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32 m a s s a g e & b o d y wo r k s e p te m b e r/o c to b e r 2 0 2 1 Oh, What a Feeling! Chemotherapy-Induced Peripheral Neuropathy and Massage Therapy By Ruth Werner, BCTMB education | PATHOLOGY PERSPECTIVES What if you had successfully battled cancer but now you have a constant "socks and gloves" kind of feeling, where your sense of touch in your hands and feet is muted or distorted? Maybe your hands and feet are cold all the time. It's hard to button a shirt or pick up a coin. Tingling and burning in your hands and feet keep you up at night. Sharp jolts of electrical pain occur without warning. You're not sure about your balance, and a fall could be devastating. Nothing seems to help. Will this ever get better? WHAT IS PERIPHERAL NEUROPATHY? Peripheral neuropathy (PN) is a stunningly vague label for the results of a wide variety of problems. It can develop as a freestanding disorder, but it is more often a complication or consequence of another issue. PN is notoriously difficult to treat, and it can outlast its initial causes by months or years. About 20 million people in the United States have PN of one kind or another. When it affects only one nerve, it can be called mononeuropathy, but when it affects multiple nerves, it is called polyneuropathy. PN is almost always a symptom, not a disease in itself. It is usually the result of nerve damage brought about by some other disease or challenge. Metabolic disruptions can cause PN: Diabetic neuropathy arises from a combination of hyperglycemia and poor circulation to nerves in the extremities. Certain vitamin deficiencies can also alter peripheral nerve function as well, especially B12. Nerve compression situations like carpal tunnel syndrome or thoracic outlet syndrome can cause PN from direct mechanical impairment; other injuries that damage nerves would fit under this description as well. Some infections can cause PN, including herpes simplex, herpes zoster, HIV, Lyme disease, and Hansen's disease. Autoimmune diseases like lupus, Sjögren syndrome, and sarcoidosis sometimes have a PN component, and one autoimmune condition, Guillain-Barré syndrome, involves immune system attacks specifically on peripheral nerves. Long-term exposure to some toxic substances can also damage the nerves, so PN is sometimes seen as a complication of alcoholism, exposure to heavy metals and solvents, and some medications—which leads us to the main topic for this discussion of PN: chemotherapy- induced peripheral neuropathy, or CIPN. KHASHAYAR-KOUCHPEYDEH/UNSPL ASH.COM

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