Chemo is Forever?
Chemotherapy induced neuropathy is a common occurrence during cancer treatment. Generally the chance of developing neuropathy is dependent on what type of chemo was used and what the total dosage over time has been.
There is some thought that having other illnesses could be damaging to nerves and make one more susceptible to neuropathy. To me, it makes sense that the human body can accommodate to a certain degree, but eventually, something has to give.
Other Potential Risk Factors:
-Alcoholism-
-Diabetes-
-Family history of nerve damage-
In general, an Oncologist’s main goal is the patient’s survival – To get rid of the cancer.
That is exactly how it should be.
But what about quality of life after? We hear from patients that during care they were told that the neuropathy would go away after treatment – and for many it does. Or it at least improves enough that it is no longer bothersome.
But perhaps up to one third of cancer survivors have ongoing and significant issues with Chemotherapy Induced Peripheral Neuropathy (CIPN )
Those who find this article of great interest can probably state that yes, peripheral neuropathy can persist after chemotherapy is done.
So why would the neuropathy persist? If someone is off of chemotherapy and chemotherapy is what caused the neuropathy, shouldn’t it go away? I recently read an interesting journal that might explain, for at least one family of chemotherapy agents, why it might never go away.
A 1992 study by the American Society of Clinical Oncology examined the nerves of patients treated with chemotherapy agents which contained platinum. There are several of these agents and they all end in “-platin” and contain a form of platinum.
They are the chemotherapy of choice for treating many types of cancer and the main goal above all others is survival of the patient. Please do not infer that I believe there is something wrong with these agents or the physicians that prescribe them. Nothing could be further from the truth.
We are just exploring why the neuropathy could persist even after chemo is done.
Okay, back to what the journal found. Read this line from the journal abstract:
That part about the platinum being retained in the nerve? That means even after chemo, the platinum was found in a “toxic” form within the nerve.
So the platinum from the chemo could stay within the nerves forever
I read that and a lightbulb went off in my head. It makes total sense. Many heavy metals, like lead, stay in our systems forever and many heavy metals are neurotoxins. The romans used to flavor their wines with lead and went nuts. Mercury is a heavy metal. Ever hear of mad hatter’s disease? Hatters used to use mercury to make felt. Mercury is a neurotoxin. Bam, mad hatter. Does it make sense that platinum would be the same way? In the last line it states that the patients with clinical evidence of neuropathy also had the highest levels of platinum.
This is a very interesting development, at least for the platinum containing compounds. They might never be gone. It might just depend on the individual person and whether or not their body can overcome that toxicity.
Citations
Quasthoff S and Hartung HP. Chemotherapy-induced peripheral neuropathy. J. Neurol. 2002: 249 (1): m9-17
Gregg RW, Molepo JM, Monpetit VJ, et al.Cisplatin neurotoxicity: The relationship between dosage, time, and platinum concentration in neurologic tissues, and morphologic evidence of toxicity.J Clin Oncol1992;10:795-803.
https://neuropathyjournal.org/cancer-related-neuropathies/
