Ovarian Cancer Chemotherapy Side Effects: Dealing with Neuropathy

"Neuropathy is probably one of the most challenging side effects," says Dr. Renata Urban, a gynecologic oncologist at the University of Washington in Seattle. Neuropathy results from damage to the peripheral nerves. It usually resolves after chemotherapy treatment, but sometimes symptoms can persist. While it’s typically characterized by numbness or a pins-and-needles sensation in the hands and feet, neuropathy can have a number of different symptoms, including:

• Weakness in the hands or feet
• Stabbing or burning pain in the hands or feet
• Difficulty gripping, such as when holding a fork
• Difficulty with fine motor skills such as writing or buttoning a shirt

Tell your doctors right away if you start to experience neuropathy symptoms, as they can have long-term effects if left untreated. "We, meaning the doctor and the provider team, want to hear about it if the patient is developing such symptoms," says Dr. Urban. She explains that helping patients to recognize what neuropathy feels like so they can alert their doctors will help them address the symptoms sooner and prevent long-term issues. According to Dr. Urban, neuropathy doesn’t always disappear after chemotherapy is stopped, but if patients alert their doctors to the side effect while they’re undergoing treatment, they can take measures to prevent nerve damage or lasting symptoms.

Treating Neuropathy Symptoms

Doctors have a number of strategies for helping patients deal with this side effect. Once a patient begins experiencing the symptoms of neuropathy, they’ll be carefully monitored to make sure it doesn’t get worse. Before each chemotherapy infusion the attending oncologist will assess whether the symptoms have progressed. If the symptoms have worsened, they may adjust the dose or even delay treatment. They may also try switching to another chemotherapy drug.

One effective treatment is cryotherapy: cold compresses applied to the hands and feet. An increasing body of evidence shows that this therapy is effective at reducing the symptoms of neuropathy and making patients more comfortable. The key is in addressing the problem early. "Whenever we're staring patients on regimens that contain paclitaxel, our team discusses this intervention with our patients, and discusses means by which they can have the cold packs available to them," says Dr. Urban.

If cryotherapy fails to alleviate the symptoms, other options are available, including:

• Pain relievers
• Numbing creams and ointments
• Steroids
• Anti-seizure medications
• Electrical nerve stimulation
• Occupational and physical therapy

Long-Term Symptoms

While in most cases neuropathy develops over the first few months of chemotherapy and then begins to get better, for some patients it never fully recedes. This means that patients may experience symptoms for years to come. According to Dr. Urban, "typically, if patients have residual neuropathy a year after they finish chemotherapy, then it probably will be persistent."

However, the good news is that when patients do experience neuropathy long-term, their symptoms are usually milder, such as faint tingling in the hands and feet. It is rare that a patient will have permanent motor skill issues or persistent pain.

Talk to Your Doctor

Side effects from chemotherapy for ovarian cancer are common, but that doesn't mean you have to suffer in silence. Always let your doctor know when you are experiencing any side effects, including neuropathy, so they can help alleviate discomfort and help your long-term recovery.

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