Chemotherapy Side Effects Can Be Reduced With Cryotherapy

Highlights

A new method using cold clothes can help prevent the tingling feeling in the limbs without any side effects in patients undergoing chemotherapy.
Chemotherapy-induced peripheral neuropathy is a frequent and disabling side effect of cancer treatment.
Due to this side effect, many patients delay treatment and even discontinue the treatment.

Cryotherapy, a treatment where the patient wears frozen gloves and socks can help prevent the side effects of chemotherapy, finds a new study published in the Journal of the National Cancer Institute.

Chemotherapy-induced peripheral neuropathy is a frequent and disabling side effect of cancer treatment. Neuropathy causes pain, numbness, and tingling that reduces the quality of life and often results in delaying treatment, reducing the doses, or discontinuing treatment altogether.

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Peripheral neuropathy is a condition that causes weakness, numbness and pain, especially in the limbs as a result of damage to the peripheral nerves.

‘Wearing frozen socks and gloves for 90 minutes can prevent neuropathy in patients undergoing chemotherapy.’

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Efficacy of Cryotherapy for Cancer

Cryotherapy is recommended treatment for the neuropathy; however, it has limited efficacy for the amelioration of chemotherapy induced pain, and none for numbness or functional disability. Furthermore, no established strategy exists for neuropathy prevention in patients being treated with chemotherapy.

The research team prospectively evaluated the efficacy of cryotherapy for neuropathy prevention. Breast cancer patients treated weekly with paclitaxel (80 mg/m2 for one hour) wore frozen gloves and socks on one side of their bodies for 90 minutes, including the entire duration of drug infusion.

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The symptoms of the treated side were compared with those on the untreated sides. The primary end point was neuropathy incidence assessed by changes in tactile sensitivity from a pretreatment baseline. Researchers also assessed subjective symptoms (as reported in a patient questionnaire) and patients’ manual dexterity.

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Among the 40 patients, four did not reach the cumulative dose (due to the occurrence of pneumonia, severe fatigue, liver dysfunction, and macular edema), leaving 36 patients for analysis.

None dropped out due to cold intolerance. The signs of neuropathy were clinically and statistically lower on those who underwent the treatment than on the control side for all measurements.

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The study supports the efficacy of cryotherapy for chemotherapy-induced peripheral neuropathy prevention, as evidenced by a clinically and statistically significant reduction in patient-reported subjective symptoms, diminished objective signs (tactile and thermosensory), and prevention of reduced manual dexterity.

The development of subjective neuropathy symptoms was clinically and statistically significantly delayed during the course of the paclitaxel treatment, the occurrence of subjective neuropathy at a cumulative dose of 960 mg/m2 was almost completely prevented, and the neuropathy incidence tended to be lower on the intervention side.

Prevention of Neuropathy in Cancer patients

The results of the study suggest that cryotherapy could be an effective strategy for the prevention of neuropathy in patients with cancer undergoing paclitaxel treatment. Cryotherapy could support the delivery of optimal chemotherapy by preventing a dose delay or reduction, as well as inhibiting the deterioration of quality of life in cancer patients during and after treatment.

"If the results are confirmed, cryotherapy has the advantage of a limited side effect profile, is low-cost, and it appears to prevent components of neuropathy other than [just] neuropathic pain," wrote Dawn Hershman, MD, leader of the breast cancer program of the Herbert Irving Comprehensive Cancer Center at Columbia University, in an editorial the accompanied the study.

"Ultimately a better understanding of the biologic mechanisms causing chemotherapy-induced peripheral neuropathy will improve our ability to effectively prevent and treat all components of this toxicity."

Reference

Akiko Hanai, Hiroshi Ishiguro,Takashi Sozu, Moe Tsuda, Ikuko Yano, Takayuki Nakagaw,Satoshi Ima, Yoko Hamab,Masakazu Toi, Hidenori Arai, Tadao Tsuboyama. Effects of Cryotherapy on Objective and Subjective Symptoms of Paclitaxel-Induced Neuropathy: 5 Prospective Self-Controlled Trial, Journal of the National Cancer Institute https://doi.org/10.1093/jnci/djx178.

Source-Medindia