Chemotherapy-Induced Peripheral Neuropathy (CIPN): Difference between revisions
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== Introduction == | == Introduction == | ||
Chemotherapy-induced peripheral neuropathy (CIPN) commonly occurs as an adverse event following chemotherapy.CIPN can have an effect on the sensory, motor and/or autonomic nerves<ref name=":0">Burgess J, Ferdousi M, Gosal D, Boon C, Matsumoto K, Marshall A, Mak T, Marshall A, Frank B, Malik RA, Alam U. Chemotherapy-induced peripheral neuropathy: epidemiology, pathomechanisms and treatment. Oncology and therapy. 2021 Dec 1:1-66.Available:https://pubmed.ncbi.nlm.nih.gov/33490836/ (accessed 18.8.2023)</ref>. | Chemotherapy-induced peripheral [[Neuropathies|neuropathy]] (CIPN) commonly occurs as an adverse event following chemotherapy.CIPN can have an effect on the sensory, motor and/or autonomic nerves<ref name=":0">Burgess J, Ferdousi M, Gosal D, Boon C, Matsumoto K, Marshall A, Mak T, Marshall A, Frank B, Malik RA, Alam U. Chemotherapy-induced peripheral neuropathy: epidemiology, pathomechanisms and treatment. Oncology and therapy. 2021 Dec 1:1-66.Available:https://pubmed.ncbi.nlm.nih.gov/33490836/ (accessed 18.8.2023)</ref>. | ||
Currently there is no gold standard for diagnosis, no proven ways to lessen or stop this condition and treatment strategies need be addressed.<ref name=":0" /> | Currently there is no gold standard for diagnosis, no proven ways to lessen or stop this condition and treatment strategies need be addressed.<ref name=":0" /> | ||
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Physiotherapy, in the form of exercise therapy, has been shown to have a role in reducing symptoms in CIPN<ref>Jesson T, Runge N, Schmid AB. [https://pubmed.ncbi.nlm.nih.gov/33490836/ Physiotherapy for people with painful peripheral neuropathies: a narrative review of its efficacy and safety.] Pain Reports. 2020 Sep;5(5).Available: https://pubmed.ncbi.nlm.nih.gov/33490836/<nowiki/>(accessed 18.8.2023)</ref>. | Physiotherapy, in the form of exercise therapy, has been shown to have a role in reducing symptoms in CIPN<ref>Jesson T, Runge N, Schmid AB. [https://pubmed.ncbi.nlm.nih.gov/33490836/ Physiotherapy for people with painful peripheral neuropathies: a narrative review of its efficacy and safety.] Pain Reports. 2020 Sep;5(5).Available: https://pubmed.ncbi.nlm.nih.gov/33490836/<nowiki/>(accessed 18.8.2023)</ref>. | ||
== Risk Factors == | |||
Include: Agent used, cumulative dose, how many treatment cycles and its duration, genetic susceptibility, age, any existing nerve damage, severity of acute symptom, chronic alcohol consumption.<ref name=":0" /> | |||
== Treatment == | == Treatment == | ||
Pharmacological: Pharmacological treatment for peripheral neuropathic pain is not very effective and also may have serious harmful consequences<ref>Jesson T, Runge N, Schmid AB. [https://pubmed.ncbi.nlm.nih.gov/33490836/ Physiotherapy for people with painful peripheral neuropathies: a narrative review of its efficacy and safety.] Pain Reports. 2020 Sep;5(5).Available:https://pubmed.ncbi.nlm.nih.gov/33490836/ (accessed 19.8.2023)</ref>. Treatment option for symptoms include: | Pharmacological: Pharmacological treatment for peripheral neuropathic [[Pain Medications|pain]] is not very effective and also may have serious harmful consequences<ref>Jesson T, Runge N, Schmid AB. [https://pubmed.ncbi.nlm.nih.gov/33490836/ Physiotherapy for people with painful peripheral neuropathies: a narrative review of its efficacy and safety.] Pain Reports. 2020 Sep;5(5).Available:https://pubmed.ncbi.nlm.nih.gov/33490836/ (accessed 19.8.2023)</ref>. Treatment option for symptoms include: | ||
* Steroids, to lessen inflammation | * [[Corticosteroid Medication|Steroids]], to lessen inflammation | ||
* Topical anesthetics | * Topical anesthetics | ||
* Antiseizure medications, which can help relieve nerve pain | * Antiseizure medications, which can help relieve nerve pain | ||
* Opioids | * [[Opioids]] | ||
* | * Antidepressants | ||
Non pharmacological: | |||
* Transcutaneous electrical nerve stimulation | * [[Transcutaneous Electrical Nerve Stimulation (TENS)|Transcutaneous electrical nerve stimulation]] | ||
