Numbness Resulting from Chemotherapy

Q:  A young relative, in her thirties, is undergoing chemotherapy treatments intravenously for several hours once a month for a rare form of lung cancer. Numbness of the fingers and toes up to the first joint is happening. So far, they are not numb all the time, but if it does become so, her doctor says the chemo treatments will have to be stopped. Can you tell us anything about this side effect? Will it become permanent? Will it spread further up the fingers and toes? And, if the chemo must be stopped, is there any alternative treatment? Any light you can shed on this worrisome and potentially disabling situation will be sincerely appreciated.

With finger numbness, she is worried about her ability to continue working... a job which involves a lot of travel and computer work. And, she is fast approaching the lifetime limits of her medical insurance. Naturally, we are very concerned about her. Again, your advice will be appreciated.

A:  Chemotherapy with certain drugs such as vincristine, vinblastine, and especially paclitaxel (Taxol) affects the nervous system. With Taxol, the numbness is related to the individual dose, the total cumulative dose and the frequency of chemotherapy. Taxol can also cause some muscle and joint pain and even weakness for a while. If symptoms become severe, the dose can be reduced or the treatment delayed. Fortunately, after chemo is completed, the symptoms may subside and should not be permanent.

Doctors at the Cancer Center at Columbia University in New York used glutamine (an amino acid) in an oral dose of 10 grams three times a day for four days after the high-dose Taxol was given, and patients experienced less neuropathy. These findings were published in May 2001 in Clinical Cancer Research.

Your relative should talk to her oncologist about trying the glutamine or alternative treatments if the neuropathy worsens. TEST

"Dear Doctor" is a compilation of patient questions answered by doctors from the Medical College of Wisconsin.