- A new method using cold clothes
can help prevent the tingling feeling in the limbs without any side effects in
patients undergoing chemotherapy.
peripheral neuropathy is a frequent and disabling side effect of cancer
- 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
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.
‘Wearing frozen socks and gloves for 90 minutes can prevent neuropathy in patients undergoing chemotherapy.’
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.
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
No Side Effects Due To Cryotherapy
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.
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
The results of the study suggest that cryotherapy could be an effective
strategy for the prevention of neuropathy in patients with cancer undergoing
. 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."
- Akiko Hanai,
Hiroshi Ishiguro,Takashi Sozu, Moe Tsuda, Ikuko Yano,
Takayuki Nakagaw,Satoshi Ima, Yoko Hamab,Masakazu Toi,
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.