Chemo Neuropathy Pain? Here's What Actually Works

 Chemo neuropathy depends on the drug. What helps one type can worsen another. Here’s how to tell. #chemotherapy #cancertreatment #neuropathy

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Episode Description: 

Neuropathy during chemotherapy is one of the most common — and most misunderstood — side effects of cancer treatment.

Tingling, burning, numbness, pain… it can sneak up quickly or linger for years. And unfortunately, much of the advice patients are given treats all neuropathy as if it’s the same condition.

It’s not.

In our latest blog post, Dr. Jay Chaplin breaks down chemotherapy-induced neuropathy by drug type and mechanism — explaining what actually helps, what consistently fails, and what can quietly make symptoms worse.

You’ll learn:

• Why platinum and taxane drugs cause neuropathy differently
• When cold therapy helps — and when it backfires
• Which supplements have strong data, and which don’t
• Why “immune boosting” during chemo can be a problem

If you or someone you care about is navigating chemotherapy side effects, this is one of those topics where the right information can make a real difference.

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Inquiries: 

info@elevatingcancertreatment.com

https://elevatingcancertreatment.com

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Disclaimer:
The information provided in this podcast is for educational and informational purposes only, and does not constitute medical advice. It is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have heard or read in this podcast or on this channel.
Reliance on any information provided by Dr. Jay Chaplin or Elevating Cancer Treatment is solely at your own risk. Dr. Jay Chaplin is a scientist and drug developer, not a medical doctor providing patient care. The content presented here reflects general scientific understanding and research, and may not be applicable to your individual health circumstances. Individual medical conditions and treatments vary, and no two situations are exactly alike.
Always consult with your personal healthcare provider before making any decisions about your health or treatment plan.

