Neuropathy is a common side effect of certain cancer chemotherapies and occurs when the nerves are damaged from the drug(s). This can result in numbness, burning, tingling, pain or loss of movement, often in the fingers or toes. Although uncomfortable and perhaps painful, chemotherapy-induced peripheral neuropathy (CIPN) is not life threatening and usually goes away once the treatment is changed or discontinued. However, in some, CIPN can persist for months or even years after treatment and in some extreme cases, the nerve damage may be permanent. Some patients may be prescribed medication to help with the symptoms however many of our patients find they require additional support. Our approach to neuropathy at the CCNM Integrative Cancer Centre is to get to the root cause and help the nerves heal and repair.

Cold weather can be especially painful and even unsafe for those living with this side effect. Here are some good tips for cold-weather management if you have neuropathy:

• Wear warm gloves/mitts and socks and keep your feet and hands dry. Since it’s hard to tell what your fingers and toes are actually feeling with neuropathy, be mindful they could be really cold and wet or damp, which may worsen symptoms. Never leave the house without proper winter gloves/mitts and boots and when you go back inside, check to make sure that your feet are actually dry. You might need to change socks once inside.


• Consider keeping an extra pair of socks and gloves with you in case they get wet and take breaks from the cold indoors or in a warm car.


• Movement helps relieve stiffness and sometimes numbness of the hands and feet. Even the simple act of clenching and unclenching the hands and wiggling the toes can increase circulation to those areas which will help warm them. Full-body exercise also works to improve overall circulation, so include that as well if you are able.


• Wear a warm coat to help promote circulation. If you under-dress for the weather, the degree of pain or numbness in your hands and feet may become worse. For CIPN in hands, it's particularly helpful to make sure even your forearms remain warm.


• Use caution when outdoors and walk safely. Leave the heels or slippery shoes at home and wear shoes/boots with traction to help prevent falls.


• Take a contrast hydrotherapy foot bath to help improve circulation and reduce symptoms. Contrast hydrotherapy involves alternating immersions in cold and warm water. For your feet or hands, get two clean tubs or large bowls, each one large enough for both feet or hands to rest side-by-side, with at least 2 inches of water covering the tops of feet or hands. Fill one tub or bowl with cold ice water, and another with warm water (test the water with the inside of your arm first to avoid burning yourself). Sink your feet or hands into the warm water tub and stay there for 3-5 minutes. After, immediately switch to the cold water for 30 seconds to one minute - it may sting a little. Practice deep breathing to get through it. Then, go back to the warm water. Repeat the process about 3-5 times. Always end with the cold water.


• Consider a neuropathy massage. One of the chief benefits of massage is increased circulation and there are massage therapy techniques that can improve neuropathy symptoms. While it can sometimes hurt to have your feet touched, neuropathy massage does provide significant benefits overall. Look for a Registered Massage Therapist (RMT) in your area who treats patients with cancer, such as Sorin Darie at the CCNM Integrative Cancer Centre.


• Try acupuncture. Acupuncture stimulates blood flow to help restore nerve damage. The American Society of Clinical Oncology endorses acupuncture as a treatment for peripheral neuropathy and in the winter, when symptoms are worse, it can be especially helpful. We offer acupuncture on Thursdays with our Registered Acupuncturist Tara Safford at the CCNM Integrative Cancer Centre.