Breast Cancer & Neuropathy

Russell HowellUPMC Intern

What is neuropathy?

• Nerve damage• Most case found in people who have diabetes• Pain is described as: “tingling”, “burning”,

“pins and needles”, and “numbness”• Chemotherapy medications can cause

neuropathy

Chemotherapy Medications that can cause Neuropathy

• Abraxane • Carboplatin• Halaven• Taxol• Taxotere• vincristine

Breast Cancer….The Numbers

• About 1 in 8 U.S women (12.5%) will develop invasive breast cancer over the course of their lifetime

• In 2015- it is estimated that 231,840 new cases of invasive breast cancer are expected to be diagnosed in women in the U.S along with 60,290 new cases of non-invasive breast cancer

The Numbers (cont.)

• About 40,290 women in the U.S are expected to die in 2015 from breast cancer, though rates have been decreasing since 1989!

• For women in the U.S- breast cancer death rates are higher than those for any other cancer, besides lung cancer

• In 2015 there are more than 2.8 million women with a history of breast cancer in the U.S

Chemotherapy

• Chemotherapy-associated neuropathy can start any time after treatment begins, and it may worsen as treatment continues

• Begins in toes, but can expand to legs, arms, and hands

Peripheral Neuropathy

• Affects feet and lower legs• Symptoms- “pins and needle feeling”, pain,

numbness and an inability to feel pain, especially in your feet; and injuries to your feet (especially breaks in the skin) that fail to heal properly

Autonomic Neuropathy

• Affects autonomic nervous system which regulates involuntary functions like heart rate, sweating, and digestion

• Symptoms- inability to sweat, excessive sweating (body doesn’t cool itself properly)

• Drop in blood pressure when moving from a seated to a standing position (light headedness or falling)

• Irregular heartbeat or stomach cramps

When Neuropathy Affects Digestive System it can lead to…

• Feeling full or bloated • Erratic glucose levels• Nausea and vomiting• Constipation• Diarrhea

Signs and Symptoms- Related to Sensory Nerve Damage

• Gradual numbness/tingling in hands and feet can spread elsewhere (legs and arms)

• Burning pain• Sharp, jabbing, or electric-like pain• Extreme sensitivity to touch• Skin, hair, or nail changes• Lack of coordination

Signs and Symptoms- Related to Motor Nerve Damage

• Muscle weakness• Paralysis• Muscle cramps & twitching• Loss of muscle (lack of use)• Loss of control/coordination

Signs and Symptoms- Related to Autonomic Nerve Damage

• Heat intolerance• Bowel, bladder, or digestive (stomach)

problems• Dizziness/ light headedness

Symptoms

• Pain, tingling, burning, weakness, tickling or numbness in arms, hands, legs, and feet

• Sudden, sharp, stabbing or shocking pain sensations

• Loss of touch sensations• Clumsiness• Trouble using hands to pick up objects or

fasten clothing

How to Manage Neuropathy?

• Handle sharp objects CAREFULLY• Be careful when moving• Put no-slip bath mats in tub or shower area• Clear areas where you frequently walk• Consider using a cane• Protect your feet from injury• Check water temperatures with a thermometer

Managing Neuropathy (cont.)

• Get plenty of rest• Find a physical therapy or exercise program• Ask your doctor about seeing a pain specialist

Exercising During / After Cancer Treatment

• Keep or improve your physical abilities • Improve balance, lower risk of falls or broken

bones• Keep muscles from wasting due to inactivity• Lower the risk of heart disease• Lessen the risk of osteoporosis• Improve blood flow to your legs and lower the

risk of blood clots

Exercising During / After Cancer Treatment (cont.)

• Make you less dependent on others • Improve self-esteem• Lower the risk of being anxious or depressed• Lessen nausea• Improve ability to keep social contacts• Lessen symptoms of fatigue• Help control your weight• Improve your overall quality of life

Certain things can affect your ability to exercise:

• Type and stage of cancer you have• Your cancer treatment• Your stamina (endurance), strength, and

fitness level

What do you do?

• Get your DOCTOR’S OKAY first!• Be sure the person working with you knows

about your cancer diagnosis and any limitations you may or may not have

• They can help figure out how often and long you should exercise

• Your doctor should have input on tailoring an exercise program to meet your interest and needs

Let’s Exercise!!

• Seated exercises• Arm Circles (10 each way) 3 sets• Toe Tapping (15 toe taps each foot) 3 sets• Sitting leg pointers (5-10 each leg) 3 sets• Marching in place (15-20 seconds) 3 sets

FIGHT ON!