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Help for Neuropathy

Posted 4/3/2013

Posted in

  If you don't know what "neuropathy" is, consider yourself lucky. It is nerve pain/numbness, usually in the hands and feet, that can be caused by a number of chemotherapy drugs. For women with breast cancer, the usual culprits are the taxanes: Taxol and Taxotere. Certainly, not every woman develops this side effect, but it can be very distressing and even disabling for those who do.

  I have known some women who experienced "mild" tingling in their hands and feet (similar to the "my hand is asleep" sensation" that persisted for a little while after treatment and then resolved. I have known some other women whose hands became almost dysfunctional as they could not button their clothes or use a keyboard due to pain in their fingertips. I have known a few women who could barely walk due to pain on the soles of their feet; one clever woman with that problem cut out bubble wrap to line her shoes and found it helped a lot. Until now, there was not been a very helpful treatment for this problem.

  Sometimes, a chemotherapy plan has been changed due to neuropathy. Some women with advanced breast cancer are switched to a different drug, and some women receiving Taxol as part of adjuvant treatment are either switched or the treatment is shortened. The usual advice has been to use lots of hand cream, maybe Vitamin B6, and hope that it gets better. Now a study suggests that an anti-depressant called Duloxetine (Cymbalta) helps.

  Here is the beginning of an article from the Gupta Report and a link to read more:

Duloxetine May Ease Neuropathy from Chemo

by Cole Petrochko, Staff Writer, MedPage Today

by Cole Petrochko, Staff Writer, MedPage Today

Published: April 02, 2013

Reviewed by Robert Jasmer, MD; Associate Clinical Professor of Medicine, University of California, San Francisco

The depression and anxiety drug duloxetine

effectively treated painful chemotherapyinduced

peripheral neuropathy, results of a

phase III trial showed.

Over 5 weeks of treatment, patients receiving

duloxetine experienced significantly larger

mean decreases in pain as measured by the

Brief Pain Inventory Short Form (BPI-SF) than

did patients on placebo (1.06 versus 0.34,

P=0.003), with a mean difference between the

=0.003), with a mean difference between the

two groups of 0.73 (95% CI 0.26 to 1.20),

according to Ellen Lavoie Smith, PhD, of the

University of Michigan School of Nursing in

Ann Arbor, and colleagues.

Additionally, more patients initially treated with

duloxetine than with placebo reported pain

decreases of any amount (59% versus 38%),

they wrote online in the Journal of the

American Medical Association.

Painful chemotherapy-induced peripheral

neuropathy occurs in roughly 20% to 40% of

patients treated with neurotoxic chemotherapy

agents such as taxanes, platinums, and vinca

alkaloids, Lavoie Smith and co-authors noted,

adding that the condition can persist for years

following completion of treatment and can induce functional and quality of life impairments.


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