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After treatment and remission

Neuropathy

Peripheral neuropathy is damage to the nerves that go to the hands and feet. This topic explains how it feels after leukaemia treatment, how long it may last and what helps in daily life.

Last updated: ~3 min read
Cool sparks at the tips of the fingers and toes.
Figure 1.Neuropathy is felt in the fingers and toes.

01Short answer

Peripheral nerves carry signals between the brain and spinal cord and the hands, feet, skin and muscles. Some leukaemia medicines can damage these nerves: most often vincristine (in ALL treatment), as well as bortezomib, some targeted medicines and, rarely, others. Signs usually start in the fingertips and feet: tingling, numbness, burning, stabbing pain, changes in sensing heat and cold, trouble doing up buttons, tripping and balance problems. Vincristine can also cause constipation, jaw pain or a hoarse voice. For most people neuropathy gradually improves over the months after the medicine is stopped, but for some it can last a long time. Helpful approaches include physiotherapy and balance exercises, occupational therapy, pain medicines prescribed by the doctor, foot protection and safety at home. Diabetes, alcohol and vitamin B12 deficiency can make neuropathy worse, so the doctor checks for these too.

02Simple explanation

Neuropathy is damage to peripheral nerves.

The main cause is vincristine, also bortezomib.

Signs: tingling, numbness, pain, balance.

It often improves gradually.

Help: physiotherapy, pain treatment, foot care.

03Scientific explanation

Causes: according to the NCI, vincristine, bortezomib and some other medicines cause peripheral neuropathy; the risk depends on the total dose and on existing conditions such as diabetes.

Course: the NCI and COG note that vincristine-related neuropathy often improves over months after treatment, but some children and adults have lasting symptoms.

Diagnosis: according to NINDS and MedlinePlus, the doctor checks reflexes, sensation and strength; if needed, a nerve conduction study and blood tests for other causes (diabetes, B12) are done.

Treatment: according to the NHS and NCI, specific medicines for nerve pain, physiotherapy and balance exercises help; ordinary painkillers often work poorly.

04What happens in the body?

What does it feel like?

Numbness as if wearing gloves or socks, “pins and needles”, burning, or pains like electric shocks. Holding small objects may get harder.

Why does it happen?

Some medicines damage long nerve fibres. The longest fibres run to the feet, so signs often start there.

Will it go away?

Nerves recover slowly. For many people signs ease over months; for some they may remain, but they can be managed.

A nerve fibre slowly glowing again.
Figure 2.Nerves recover gradually.

Everyday safety

Keep walkways at home clear, use good lighting and handrails, wear comfortable closed shoes and take care with hot water.

A bright clear hallway with a handrail.
Figure 3.A safe home prevents falls.

Treatment and rehabilitation

A physiotherapist teaches strength and balance exercises; an occupational therapist suggests aids for daily tasks. Only your doctor should prescribe pain medicine.

When to call your doctor

Worrying signs — fever, bleeding, new pain, breathlessness — should be reported to your doctor between visits too. Getting in touch early is always better than waiting.

05Living with neuropathy

Steps.

Check feet — Look at your feet every day.1Check feetLook at your feet every day.
Protect — Test the water temperature.2ProtectTest the water temperature.
Move — Balance and strength exercises.3MoveBalance and strength exercises.
Report — Tell your doctor if it worsens.4ReportTell your doctor if it worsens.
SensationSigns ease.
BalanceLower fall risk.
SafetyInjuries prevented.

06Neuropathy: signs and help (simplified)

SignWhat helpsWho helps
Tingling, numbnessProtection, monitoringDoctor
Burning, painNerve pain medicinesDoctor
Balance problemsExercises, home safetyPhysiotherapist
Trouble with fine movementsAssistive aidsOccupational therapist

* Your doctor chooses the treatment.

07Key terms

Peripheral neuropathy
Damage to the nerves going to the hands and feet.
Vincristine
A chemotherapy medicine that can cause neuropathy.
Neuropathic pain
Pain caused by nerve damage.
Nerve conduction study
A test that measures how nerves work.
Physiotherapy
Treatment for movement and strength.
Occupational therapy
Support for adapting daily tasks.

08Key points

  • Neuropathy is common.
  • It often improves.
  • Check your feet every day.
  • Test water temperature.
  • Do balance exercises.
  • Report any worsening.

09Frequently asked questions

How long does neuropathy last?

It often eases over months; sometimes it lasts a long time.

Which painkiller helps?

There are specific medicines for nerve pain; your doctor chooses them.

Is exercise safe?

Yes, suitable exercise helps; start with a physiotherapist.

Will vitamins help?

Only if you have a deficiency; your doctor needs to check.

Does this information replace medical advice?

No. This is general education; only your treating doctor can assess your situation.

10Questions for your doctor

Take these questions to your appointment. The ones you save are collected on the “My questions” page and stay on this device only.

  1. How long does neuropathy last?

  2. Which painkiller helps?

  3. Is exercise safe?

  4. Will vitamins help?

  5. Does this information replace medical advice?

My questions

12Sources

  1. National Cancer Institute. Nerve Problems (Peripheral Neuropathy) and Cancer Treatment
  2. National Institute of Neurological Disorders and Stroke. Peripheral Neuropathy
  3. MedlinePlus (U.S. National Library of Medicine). Peripheral Nerve Disorders
  4. NHS. Peripheral neuropathy
  5. Children's Oncology Group. Long-Term Follow-Up Guidelines for Survivors of Childhood, Adolescent and Young Adult Cancers
  6. National Cancer Institute (NCI). Late Effects of Treatment for Childhood Cancer (PDQ®)–Patient Version
  7. National Cancer Institute (NCI). Follow-Up Medical Care
  8. National Cancer Institute (NCI). Cancer Survivorship
  9. Cancer.Net (ASCO). Follow-Up Care After Cancer Treatment
  10. Leukemia & Lymphoma Society (LLS). Long-Term and Late Effects of Treatment
Medical disclaimerThis information is for educational purposes only and does not replace medical advice.
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