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Self-Management of Oxaliplatin-Related Peripheral Neuropathy in Colorectal Cancer Survivors

DOI: 10.1155/2013/547932

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Abstract:

Purpose. The purpose of this study was to evaluate medications that cancer survivors with oxaliplatin-induced peripheral neuropathy take to control neuropathic symptom, and to explore self-management techniques used at home to provide temporary relief of painful neuropathy. This was a mixed methods, descriptive, cross-sectional study using self-reported data from colorectal cancer survivors previously treated with oxaliplatin. We analyzed demographic and medication data obtained from participants, along with written comments from an open-ended question regarding methods participants had tried to self-manage symptoms of neuropathy. Results. Twenty-nine percent of the sample reported taking some type of nutritional supplement with potential neuroprotective qualities. Opioids were being taken by 10% of the sample, and nonsteroidal anti-inflammatory and over-the-counter medications were taken by 15% of participants. Twelve percent of participants were taking antidepressants and 10% were taking anticonvulsants, primarily gabapentin. Recurrent themes for nonpharmacologic treatment included avoiding the cold/keeping warm, keeping moving, massaging or rubbing the affected area, and living with it. Conclusions. Patients treated with oxaliplatin for colorectal cancer utilize a variety of traditional pharmacologic agents and nutritional supplements in an effort to self-manage neuropathic symptoms. Patients also employ a variety of home-based therapies to provide temporary relief of peripheral neuropathy symptoms. 1. Introduction Oxaliplatin is a highly neurotoxic chemotherapy drug routinely used to treat colorectal cancer in the adjuvant and metastatic disease settings [1]. Among the approximately 100,000 persons diagnosed with colon cancer each year, approximately 60% will be candidates to receive oxaliplatin-based chemotherapy [2]. At least 48% of patients who receive oxaliplatin will develop chronic peripheral neuropathy that arises during treatment, and still more patients will go on to develop chronic neuropathy after cessation of treatment, a phenomenon known as “coasting” [3–6]. Few evidence-based interventions exist for treatment of oxaliplatin-related neuropathy [7–9]. Supportive care for peripheral neuropathy includes pain management, fall prevention, home safety education, provision of psychological support, measures to enhance or maintain physical functioning, and recommendations for assistive devices to help with daily activities [10]. In clinical practice, the focus of management of peripheral neuropathy is primarily aimed at control of neuropathic

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