For everyone who has overcome arduous chemotherapy for their beloved family, this numbness in hands and feet may arrive as another layer of suffering. Modern medicine refers to these symptoms appearing after chemotherapy as 'chemotherapy-induced peripheral neuropathy (CIPN).' It occurs when powerful anticancer drugs that attack cancer cells unfortunately affect and cause nerve injury to our body's delicate peripheral nervous system. Typically, nerves farthest from the heart, such as the fingertips and toes, tend to be affected first.
CIPN can manifest in a very wide variety of forms beyond a simple sensation of tingling. It may present as prickling, electric-shock sensations, a burning sensation, sharp needle-like prodding, and in severe cases, it can progress to extreme pain or sensory loss. One may even find it difficult to distinguish between hot and cold water, or feel pain just from putting on socks or having clothing brush against the skin. These symptoms can seriously degrade quality of life, making even small everyday actions like buttoning a shirt, using chopsticks, or tying shoelaces challenging.
The mechanisms of this nerve injury vary slightly depending on the type of anticancer drug. For example, platinum-based anticancer drugs such as cisplatin damage the DNA of neurons or induce oxidative stress. Taxanes (paclitaxel, docetaxel) or vinca alkaloids (vincristine, vinblastine) interfere with the function of microtubules forming the cytoskeleton of neurons, causing axon damage. Beyond these, nerve injury occurs through complex causes including mitochondrial dysfunction in neurons and the induction of inflammatory responses.
CIPN can appear during or immediately after chemotherapy, but sometimes it develops gradually weeks to months after treatment has ended. Furthermore, in some patients, nerve injury remains permanently, leading to chronic pain and paresthesia. Because of this, prevention and early management are crucial. While there is not yet a drug that completely cures CIPN, focus is placed on alleviating symptoms and improving quality of life through pain management medications, neuroprotective agents, and the lifestyle improvements we will discuss today. Just as the wisdom of Donguibogam teaches, helping the circulation of qi and blood throughout the entire body and delivering warm energy to nerve endings is, from a modern medical perspective, the path to enhancing nerve recovery.