Transcript

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Chemo-induced neuropathy isn't one thing, and bad advice can make it much, much worse. Here's what actually helps, what fails, and what to avoid completely. So we're talking about one of the least discussed and most frustrating side effects of chemotherapy. Peripheral neuropathy. That unwelcome tingling, burning, numbness, and pain, usually in the hands and feet. The thing that sneaks up on people or may just jump on your back like a rabid monkey and completely overstays its welcome every time. You may not be able to avoid it, but there are things that you can do to reduce it. Have you or someone you cared about experienced neuropathy during chemo? Drop a yes or not yet down in the comments. I want to know who I'm talking to today. Hello and welcome to Elevating Cancer Treatment, where we explain the science and debunk myths to help you navigate your health journey. My background is a little different. Beyond educating about cancer, I'm actually designing new drugs that are defining the future of oncology. This direct hands-on experience offers me a very different perspective of how these cancer treatments work on the body, interact with the cancer cells, and cause side effects. And these are insights that I'm excited to share with you. If that sounds interesting, make sure to like this video, subscribe to the channel, and hit that notification bell so you never miss an update. And please share it if you find it useful. I'm Dr. Jay Chaplin. An important reminder, I'm a PhD, not an MD. The information in this video is education and it's not medical advice. Every cancer is unique and no general information applies to everyone. Please remember that. Always consult with your healthcare provider for guidance on your specific situation. And two quick things. First, as a thank you for being here, I've created a free resource, 10 things to elevate your chemo journey, which you can download from the link below. And second, by signing up, you'll also get updates on that innovative cancer treatment I'm working on. I'm confident it represents a significant advancement in immunotherapy. So please take a moment, download your free guide, and join us in shaping the future of cancer treatment. There's a big mistake that people often make. Here's the problem. Most advice online is generic and treats all neuropathy like it's the same thing. Like people treat all cancer as if it's the same thing. It's not. There are different drugs and different mechanisms behind them and very different solutions for the kinds of neuropathy. If you don't separate those, you're going to waste time and probably make things much worse for yourself. Unfortunately, most of the review articles on chemotherapy-induced neuropathy do exactly this. It's like that old bad cartoon trying to get all the different animals to do the exact same test. Platinum class drugs and taxol-based drugs have completely different things that work for them, and you can't evaluate them all together, but most of the literature does just this. So we have to break it apart. So today we're going to break neuropathy down into four categories. We'll really only talk about three, but there's four. We've got the platinum-based drugs over here, those are carboplatin, cisplatin, oxaliplatin. We've got the taxane-based drugs over here, that's taxol and abraxane. You've got things that happen fast, your acute neuropathy, and you've got chronic neuropathy, the stuff that takes months to kick in and can take years to go away. And yes, what helps one can absolutely fail for another. So another quick poll down for the comments. Are you currently on platinum drugs or taxanes? Or are you not clear about what your chemotherapy regimen is? Let us know. So, platinum drugs and acute neuropathy. Let's start there. Again, this is things like carboplatin, cisplatin, and oxaliplatin, the ox and full fox. Acute neuropathy here usually shows up both often, over 90% of the time, and fast. Often right after or even during the infusion, and it's driven by two main issues. A buildup of calcium inside the nerve cells, because of the actual drugs, oxaliplatin binds calcium, and sodium channel dysfunction on the nerve surfaces. Translation? Your nerves get electrically cranky. And that crankiness can last for an entire week before resolving itself. So, what actually helps this? What helps platin-based acute neuropathy? Reducing your calcium intake about a week before the infusion. Stop all calcium supplements and dietary sources if you can. And use compression gloves and stockings during the infusion. Notice I didn't say cold. Important distinction here. Cold packs? Not really, not for platinum drugs. You can use them, but these drugs cause cold sensitivity. So cold can make the symptoms much worse. If you do use cold packs during platinum class chemotherapy, please be sure to remove them within 15 minutes of the drug infusion finishing. Maybe even faster. You want to get that cold off before the neuropathy kicks in. So did anyone here just get told to ice everything without explanation? If yes, you're not alone. That's bad but incredibly common advice. Okay. Supplements, things that you can do yourself. What works and what fails? Let's clear up a bunch of myths here. Vitamin E for platinum neuropathy, studied extensively, failed miserably, no effect. Glutathione infusions, massive doses, grams and grams and grams of glutathione. Nothing didn't work. Anacetylcysteine pills, big megadoses, grams and grams and grams. Nope, nothing. Didn't work. Alpha lipoic acid megadoses? Nothing there either, just placebo effect. How about drugs? Gabapentin for prevention or treatment. No meaningful benefit for the plate classes. So what can you do? What actually helps? So what can you do? You can increase your magnesium levels. Magnesium and calcium counterregulate each other. If you up magnesium, calcium is less of a problem. That helps you. You can use the Japanese or conpo medicine, Gosha Jinkigan. Sorry about my pronunciation. Yes, this has been very well studied and it works. Is there anything that your medical team can do? Yes. Dose and infusion adjustments. Very big yes. These can be useful for both acute and chronic platinum neuropathy. If