There isn't a treatment to prevent or reverse nerve damage caused by anti-cancer drugs. Studies are looking at various drug treatments to see if they can help protect against nerve damage during anti-cancer treatment. There are also studies looking into whether any treatments can reverse nerve damage that has occurred. At the moment, however, there isn’t enough evidence that any of these drugs work.
The most effective treatment for peripheral neuropathy is to prevent further damage to the nerves. Sometimes it can help to lower the dose of the drug that is causing the problem. If your symptoms continue to get worse, your doctors may have to stop the treatment.
For most people, symptoms gradually improve once the drug is stopped, but they can sometimes continue to get worse for a few weeks. This is known as coasting.
Stopping treatment because of symptoms can be very difficult for some people to accept, especially if the treatment is working well. Your doctors will usually discuss with you whether another type of anti-cancer drug can be given instead. Alternatively, some other kind of treatment such as radiotherapy may be suggested. It is extremely important not to stop treatment without talking to your cancer specialist first.
Most people find that their symptoms gradually improve with time as the nerves slowly recover. This may take several months or more. For some people, nerve damage will be permanent. In this situation, however, many people find that their symptoms become less troublesome over time, as they adapt and find ways of coping with the changes.
If you have nerve pain, sometimes called neuropathic pain, this can be managed in a number of ways:
Some types of drugs can alter nerve impulses and help relieve nerve pain. Gabapentin (Neurontin®) and pregabalin (Lyrica®) are drugs that work in this way. They are also anticonvulsants (drugs used to treat epilepsy). Other anticonvulsants and antidepressants are also used to treat nerve pain. If your doctor suggests an antidepressant drug, such as amitriptyline, this is because of the way it acts on nerves, not because they think that the pain is just in your mind. Drugs such as morphine can also sometimes help.
Transcutaneous electrical nerve stimulation (TENS)
This may help reduce pain. TENS uses pads, which are put on to the skin, that give off small electrical pulses. This causes a tingling sensation, which aims to stimulate nerves close to the painful area. It's thought that this may work by blocking pain messages from being carried along the nerves to the brain. TENS is unlikely to cause any side effects. Physiotherapists or pain teams can advise you on whether TENS is suitable for you and how to use it. They may be able to loan you a TENS machine on a short-term basis so that you can find out if it’s helpful.
Very fine needles are placed through the skin at particular points. It isn’t clear exactly how this works, but it may help block pain messages from being sent to the brain.
This may help reduce the anxiety, tension and fear caused by the pain, and support can make it feel more bearable. Psychological support can be offered by psychotherapists, counsellors and some pain teams.
Many hospitals have pain teams that have specialist doctors and nurses who advise on all aspects of pain control. Your GP or hospital doctor can refer you to a pain team if your pain is troublesome.
Other types of help
If your symptoms are mild, you may not need any additional help in managing them. However, if you have more troublesome symptoms, support is available to help you cope with them.
A physiotherapist will be able to offer treatment and advice if you're having problems with coordination, muscle weakness, balance or walking.
If you're having difficulty carrying out daily tasks because of peripheral neuropathy, you can ask to be referred to an occupational therapist. They can assess your needs and recommend appropriate aids and equipment to help you. There are organisations that provide equipment for people who need help with daily tasks (see below).
Benefits and financial help
If symptoms continue for more than six months and cause you difficulty in walking or carrying out daily activities, you may be entitled to financial help. You may be able to claim Disability Living Allowance if you're younger than 65 or Attendance Allowance if you're older than 65.
For more details on benefits and financial support, look at our financial issues section or talk to us.