Managing Chemo-Induced Peripheral Neuropathy in Breast Cancer

To effectively manage chemotherapy-induced peripheral neuropathy (CIPN), oncology nurses and APPs should proactively assess patients before each cycle using clear language to identify symptoms and implement timely interventions like medication or dose adjustments, an expert said.

Oncology Nursing News spoke with La-Urshalar Brock, FNP-BC, CNM, RNFA, to learn more about the oncology nurse and advanced practice provider’s (APP’s) role in managing adverse events like CIPN. Brock is part of the Breast/Gynecologic Specialty – Medical Oncology at Winship Cancer Institute of Emory University in Atlanta, Georgia.

Transcript:

In terms of the APPs—so nurse practitioners or physicians’ assistants—when we're seeing patients specifically, let's start off with when they are in chemotherapy, they're doing their chemotherapy. It's very important to assess, do they understand what that side effect is, first of all. Because in the beginning, when patients actually start off, there's a lot of side effects that we're throwing at them. There's a lot of information that we're throwing at them. And so everyone doesn't pick up every side effect, or doesn't remember all of the conversation.

So for me, I like to at least ask every visit, because we're seeing them before they get their treatment for every cycle. So I want to ask and to say, “Are you experiencing any peripheral neuropathy?” And if they don't understand that, then it's like, do you—are you having any tingling? Are you having any numbness or funny feelings in your hands and feet? So you want to monitor this throughout their regimen.

And if it is becoming to be where it's becoming more common, do we need to start medications for them to try to help ease with that sensation that they're having? Or if they're having where we think— when we start talking about grades, where there's a grade 1, grade 2, grade 3. Grade 4 is totally bad. But depending on where they are and how they describe this peripheral neuropathy, do we need to reduce the dose?

This transcript has been edited for clarity and conciseness.