Chemo nerve damage: Researchers identify factors that put over-60s at risk

A new study led by the University of New South Wales has found being older, carrying a few extra kilos and having low haemoglobin levels (fewer red blood cells) could increase one’s risk of developing debilitating nerve damage following cancer treatment.

For the study, published in JAMA Network Open, the researchers set out to find possible risk factors in patients who developed chemotherapy-induced peripheral neuropathy (CIPN), nerve damage in peripheral body parts, like hands or feet, as a result of chemotherapy.

To do this, they examined patients — mostly women (the median age was 58 years old) — who received paclitaxel or oxaliplatin chemotherapy treatment, which are common treatments for breast, colorectal and gynaecological cancers. The researchers analysed initial pre-treatment blood samples from patients before they started chemotherapy and then assessed participants for nerve damage three to 12 months post-treatment, then compared results.

Lead author Dr David Mizrahi said they found patients with low haemoglobin at the beginning of treatment, and those who carried more weight, were more susceptible to developing nerve damage, adding older patients seemed to be more at risk too.

“One in two Australians will be diagnosed with cancer by age 85, including 145,000 new cases each year,” Dr Mizrahi explained. “Thankfully many survive, but side effects as a result of life-saving treatments are less talked about.

“CIPN is damage to the nerves that can impact your sensation and muscle control, generally in the hands and feet. This can have major implications for those who work with their hands and can impair balance, which can become an even bigger problem for older patients who are then at increased risk of falls. Many patients experience painful symptoms too.”

Dr Mizrahi went on to say that further exploration of the findings was needed but said the team’s research was a step in the right direction and may help researchers in the future develop predictive models for CIPN.

Meanwhile, the study’s senior author Professor David Goldstein said the findings reinforced what researchers already knew, as past studies also showed older patients and those with a higher body mass index, in both healthy adults and those with conditions such as diabetes, may be prone to developing nerve damage.

“Our findings add a new perspective to the current knowledge that patients who receive these types of chemotherapy could have a range of contributing factors putting them at an increased risk of nerve damage,” he said.

“Our findings could help cancer doctors and nurses to identify those who merit either a modified more tailored management approach or much closer and more intensified monitoring for the development of symptoms. This work will also assist medical teams to reduce the long-term severity of symptoms and positively impact patients’ quality of life.”