changes to your treatment plan.
Treating and managing neuropathy
While there’s no current treatment to directly repair the nerve damage from neuropathy, some supplemental therapies can ease symptoms. Many people with neuropathy find that it’s helpful to try some combination of these:
medicines such as anti-seizure medications (particularly gabapentin and pregabalin), pain relievers, corticosteroids, and antidepressants such as duloxetine
topical creams, gels, lotions, and patches for pain relief
physical therapy
occupational therapy
electrical stimulation of nerves and muscles with a TENS (transcutaneous electrical nerve stimulation device)
various forms of exercise, including neuromuscular training, balance (vestibular) rehab, yoga, and tai chi
surgery to alleviate pressure on nerves
Ask your medical team for referrals to specialists with experience treating neuropathy from cancer treatment. A number of different specialists can help treat neuropathy symptoms, including:
neurologists
pain specialists
cancer rehabilitation specialists (physiatrists)
physical therapists
occupational therapists
massage therapists
acupuncturists
You may also consider getting referrals to specialists from a cancer survivorship program or clinic, a cancer rehabilitation therapy program, or a palliative care program or team. Also, some physical therapists and personal trainers offer exercise programs that can help prevent or treat neuropathy.
If you have severe neuropathy that is causing limitations in your physical function and ability to work, you may qualify for Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) benefits.
If you’re experiencing neuropathy, these strategies can help you adapt and stay safe:
Handle sharp objects carefully to avoid accidentally cutting yourself.
Wear gloves to protect your hands in the cold or when you’re doing housework or yard work.
Check water temperature with a thermometer or wear gloves to avoid burning yourself when you're bathing or cleaning.
Be careful when moving. Walk slowly and use handrails if they're available.
Put no-slip bath mats in your tub or shower to avoid falling.
Clear objects off the floor, such as area rugs, cords, toys, and other clutter, to reduce your risk of tripping and falling.
Consider using a cane to steady yourself.
Protect your feet from injury by wearing shoes or slippers as often as possible.
Ask your healthcare provider if driving is unsafe for you. If you have neuropathy in your feet, you may be unable to feel the gas or brake pedals.
— Last updated on July 1, 2025 at 5:50 PM
