About Lymphoma

Peripheral neuropathy

Peripheral neuropathy can be either a temporary or permanent damage to the peripheral nervous system. The peripheral nervous system consists of all nerves outside of the brain and spinal cord.

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What is peripheral neuropathy?

The peripheral system is made up of the sensory nervous system, autonomic nervous system, and the motor nervous system. The sensory nerve cells carry messages from the sensory receptors all around the body to the brain along sensory nerves. These messages enable us to feel physical sensations such as pain and touch.

The autonomic nerves regulate functions of organs we have no conscious control over. Such as blood pressure, heart rate and the need to urinate. The motor nerve cells carry messages from the brain to the muscles along the motor nerves.

Causes of peripheral neuropathy in lymphoma

Side effect of treatment

Side effects may be a result of the chemotherapy or radiotherapy.

Drugs that are likely to cause peripheral neuropathy are:

  • Vinca alkaloids- vincristine and vinblastine
  • Platinum-based drugs-cisplatin, oxaliplatin and carboplatin
  • Velcade, thalidomide and brentuximab vedotin

Symptoms of lymphoma

  • If paraproteins stick to nerve cells and cause damage. Common in Waldenstrom’s macroglobulinemia
  • Lymphoma cells spread into nerves, compress them, or grow around blood vessels that supply the nerves

Other diseases

  • Diabetes
  • Low vitamin B12 levels
  • Infections such as Shingles
  • Autoimmune diseases
  • Alcoholism

Symptoms

It is very important to notify a nurse and doctor if there are any signs or symptoms of peripheral neuropathy. The doctor may reduce the dosage or change the treatment if the symptoms are severe.

Symptoms depends on what nerves are affected

Sensory neuropathy

  • Tingling in hands or feet
  • Burning sensation in hands or feet
  • Electric type pain in hands and feet
  • Loss of sensation or numbness
  • Altered sensation to stimuli. Something feeling hot when it is cold
  • Inability to maintain balance when eyes are shut
  • Loss of reflexes
  • Ringing or buzzing in your ears

Motor neuropathy

  • Painful cramps
  • Muscle twitching
  • Decreased reflexes
  • Muscle weakness
  • Unsteady gait when walking
  • Inability to do up buttons easily
  • Trouble writing
  • Restless legs

Autonomic neuropathy

  • Dizziness
  • Bladder changes
  • Diarrhoea
  • Constipation
  • Feeling of being full earlier than normal
  • Impotence
  • Abnormal sweating

Treatment

  • Anti-neuropathic pain medication. For example, Amitriptyline, Pregablin and gabapentin
  • Capsaicin cream
  • Lidocaine plasters
  • Oral opioids such as tramadol
  • Plasmapheresis to remove paraproteins from the blood
  • Eat a balanced diet
  • Take supplements if you have low vitamin levels
  • Drink less alcohol
  • Quit smoking
  • Control blood sugar levels if you are diabetic
  • Acupuncture
  • Massage
  • Physiotherapy
  • Exercise to improve blood circulation and the oxygen supply to the nerves
For more info see
EVIQ Peripheral neuropathy during cancer treatment

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