Nerve damage from chemotherapy may persist for years, worsening risk of falls

In a study that kept in touch with more than 500 women cancer survivors for an average of six years, nearly half continued to experience chemotherapy-induced peripheral neuropathy and a heightened risk of falling.

The findings, published in the Journal of Clinical Oncology, challenge the widely held assumption that chemotherapy-induced neuropathy will mostly cause no serious long-term effects.

“Many cancer survivors are told these chemo-related symptoms will eventually go away. Our study found that’s just not the case,” said first author Kerri Winters-Stone, Elnora E. Thompson Distinguished Professor in the OHSU School of Nursing and co-leader of the Knight Cancer Institute’s Cancer Prevention and Control Program.

She first reported the findings at the American Society of Clinical Oncology Cancer Survivorship Symposium in San Francisco last year.

“This appears to be the first study to combine patient self-report and valid objective measures that demonstrate clinically meaningful mobility deficits and altered gait patterns that are associated with an elevated risk of falls,” Nicole L. Stout of the National Institutes of Health wrote in a commentary published with the paper by Winters-Stone and co-authors.

The findings “provide an impetus to enhance current practice by seeking to manage mobility and balance deficits early, rather than waiting for an adverse event to occur,” Stout wrote.

She said the new study heralds the need to expand practice guidelines that currently rely heavily on the use of pharmacologic agents. Stout said it’s time for guidelines to include the assessment of gait and functional mobility and the use of therapeutic interventions that mitigate balance deficits, functional limitations, and fall risk in this population of known high risk.

Co-author Sara Faithfull, Ph.D., a professor of cancer nursing practice at the University of Surrey, was in a unique position to contribute to the study: she is a cancer survivor who has experienced the symptoms of peripheral neuropathy. Her work is focused on developing interventions for people with CIPN.

Read more about the research at OHSU News.

Photo: Getty Images


Falls, Functioning, and Disability Among Women With Persistent Symptoms of Chemotherapy-Induced Peripheral Neuropathy by Kerri M. Winters-Stone, Fay Horak, Peter G. Jacobs, Phoebe Trubowitz, Nathan F. Dieckmann, Sydnee Stoyles, and Sara Faithfull, Journal of Clinical Oncology (published online before print June 6, 2017)

Expanding the Perspective on Chemotherapy-Induced Peripheral Neuropathy Management by Nicole L. Stout, Journal of Clinical Oncology (published online before print June 6, 2017)