you can convince your medical team to switch from a one-hour infusion to a two-hour infusion, or to do smaller, more frequent doses, say every other week infusions, instead of once per month, those help. Because you dramatically reduce the maximum dose of drug at any one time, and with that you reduce the stress on the nerves. Makes it easier for your nerves to tolerate it. Another switch that seems to make a difference is from full fox to cappox. While the oxaliplatin is the one that's actually doing the damage, the 5FU in full fox appears to make it worse than the combination with capocitabine. So switch to cappox, it's easier to tolerate, same efficacy. So, another question for you. Have any of you successfully asked your oncologist or your medical team about infusion timing or drug changes? If you have, please share what strategies either worked or tanked and backfired, because that kind of strategic knowledge really helps others. So you may also hear about the stop and go approach of stopping oxaliplatin early while continuing on with 5FU. That one is really touchy because while it does reduce neuropathy and it doesn't compromise initial tumor control, there may be significant and problematic long-term costs associated with it. That'll be part of an upcoming episode. I'll deal with that later. Now for the tougher one, the chronic neuropathy. This affects about half of patients. It often does go away eventually. Forty five percent of people still have it after a year, and 24% still have it three years out. This kind isn't about electrolytes anymore. It's about direct damage to the nerves and immune-driven inflammation and nerve damage. So what actually helps for this? Different stuff. Exercise, even just a brisk walk three times a week, makes a massive difference. Vitamin D3, up to 10,000 IU per day, helps dampen down inflammation. Glutamine, 15 grams twice a day, two days before and through to two days after the oxaliplatin infusions. Vitamin B6, high dose pyridoxine, 300 milligrams a day, starting two days before and again going through to two days after the infusion. What to avoid? Anything immune stimulating near those platinum infusions. That includes immune system stimulating supplements, heat therapies, any immune boosting strategies. Don't take your thymicin alpha-1 peptide then. Bad move. So you've probably been told to just boost your immune system during chemo. That advice is complicated and usually wrong. Again, that's why we work with clients to design strategies that work together well, rather than just mixing things randomly. My daughter loves both milk and lemonade. That doesn't mean they go together well. Don't do that with your treatment. So, pivoting, we're going to switch gears to taxanes like a braxane and paclataxyl. This neuropathy over here is not cold triggered. Cold helps over here. And this shows up as muscle and joint pain or myalgias. It often becomes chronic and stubborn. It can take one to three days to show up and it can last for the rest of your life. You really want to prevent it if you can. So, big difference. Both cold and compression are useful for taxanes. Cold packs on your hands, on your feet during infusion help a lot. What hurts you with platinum class drugs helps you here. You will probably need a few pairs for a long infusion. Again, what helps most, longer infusions, same kind of thing. If you can get a 96-hour pump versus a one or three hour bolus infusion, that's massively helpful. NSAIDs like ibuprofen, advil, can actually help a fair amount with the pain, as can antihistamines like Claritin or Clarinex. Just follow the directions on the box. Easy dosing. Glutamine, 10 to 15 grams three times per day. Again, starting two days before and going through to two days after the infusions. Omega-3s help, there's a modest benefit. You need about 4 grams per day all the time. But vitamin E is the big win here. Vitamin E at huge doses, 300 milligrams twice a day, significantly reduces severity. It may not always prevent neuropathy outright, but it can turn the dial down on the intensity pretty significantly. So, quick comment. Obviously, if you go with a long pump, 96-hour pump, you don't wear compression socks or cold packs for that long. That changes things. Now, the big warning about helpful supplements. We've got some important cautions, three of them. Two on supplements, one on a drug. Acetyl L-kernitine. Yes, this helps taxol neuropathy. Acute neuropathy, but it makes the chronic neuropathy significantly worse. This is a bad trade-off. Vitamin B12 may protect the nerves. The data on that is positive, but really weak. However, vitamin B12 doubles the recurrence risk it has in large clinical trials. We showed it here. It's also not a good trade-off. Finally, for both platinum and taxol-based neuropathy, it's pretty common for people to be given prednisone or deximethasone. Both of those are great for reducing the symptoms, but they will protect your cancer from dying, undercut your chemo, and make your cancer grow faster. That's a horrible trade-off. Please don't just stack supplements blindly, and if you can, avoid prednisone and deximethasone. Again, this is one of the ways we work with people to make sure that the supplement your friend or naturopath or the palliative care person recommend doesn't accidentally make your treatment much worse or completely stop it from working. So here's really the bottom line. Neuropathy is not one thing. The drug class that you're taking matters. The timing matters. More supplements do not mean better outcomes, and please avoid glucocorticoids if you can. And the most important tool, understanding what you're actually dealing with. If this helped you, please like the video, subscribe for upcoming deep dives, and share this with someone navigating cancer right now. Thank you. Beyond these videos, if you need more personalized guidance or a deeper dive into specific treatments to have your treatment be as effective as possible, I offer one-on-one sessions and medical advocacy. You can find information on our website, which is linked down below. Again, if you found this video informative, please give it a thumbs up, click the notification bell, and subscribe to our channel for more science based cancer insights.