If you are having chemotherapy that has a high risk of causing nerve damage, your treatment team will monitor you closely for early signs of peripheral neuropathy. In other cases, peripheral neuropathy may be diagnosed after you report symptoms to your cancer specialist or general practitioner (GP).
If your doctor suspects that you have peripheral neuropathy, they will check how the symptoms affect your daily life and may ask you to complete a symptom checklist. The doctor may also check your:
- awareness of where your body is – you close your eyes and answer questions about the position of parts of your body
- reflexes – your ankles, knees and wrists are tapped with a small hammer to check their automatic movement
- balance and coordination – you may be asked to walk in a straight line or balance on one leg
- blood pressure – your blood pressure is measured when you are lying down and standing up to see if there is a difference.
In some cases, your cancer specialist or GP may refer you to a neurologist, a specialist doctor who diagnoses and treats diseases of the nervous system. They may arrange special tests known as nerve conduction studies, which check how many cells are working and how quickly they send electrical signals along to the next cells.
Based on your symptoms and test results, your doctors may give the peripheral neuropathy a grade. Different grading systems are used in Australia, but a common one has grades 1 to 3, with grade 3 being the most severe and needing urgent attention.
If symptoms appear, the only known way to stop chemotherapy-induced peripheral neuropathy from getting worse is to change how much or how often you have chemotherapy. In severe cases, chemotherapy may need to be stopped altogether.
If peripheral neuropathy is caused by the cancer itself, symptoms may ease once the cancer is treated, but sometimes the damage is permanent.
You may be worried about telling your treatment team that you have symptoms of peripheral neuropathy because you want to complete the cancer treatment. But not speaking up about your symptoms could mean that more of the nerve is damaged and symptoms that could be reversed end up becoming permanent.
If your doctor recommends pausing or stopping the chemotherapy, they will talk to you about other ways to treat the cancer.
Asking your doctor questions will help you make an informed choice about your treatment and care. You may want to include some of the questions below in your own list:
- Am I likely to develop peripheral neuropathy?
- What symptoms should I watch out for?
- Who should I contact if I start having symptoms?
- Could these symptoms be a sign that I’m starting to develop peripheral neuropathy?
- Should my chemotherapy be adjusted or stopped? If so, how else can the cancer be treated?
- How long are these symptoms likely to last?
- What treatments do you recommend for the pain?
- How can I manage the constipation?
- How can I reduce my risk of falls or other injuries?
- What aids and equipment might help me? Can you refer me to an occupational therapist?
- What type of exercise should I do? Can you refer me to a physiotherapist or exercise physiologist?
- Could a psychologist help me cope with this?
- Are there any clinical trials I could join?
Understanding Peripheral Neuropathy and Cancer
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Expert content reviewers:
Dr Susanna Park, IN FOCUS research program and Senior Lecturer, Brain and Mind Centre, Faculty of Medicine and Health, The University of Sydney, NSW; Katrina Dick, Consumer; Rosemerry Hodgkin, 13 11 20 Consultant, Cancer Council WA; Phil Mendoza-Jones, Consumer; Jodie Nixon, Clinical Team Leader, Occupational Therapy, Cancer Services, Princess Alexandra Hospital, QLD; Rachel Tunney, Consumer; Jane Turner, Senior Exercise Physiologist, Sydney Cancer Survivorship Centre, Concord Hospital, NSW; Dr Shirley Wong, Consultant Medical Oncologist, Sunshine Hospital, Western Health, VIC.
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The information on this webpage was adapted from Understanding Peripheral Neuropathy and Cancer - A guide for people affected by cancer (2020 edition). This webpage was last updated in September 2021.