Summary: Evaluates the risks for developing neuropathy after transplant, and strategies to manage the weakness and pain associated with neuropathy.

Presenter: Sasha Knowlton MD, Assistant Director of Cancer Rehabilitation, Massachusetts General Hospital. Meet Dr. Knowlton: https://www.massgeneral.org/doctors/20310/sasha-knowlton

To read full transcript: https://www.bmtinfonet.org/video/managing-neuropathy-after-transplant-0

Highlights:

- 70% of patients will experience some level of neuropathy after chemotherapy.
- The main risk factors of developing worsening neuropathy during or after chemotherapy are smoking, poor kidney function and diabetes.
- Neuropathy should be managed by a physiatrist, neurologist, or neuro-oncologist.
- Nearly 1 in 5 who develop neuropathy from chemotherapy will experience a fall.
- Duloxetine has been found to be the most effective drug treatment.
- Exercise is very important for managing neuropathy and pain associated with it.

July 16th, 2020 Presented at the Celebrating a Second Chance at Life Survivorship Symposium 2020. Presentation is 28 minutes with 14 minutes of Q&A.

Key Points:

01:57 Neuropathy is damage of the peripheral nerves and affects how nerves feel sensation, and their ability to tell where the body is in space.

06:55 Typical symptoms of neuropathy include burning or stabbing pain, hypersensitivity, and numbness.

08:17 Goal of treatment should include pain management, maintaining independence and or vocation.

10:05 A typical evaluation should include evaluation of sensation, balance, and strength.

13:04 Chemotherapy agents that cause neuropathy include platinum agents, Taxol and many more.

18:33 If a patient experiences increasing neuropathy while taking chemotherapy, the oncologist may be able to reduce the dosage or frequency of the chemotherapy treatment.

24:00 Talk to your doctor before starting an exercise program. A personalized exercise plan is key to prevent injury. All medications and conditions should factor into the physician-prescribed exercise plan.

25:15 Working with a physical therapist can help address balance and dexterity.

26:20 Proper training with a physical therapist is needed before using a TENS unit for sensation issues.

27:08 Compression socks, braces or ankle foot orthotics can be helpful for those experiencing foot drops or who have the inability to tell where their feet are in space.

27: 20 Canes, walkers, and rollators are extremely helpful to prevent a fall.

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