This Health Facts for You discusses how to treat chemotherapy induced peripheral neuropathy (CIPN).
Chemotherapy (chemo) is the use of drugs to fight cancer. It affects cells that grow quickly, like cancer cells. It can also affect some of your child’s normal cells. Chemo, especially the drug Vincristine, can damage the nerves that go to muscles, joints, and skin. These are called peripheral nerves. Damage to these nerves is known as neuropathy. Not all children being treated with chemo will have CIPN.
Neuropathy
Neuropathy most often affects nerves that carry sensory information: touch, pain, temperature, and vibration. It may also affect nerves that carry information for the muscles to work.
Understanding Your Child’s Pain
Listen to what your child tells you. The first thing many children feel is a change in the way their feet or hands feel. They may feel numbness, tingling, pain, burning, cramping, or be more sensitive to cold.
Many children may have trouble describing the pain. They may say it feels like they are wearing socks or gloves when they are not. They may say their hands or feet hurt or feel funny. Your child may also feel weaker or have trouble doing normal tasks like walking or writing.
Very young children may not be able to describe their symptoms, so you will need to watch for signs.
Medicine
The dose of your child’s chemo medicine may need to change. Your doctor may prescribe medicine to help decrease the pain and tingling.
Physical Therapy
Doctors may also suggest physical and occupational therapy and foot braces.
Home Safety
Make sure your home is safe for your child to prevent injuries, falls, and skin breakdown. Follow these guidelines:
Have your child wear lighter nonslip shoes with good arch support in your house.
Inspect your child’s skin every day for redness, wounds, blisters, and cuts.
Remove rugs and cords that are tripping hazards.
Re-install baby gates for younger children.
Use night lights.
Use non-slip mats in the bath and shower.
Protect your child from hot and cold temperatures (e.g., air and water).
Managing CIPN Symptoms
Many of the symptoms of CIPN go away after your child is done with chemo treatment. Some children will still have symptoms for years after treatment has stopped. If this happens, please tell your doctor. Your child can get physical and occupational therapy to help with these issues.
When to Call
Report signs and symptoms to your doctor right away. These include:
Change in feeling or sensation of their feet or hands: numbness, tingling, or pain. This may look like:
Shaking out, rubbing, or wringing of hands or feet
Excessive chewing or biting of hands
Change in walking:
Foot drop or dragging toes
Toe walking (most common in younger children)
Wider stance
Slower speed
Refusal to stand or walk (most common in younger children)
Loss of balance or coordination:
Increased tripping or falling
Increased swaying while standing
Dropping things.
Trouble with fine motor skills:
Writing or a change in handwriting
Coloring
Using zippers or buttons
Using scissors