Nav: Home

Study finds cold therapy may be effective at controlling cancer treatment side effects

October 12, 2017

A new study published in the Journal of the National Cancer Institute finds that cryotherapy, specifically having chemotherapy patients wear frozen gloves and socks for 90-minute periods, is useful for preventing symptoms of neuropathy.

Chemotherapy-induced peripheral neuropathy is a frequent and disabling side effect of cancer treatment. The pain, numbness, and tingling that patients experience reduces their quality of life and often results in them delaying treatment, reducing their doses, or discontinuing treatment altogether. Duloxetine is recommended treatment for the neuropathy; however, it has limited efficacy for the amelioration of chemotherapyinduced pain, and none for numbness or functional disability. Furthermore, no established strategy exists for neuropathy prevention in patients being treated with chemotherapy.

Researchers prospectively evaluated the efficacy of cryotherapy for neuropathy prevention. Breast cancer patients treated weekly with paclitaxel (80 mg/m2 for one hour) wore frozen gloves and socks on one side of their bodies for 90 minutes, including the entire duration of drug infusion. Researchers compared symptoms on the treated sides with those on the untreated sides. The primary end point was neuropathy incidence assessed by changes in tactile sensitivity from a pretreatment baseline. Researchers also assessed subjective symptoms (as reported in a patient questionnaire) and patients' manual dexterity.

Among the 40 patients, four did not reach the cumulative dose (due to the occurrence of pneumonia, severe fatigue, liver dysfunction, and macular edema), leaving 36 patients for analysis. None dropped out due to cold intolerance. The incidence of objective and subjective neuropathy signs was clinically and statistically significantly lower on the intervention side than on the control side for all measurements.

Researchers report that their study supports the efficacy of cryotherapy for chemotherapy-induced peripheral neuropathy prevention, as evidenced by a clinically and statistically significant reduction in patient-reported subjective symptoms, diminished objective signs (tactile and thermosensory), and prevention of reduced manual dexterity. The development of subjective neuropathy symptoms was clinically and statistically significantly delayed during the course of the paclitaxel treatment, the occurrence of subjective neuropathy at a cumulative dose of 960 mg/m2 was almost completely prevented, and the neuropathy incidence tended to be lower on the intervention side.

The results of the study suggest that that cyrotherapy could be an effective strategy for the prevention of neuropathy in patients with cancer undergoing paclitaxel treatment. Cyrotherapy could support the delivery of optimal chemotherapy by preventing a dose delay or reduction, as well as inhibiting the deterioration of quality of life in cancer patients during and after treatment.

"If the results are confirmed, cryotherapy has the advantage of a limited side effect profile, is low-cost, and it appears to prevent components of neuropathy other than [just] neuropathic pain," wrote Dawn Hershman, MD, leader of the breast cancer program of the Herbert Irving Comprehensive Cancer Center at Columbia University, in an editorial the accompanied the study. "Ultimately a better understanding of the biologic mechanisms causing chemotherapy-induced peripheral neuropathy will improve our ability to effectively prevent and treat all components of this toxicity."
-end-
The paper "Effects of Cryotherapy on Objective and Subjective Symptoms of Paclitaxel-Induced Neuropathy: 5 Prospective Self-Controlled Trial" is available at: https://academic.oup.com/jnci/article/doi/10.1093/jnci/djx178/4443215/Effects-of-Cryotherapy-on-Objective-and-Subjective

Direct correspondence to:

Hiroshi Ishiguro, MD, PhD, FACP
Department of Medical Oncology
International University of Health and Welfare Hospital
537-3 Iguchi,
Nasushiobara, Tochigi, 329-2763, JAPAN
e-mail: hishiguro@iuhw.ac.jp

To request a copy of the study, please contact:

Daniel Luzer
daniel.luzer@oup.com

Sharing on social media? Find Oxford Journals online at @OxfordJournals

Oxford University Press USA

Related Pain Articles:

