Cancerwise

Neuropathy is the clinical term for nerves that are not working properly.

From a structural perspective, that could mean they’re either broken or just malfunctioning. Usually, those two things go hand in hand, but not always. Either way, it means that the nerves are not doing what they’re supposed to be doing.

Neuropathy is a problem for many of our patients here at UT MD Anderson because it can be a side effect of some of the drugs we use to treat cancer, including certain types of chemotherapy. But what else might cause neuropathy? And what can we do to treat or even prevent it?

Here’s what to know about neuropathy, including why it happens, how it can look, and why we’re more focused on prevention right now than treatment.

What are the symptoms of neuropathy?

The nervous system is our bodies’ way of interacting with and making sense of the world. We perceive it through our five senses, process that information, then respond, based on how our brains interpret it.

Some of these processes we can control, such as reaching for a pencil or a cup of coffee. Others just go on in the background, like regulating our body temperature, blood sugar and blood pressure. When the nervous system is damaged, though, any of these processes might be affected. So, here are some of the many ways neuropathy can look:

• Autonomic: If the nerves controlling automatic processes are affected, you might faint due to a sudden drop in blood pressure or have heart palpitations.
• Central nervous system: If the nerves in your brain are affected, you might struggle with attention, memory or multitasking.
• Cranial: If the nerves in your ears are affected, you might experience tinnitus (ringing) or have trouble hearing.
• Motor: If the nerves in your muscles are affected, you might experience weakness, cramps or twitching.
• Peripheral: If the nerves in your skin are affected, you might experience numbness, tingling, or excessive sensitivity, sometimes to cold.

What are the main causes of neuropathy?

Among cancer patients, neuropathy is usually due to chemotherapy. These could be platinum-based drugs, such as carboplatin and cisplatin, or taxane-class drugs like paclitaxel.

Chemotherapy is a cytotoxin, meaning that it kills cells. Some cancer cells are more vulnerable to it than others. Unfortunately, our nerve cells share that same quality. So, if they’re left unprotected during treatment, they can be damaged early on.

But chemotherapy isn’t the only possible cause of neuropathy. Others include:

• Alcohol abuse
• Autoimmune disorders, such as lupus and rheumatoid arthritis
• Diabetes
• Injury, such as carpal tunnel syndrome, which results from repetitive motions
• Kidney disease
• Viral infections, such as HIV, Epstein-Barr, herpes, cytomegalovirus, hepatitis and others
• Vitamin deficiency, especially vitamin B