Peripheral neuropathy after treatment for breast cancer

Nerve damage can cause symptoms such as pins and needles, numbness or pain in the hands and feet. For a few people, this may lead to problems with balance and walking.

Treatment with the chemotherapy drugs docetaxel (Taxotere®)| or paclitaxel (Taxol®)| is the most common cause of peripheral neuropathy in women who have had breast cancer. Surgery| and radiotherapy| to the breast may also cause nerve damage.

After treatment is over, most people find that their symptoms gradually improve as the nerves slowly recover. This usually takes several months. But, for some people, the nerves don’t completely recover and some nerve damage is long-term. Despite this, many people find that their symptoms become less troublesome over time, as they adapt and find ways of coping with the changes.

Managing peripheral neuropathy

At the moment, there isn’t a drug or treatment that can repair damaged nerves. But, nerve pain (sometimes called neuropathic pain) can be treated and there are also things you can do to help yourself.

Treating nerve pain

Nerve pain can be treated in different ways. Non-steroidal anti-inflammatory drugs (NSAIDS), such as ibuprofen, are often used. Some drugs alter nerve impulses and so help to relieve nerve pain. Drugs that can do this include some antidepressants, anticonvulsants (drugs used to treat epilepsy) and some heart drugs. Drugs such as morphine can also sometimes be helpful. If your pain is difficult to treat, you can ask for a referral to a pain clinic where there’s expert help available from specialist doctors and nurses.

Transcutaneous electrical nerve stimulation (TENS) uses pads, put onto the skin, that give off small electrical pulses to stimulate nerves close to the pain. This may block pain messages from the nerves to the brain and is unlikely to cause side effects.

Acupuncture| uses very fine needles that are placed through the skin at particular points. It isn’t clear exactly how this works, but it may help to block pain messages from being sent to the brain. Some hospitals and GP surgeries offer acupuncture on the NHS.

We have more information about different ways that pain can be treated in our section on controlling cancer pain|. We also have a section on complementary therapies|.

Other support

A physiotherapist will be able to offer treatment and advice for problems with balance or walking. If you’re having difficulty carrying out daily tasks, you can ask to be referred to an occupational therapist. They can assess your needs and recommend aids and equipment to help you.

If your symptoms continue for more than six months and cause you difficulty walking or carrying out daily activities, you may be entitled to financial help. You can contact our cancer support specialists| for more information.

What you can do

If your hands and/or feet are affected, it’s important to protect them as much as possible. If your balance, coordination or walking is affected, it’s important to reduce your risk of accidents and falls. Here are some general tips:

• Keep hands and feet warm - wear gloves and warm socks in cold weather.
• Wear well-fitting shoes or boots.
• Wear gloves when working with your hands, for example doing household chores, gardening or DIY.
• Use pot holders and oven gloves to avoid burning your hands when cooking.
• Avoid walking around barefoot and check your feet regularly for any problems.
• Test the temperature of water with your elbow to make sure it isn’t too hot before baths or showers.
• Turn the temperature control to a lower setting for hot water or have a temperature control (thermostat) fitted.
• Make sure rooms are well lit, and always put on a light if you get up during the night.
• Keep areas that you walk through, such as halls, free of clutter and make sure there aren’t things such as loose rugs you could trip over.
• Get advice from a physiotherapist about walking aids if your balance is affected.