Spinal manipulation treatment for low back pain associated with modest improvement in pain, function
Among patients with acute low back pain, spinal manipulation therapy was associated with modest improvements in pain and function at up to six weeks, with temporary minor musculoskeletal harms, according to a study published by JAMA.
Pain in the neck
Researchers led by University of Utah bioengineering assistant professor Robby Bowles have discovered a way to curb chronic pain by modulating genes that reduce tissue- and cell-damaging inflammation.
Can staying active help to prevent chronic pain? Physical activity affects pain modulation in older adults
Older adults with higher levels of physical activity have pain modulation patterns that might help lower their risk of developing chronic pain, reports a study in PAIN®, the official publication of the International Association for the Study of Pain (IASP).
Is back pain killing us?
Older people who suffer from back pain have a 13 per cent increased risk of dying from any cause, University of Sydney research has found.
Improving pain care through implementation of the Stepped Care Model for Pain Management
A new study published in the Journal of Pain Research provides evidence that implementation of a Stepped Care Model for Pain Management has the potential to more adequately treat chronic pain.
Surgery for back pain reduces problems with sex life-related pain
For patients with degenerative spinal disease, surgery is more effective in reducing pain that interferes with sexual activity, compared to nonsurgical treatment, reports a study in the Nov.
'Pain paradox' discovery provides route to new pain control drugs
A natural substance known to activate pain in the central nervous system has been found to have the opposite effect in other parts of the body, potentially paving the way to new methods of pain control.
Treating pain without feeding addiction: Study shows promise of non-drug pain management
A new study shows the potential for patients who have both addiction issues and chronic pain to get relief from an approach that combines behavioral therapy and social support to help them manage their pain without painkillers that carry an addiction risk.
Neuropathic pain unmasks subliminal excitation in pain processing circuits
Research by Steven Prescott, at Toronto's Hospital for Sick Children, sheds new light on the mechanism underlying the establishment of neuropathic pain.
The anatomy of pain
Emotions consist of general components that are also elicited by similar impressions and specific components.

Related Pain Reading:

Pain Free: A Revolutionary Method for Stopping Chronic Pain
by Pete Egoscue (Author), Roger Gittines (Author)

Healing Back Pain: The Mind-Body Connection
by John E. Sarno (Author)

The Problem of Pain
by C. S. Lewis (Author)

Pain Killer: An Empire of Deceit and the Origin of America's Opioid Epidemic
by Barry Meier (Author)

Pain: The Science of Suffering (Maps of the Mind)
by Patrick Wall (Author)

8 Steps to a Pain-Free Back: Natural Posture Solutions for Pain in the Back, Neck, Shoulder, Hip, Knee, and Foot
by Esther Gokhale (Author), Susan Adams (Editor)

No Grain, No Pain: A 30-Day Diet for Eliminating the Root Cause of Chronic Pain
by Peter Osborne (Author)

The Miracle Ball Method: Relieve Your Pain, Reshape Your Body, Reduce Your Stress [2 Miracle Balls Included]
by Elaine Petrone (Author)

Pain: A Very Short Introduction (Very Short Introductions)
by Rob Boddice (Author)

Explain Pain (8311)
by David Butler;Lorimer Moseley (Author)

Best Science Podcasts 2018

We have hand picked the best science podcasts for 2018. Sit back and enjoy new science podcasts updated daily from your favorite science news services and scientists.
Now Playing: TED Radio Hour

Why We Hate
From bullying to hate crimes, cruelty is all around us. So what makes us hate? And is it learned or innate? This hour, TED speakers explore the causes and consequences of hate — and how we can fight it. Guests include reformed white nationalist Christian Picciolini, CNN commentator Sally Kohn, podcast host Dylan Marron, and writer Anand Giridharadas.
Now Playing: Science for the People

#482 Body Builders
This week we explore how science and technology can help us walk when we've lost our legs, see when we've gone blind, explore unfriendly environments, and maybe even make our bodies better, stronger, and faster than ever before. We speak to Adam Piore, author of the book "The Body Builders: Inside the Science of the Engineered Human", about the increasingly amazing ways bioengineering is being used to reverse engineer, rebuild, and augment human beings. And we speak with Ken Thomas, spacesuit engineer and author of the book "The Journey to Moonwalking: The People That Enabled Footprints on the Moon" about...