Diabetes & Chemotherapy Neuropathy

Essentially, neuropathy pertains to nerve disorders that affect the central nervous system. Neuropathy is considered to be equivalent to peripheral neuropathy, which is defined as deranged function and structure of peripheral motor, sensory, and autonomic neurons. Those with diabetes are very susceptible to problems with their peripheral nerves, which commonly include numbness in the fingers and carpal tunnel syndrome. It was recently discovered that those who have diabetes and have recently undergone chemotherapy because of cancer suffer from numbness and pain that begins in the feet and moves to the legs due to peripheral neuropathy brought on through the chemo.

The Facts:

• People with diabetes who also develop cancer come into contact with some of the newest and best cancer fighting drugs on the market. These drugs, however, have a side effect related to the peripheral nerves and it's called chemotherapy-induced neuropathy. As mentioned, diabetics are already at risk of experiencing nerve compression and neuropathy, but they will be twice as likely to experience this chemotherapy side effect.

Types

• Aside from drugs that feature the compound cisplatin and taxol, drugs such as vinca alkaloids, paclitaxel, and podophyllotoxins can cause peripheral neuropathy as well.

Effects

• The most common chemotherapy drugs currently in use have certain compounds in them that cause nerve disorders. The drugs that have the highest risk of causing neuropathy are those related to the compound cisplatin and the compound taxol. If a cancer patient with diabetes has a form of cancer called multiple myeloma, the most highly effective drug for this type of cancer is called thalidomide. Unfortunately, this drug has also been proven to cause neuropathy.

Prevention/Solution

• Patients with symptomatic chemotherapy-induced neuropathy in both their hands and legs can be relieved of the nerve disorder's symptoms through the decompression of multiple peripheral nerves. The surgery is an outpatient procedure and it takes about one and a half hours per limb. Doctors will perform the surgery on each limb separately, with about a three-month break in between.

Theories/Speculation

• Speculation concerning chemotherapy-induced neuropathy began after a study by a doctor named A. Lee Dellon was published. The study followed diabetic rats with blood sugars of 400. The rats were prevented from developing neuropathy when their tibial nerve was decompressed through surgery. Colored paint on their feet measured their neuropathy (or lack of) by making their walking tracks visible. These specific rats' footprints were no different than non-diabetic rats of the same weight.

  Dellon conducted a similar study to evaluate the effect of nerve decompression in rats given cisplatin chemotherapy. Based on their painted footprints, it was determined that rats given chemotherapy with cisplatin developed neuropathy. Once the rats developed abnormal walking tract patterns, they were helped by surgical decompression of their tibial nerve.