a hand experiencing radiating nerve pain

Neuropathy and Advanced Breast Cancer

Neuropathy, or nerve pain, is a common issue for individuals with breast cancer, specifically advanced breast cancer. Individuals whose breast cancer is further progressed or who have been undergoing chemotherapy and other breast cancer treatments for a longer period of time are at the highest risk of developing neuropathy.1 Neuropathy can be uncomfortable and impact an individual’s quality of life if it’s not addressed.

What is neuropathy?

The general term for nerve-related discomfort is neuropathy. Nerve pain can arise when peripheral nerves become damaged, inflamed, or compressed. Peripheral nerves are nerves that send messages to and from the limbs and other distant sites of the body. Peripheral nerves communicate with central nerves that live within the brain and spinal cord.1,2

When an individual experiences neuropathy, they often report feeling general pain or discomfort, as well as experiencing numbness, “pins and needles”, or a loss of sensation in distant (or peripheral) parts of the body, like the limbs, fingers, hands, toes, or feet. Other limb-related symptoms of neuropathy include trouble picking up objects or performing small, fine motor movements (like buttoning a shirt or tying shoes), as well as clumsiness, or sudden bursts of sharp or shocking pain. In addition to these symptoms, individuals with neuropathy may also experience trouble with their hearing, decreased reflexes, difficulty swallowing, or going to the bathroom, or notice differences in the way they perceive various temperatures. Symptoms can often vary greatly from person to person, depending on the underlying cause and what nerves are impacted.1,2

What causes neuropathy for individuals with breast cancer?

In some cases of neuropathy, the cause is not completely clear. Especially for individuals without an underlying condition or who are not currently undergoing treatment that may cause neuropathy as a side effect. However, neuropathy can be directly caused by a tumor pressing on a nerve (or multiple nerves), as well as medications, including chemotherapy. Common neuropathy-causing chemotherapy drugs include carboplatin, Taxol, Taxotere, and vincristine, among others. Targeted therapies (including Perjeta and Ibrance) have also been linked to neuropathy. Additionally, neuropathy can be caused by nerves that are damaged during surgery or radiation therapy. If you think you are experiencing neuropathy, it’s important to consult your doctor or healthcare provider, so that they can help to determine the source of your pain.2

How can I manage neuropathy from breast cancer?

Depending on the cause of your neuropathy, there may be ways to manage it that can provide relief. In some cases, your healthcare provider may be able to prescribe medication designed to specifically target nerve pain, such as Lyrica (pregabalin) or Neurontin (gabapentin). Along the same lines as adding medications, your doctor can also adjust or change your current medications. Your doctor may also recommend trying a new medication altogether that is less likely to cause neuropathy. In other situations, your provider might be able to scale back on the dosage of your current medication to avoid or reduce nerve pain, while still providing effective treatment. If your neuropathy is severe and unrelenting, you may be referred to a pain management specialist.

Other than medication adjustments, there are other methods that might be helpful in providing relief from neuropathy. Some of these include physical therapy, regular exercise (within your limits), acupuncture, massage, or yoga. However, it’s important to remember to check in with your healthcare provider before trying any new, alternative therapy, to make sure it’s safe in your specific situation. Additionally, if you are experiencing clumsiness, trouble feeling sensation in your hands and feet, or trouble grasping objects, it’s important to make sure you're taking appropriate safety precautions to avoid future injuries. Some of these precautions may include avoiding handling sharp objects; using a walking device, like a walking stick or cane; wearing shoes as often as possible; and clearing adequate pathways in your home from objects, area rugs, mats, and other tripping hazards.1,2

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