Numbness and tingling is swelling or damage to a nerve fiber and is associated with some cancer treatments, such as chemotherapy or radiation. It occurs generally in the hands and feet. It may interfere with walking, driving, ability to sense temperature differences, and other normal daily activities.

How do people describe numbness and tingling?

People will use many words to describe this sensation such as burning, tingling, “pins and needles”, or numbness. Others describe it as sharp, jabbing, shooting, pricking and electric-shock-like. Some people will experience shaky handwriting under these symptoms. Some people describe peripheral neuropathy as a decreased ability to feel changes in temperature, touch, pain or vibration. Some may also describe peripheral neuropathy as weakness in arms or legs and other muscles. This may occur with pain (or loss of pain) or loss of feeling and loss of temperature sensation (hot and cold). Constipation and difficulty with hearing and vision may also occur. Loss of balance, dizziness, and difficulty walking may occur as well. Difficulty picking up objects, typing, or buttoning clothes may occur. For most people symptoms will improve or resolve in 6-12 months.

What causes numbness and tingling?

A number of chemotherapy drugs such as the Taxane drugs (Taxol, Taxotere), Cisplatin, Oncovin, Navelbine, Vincristine, and Vinblastine can cause peripheral neuropathy. Tumors that press on nerves or radiation therapy can also cause damage to nerve endings.

How do people cope with numbness and tingling?

Although it’s not possible to prevent nerve damage, it is possible to protect yourself and your hands or feet.

Here are some suggestions for numbness in hands and feet:

• Move furniture so you have a clear pathway at home.
• Remove objects from the floor to help prevent falls, such as clutter or throw rugs.
• Use potholders when cooking in the kitchen.
• Make sure you have adequate lighting for activities.
• Install a nightlight so a walking path is visible.
• Use a cane or walker if arm or leg is too numb or limp.
• Be sure of safety such as using a nightlight.
• Avoid extremes of heat and cold.
• Wear sturdy shoes; avoid slippers and running shoes with thick soles.
• Put a non-slip rubber mat or self-stick strips on the floor of the bathroom or shower.
• Test water temperature when showering or bathing to prevent burns.
• Avoid using heating pads; they can get and stay very hot without you being able to feel it.
• Be sure you have sufficient strength and coordination when driving.
• Use soap dispensers instead of bar soap, these can easily slip out of your hands.
• Try capsaicin cream, apply 3-4 times to affected area daily to relieve pain.
• Inspect numb hand or foot daily for sores or lesions.
• Perform Range-of-Motion exercises including your fingers and toes.
• Talk to your doctor or nurse about whether the use of a T.E.N.S unit (transcutaneous electronic nerve stimulation) might benefit you.
• Some patients benefit from physical therapy.

• Use cotton gloves when washing the dishes or gardening.
• Use a potholder when cooking to avoid further injury to nerve endings.
• Inspect your skin daily for abrasions, burns and cuts, especially your arms, legs, fingers and toes.
• Take time to complete daily activities, focus closely on the task at hand.
• Use thicker socks to prevent further foot injury.
• Check hands or feet for sores, as you will have a diminished sensation to feel these.
• Try a massage or water therapy in a whirlpool or swimming pool.
• Try a relaxation, or visual or guided imagery. There are many audiotapes you can purchase.
• Buddy up with a friend for routine exercise such as walking to improve strength, balance and coordination.

Numbness:

• Ask family members and friends to prepare meals for you.
• Ask family members and friends to help with daily household chores such as gardening or dishwashing.
• Ask family members and friends for help with buttoning pants or shirt as needed or to purchase Velcro closures.
• Ask family members and friends to assist in getting objects off the floor and making sure rugs have tape to secure to the floor.
• Ask family members and friends to test water temperatures before bathing or washing dishes.
• Ask family members and friends to install brighter light bulbs.
• Ask family members and friends to buy soft soap in a dispenser instead of bar soap.

• Ask family members and friends to purchase cotton gloves and thicker socks for added comfort and to help prevent injury.
• Ask family members and friends to wash dishes for you.
• Ask family members and friends to encourage you in routine exercise such as walking or swimming.

Numbness:

• Be open and honest when telling family members and friends about difficulties you have with numbness.
• Ask family members and friends for suggestions to help you function as close to normal activity level as possible.
• Tell family members and friends how the numbness is affecting your emotions.
• Ask family members and friends how the numbness is affecting them.

• Discuss with family members and friends how the tingling affects your life.
• Ask family members and friends how the tingling may be interfering with their life.
• Talk with family members and friends about how the tingling is affecting your emotions.

• Any changes in physical function, pain, numbness, prickling or tingling that interfere with your ability to care for yourself.
• Changes that keep you limited to your bed or chair.
• Any new problems walking.
• Interference with your daily activities.
• Any falls, burns or other injuries to your affected hands and feet, or any other part of your body.
• Difficulty urinating or constipation.
• Need for equipment.

• Contact your doctor or nurse.
• Call the American Cancer Society at: 1-800-ACS-2345 or visit on the internet at: http://www.cancer.org.
• Visit the Family Care Research Program on the internet at: http://www.cancercare.msu.edu.
• Visit http://www.oncolink.com/coping/.
• Call the National Cancer Institute at 1-800-4-CANCER or visit on the internet at: http://www.cancer.gov/cancerinfo/. Click on Coping with Cancer.
• Visit the National coalition for cancer survivorship: essential care on the internet at: http://www.canceradvocacy.org. Click on Essential Care.

• Holley, S. (2002). A look at the problem of falls among people with cancer. Clinical Journal of Oncology Nursing, 6(4), 193-197.
• Smith, E.L., Whadon, M.B., & Bookbinder, M. (2001). Improvement for painful peripheral neuropathy. Seminars in Oncology Nursing, 18(1), 36-43.
• Wilkes, G.M. (1999). Neurological Disturbances. In C.H. Yarbro, M.H. Frogge, & M. Goodman (Eds.), Cancer Symptom Management, 2nd. Ed. (pp. 344-81). Sudbury, MA: Jones and Bartlett Publishers.
• Wilkes, G.M. (2003). Peripheral neuropathy. In C.H. Yarbro, M.H. Frogge, & M. Goodman (Eds.), Cancer symptom management, 3rd Ed. (pp. 77-96). Boston: Jones and Bartlett.