* Physical therapy | * Physical therapy | ||
* Occupational therapy | * Occupational therapy | ||
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* Suggest strongly that duloxetine (a serotonin–norepinephrine reuptake inhibitor) is the only currently recommended treatment. | * Suggest strongly that duloxetine (a serotonin–norepinephrine reuptake inhibitor) is the only currently recommended treatment. | ||
* No recommendations for treatment of CIPN in regards to exercise therapy, acupuncture, scrambler therapy, gabapentin, pregabalin, topical gel treatment (containing baclofen/amitriptyline plus/minus ketamine), tricyclic antidepressants or oral cannabinoids.<ref name=":0" /> | * No recommendations for treatment of CIPN in regards to exercise therapy, [[acupuncture]], scrambler therapy, gabapentin, pregabalin, topical gel treatment (containing baclofen/amitriptyline plus/minus ketamine), tricyclic antidepressants or oral cannabinoids.<ref name=":0" /> | ||
== Resources == | == Resources == | ||
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<references /> | <references /> | ||
[[Category:Neuropathy]] | |||
[[Category:Pain]] | |||
Revision as of 03:08, 19 August 2023
Original Editor - Lucinda hampton
Top Contributors - Lucinda hampton and Mason Trauger
Introduction[edit | edit source]
Chemotherapy-induced peripheral neuropathy (CIPN) commonly occurs as an adverse event following chemotherapy.CIPN can have an effect on the sensory, motor and/or autonomic nerves[1].
Currently there is no gold standard for diagnosis, no proven ways to lessen or stop this condition and treatment strategies need be addressed.[1]
CIPN regularly impacts chemotherapy, occasionally requiring the dose to be reduced or treatment ceased, effecting survival. Around 30% of patients will still have CIPN a year, or more post chemotherapy[2].
Physiotherapy, in the form of exercise therapy, has been shown to have a role in reducing symptoms in CIPN[3].
Risk Factors[edit | edit source]
Include: Agent used, cumulative dose, how many treatment cycles and its duration, genetic susceptibility, age, any existing nerve damage, severity of acute symptom, chronic alcohol consumption.[1]
Treatment[edit | edit source]
Pharmacological: Pharmacological treatment for peripheral neuropathic pain is not very effective and also may have serious harmful consequences[4]. Treatment option for symptoms include:
- Steroids, to lessen inflammation
- Topical anesthetics
- Antiseizure medications, which can help relieve nerve pain
- Opioids
- Antidepressants
Non pharmacological:
- Transcutaneous electrical nerve stimulation
- Physical therapy
- Occupational therapy
Note. Recently published American Society of Clinical Oncology (ASCO) guidelines
- Suggest strongly that duloxetine (a serotonin–norepinephrine reuptake inhibitor) is the only currently recommended treatment.
- No recommendations for treatment of CIPN in regards to exercise therapy, acupuncture, scrambler therapy, gabapentin, pregabalin, topical gel treatment (containing baclofen/amitriptyline plus/minus ketamine), tricyclic antidepressants or oral cannabinoids.[1]
Resources[edit | edit source]
- bulleted list
- x
or
- numbered list
- x
References[edit | edit source]
- ↑ 1.0 1.1 1.2 1.3 Burgess J, Ferdousi M, Gosal D, Boon C, Matsumoto K, Marshall A, Mak T, Marshall A, Frank B, Malik RA, Alam U. Chemotherapy-induced peripheral neuropathy: epidemiology, pathomechanisms and treatment. Oncology and therapy. 2021 Dec 1:1-66.Available:https://pubmed.ncbi.nlm.nih.gov/33490836/ (accessed 18.8.2023)
- ↑ Colvin LA. Chemotherapy-induced peripheral neuropathy (CIPN): where are we now?. Pain. 2019 May;160(Suppl 1):S1.Available:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6499732/ (accessed 19.8.2023)
- ↑ Jesson T, Runge N, Schmid AB. Physiotherapy for people with painful peripheral neuropathies: a narrative review of its efficacy and safety. Pain Reports. 2020 Sep;5(5).Available: https://pubmed.ncbi.nlm.nih.gov/33490836/(accessed 18.8.2023)
- ↑ Jesson T, Runge N, Schmid AB. Physiotherapy for people with painful peripheral neuropathies: a narrative review of its efficacy and safety. Pain Reports. 2020 Sep;5(5).Available:https://pubmed.ncbi.nlm.nih.gov/33490836/ (accessed 19.8.2023)
