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Age-related differences in patient-reported and objective measures of chemotherapy-induced peripheral neuropathy among cancer survivors

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Abstract

Purpose

While older adults with cancer are more likely to develop chemotherapy-induced peripheral neuropathy (CIPN), the study aimed to determine if patient-reported and objective measures of CIPN differ by age among cancer survivors.

Methods

Cancer survivors with persistent CIPN after completion of platinum and/or taxane chemotherapy completed CIPN questionnaires (severity, interference with activities, sensory, and motor symptoms) and objective testing (light touch, vibration, pain, cold sensation). CIPN measures were compared by age group (< 65 n = 260 versus ≥ 65 n = 165) using parametric and nonparametric tests.

Results

Among 425 cancer survivors with CIPN, mean age was 60.9 (SD 10.5). CIPN location did not differ by age (overall 68% hands and feet, 27% only feet, 5% only hands). For patient-reported measures, older survivors reported less severe pain in the hands and feet than younger survivors. In addition, older survivors reported lower interference with general activity, routine activities, normal work, enjoyment of life, sleep, mood, relations with other people, and sexual activity. No age differences in sensory and motor symptom scores were found. In contrast, for objective measures, older survivors had worse light touch and cold sensations in their feet and worse vibration detection in their hands and feet.

Conclusions

Despite having worse light touch, cold, and vibration sensations, older cancer survivors with CIPN reported less severe pain and interference with activities. This discordance highlights the importance of including both patient-reported and objective measures to assess CIPN in cancer survivors to better evaluate this clinical condition.

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References

  1. Smith BD, Smith GL, Hurria A, Hortobagyi GN, Buchholz TA (2009) Future of cancer incidence in the United States: burdens upon an aging, changing nation. J Clin Oncol 27:2758–2765

    Article  PubMed  Google Scholar 

  2. Bluethmann SM, Mariotto AB, Rowland JH (2016) Anticipating the “silver tsunami”: prevalence trajectories and comorbidity burden among older cancer survivors in the United States. Cancer Epidemiol Biomark Prev 25:1029–1036

    Article  Google Scholar 

  3. Brewer JR, Morrison G, Dolan ME, Fleming GF (2016) Chemotherapy-induced peripheral neuropathy: current status and progress. Gynecol Oncol 140:176–183

    Article  CAS  PubMed  Google Scholar 

  4. Beijers AJM, Mols F, Vreugdenhil G (2014) A systematic review on chronic oxaliplatin-induced peripheral neuropathy and the relation with oxaliplatin administration. Support Care Cancer 22:1999–2007

    Article  CAS  Google Scholar 

  5. Tofthagen C, Overcash J, Kip K (2012) Falls in persons with chemotherapy-induced peripheral neuropathy. Support Care Cancer 20:583–589

    Article  PubMed  Google Scholar 

  6. Mols F, Beijers T, Vreugdenhil G, van de Poll-Franse L (2014) Chemotherapy-induced peripheral neuropathy and its association with quality of life: a systematic review. Support Care Cancer 22:2261–2269

    Article  PubMed  Google Scholar 

  7. Karavasilis V, Papadimitriou C, Gogas H, Kouvatseas G, Pentheroudakis G, Koutras A, Christodoulou C, Bafaloukos D, Samantas E, Pisanidis N, Papakostas P, Aravantinos G, Karanikiotis C, Kosmidis P, Pectasides D, Dimopoulos MA, Fountzilas G (2016) Safety and tolerability of anthracycline-containing adjuvant chemotherapy in elderly high-risk breast cancer patients. Clin Breast Cancer 16:291–298

    Article  CAS  PubMed  Google Scholar 

  8. Hershman DL, Till C, Wright JD, Awad D, Ramsey SD, Barlow WE, Minasian LM, Unger J (2016) Comorbidities and risk of chemotherapy-induced peripheral neuropathy among participants 65 years or older in Southwest Oncology Group Clinical Trials. J Clin Oncol 34:3014–3022

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. Argyriou AA, Polychronopoulos P, Koutras A, Iconomou G, Gourzis P, Assimakopoulos K, Kalofonos HP, Chroni E (2006) Is advanced age associated with increased incidence and severity of chemotherapy-induced peripheral neuropathy? Support Care Cancer 14:223–229

    Article  PubMed  Google Scholar 

  10. Basch E, Iasonos A, McDonough T, Barz A, Culkin A, Kris MG, Scher HI, Schrag D (2006) Patient versus clinician symptom reporting using the National Cancer Institute common terminology criteria for adverse events: results of a questionnaire-based study. Lancet Oncol 7:903–909

    Article  Google Scholar 

  11. Blagden SP, Charman SC, Sharples LD, Magee LRA, Gilligan D (2003) Performance status score: do patients and their oncologists agree? Br J Cancer 89:1022–1027

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  12. Basch E, Deal AM, Dueck AC, Scher HI, Kris MG, Hudis C, Schrag D (2017) Overall survival results of a trial assessing patient-reported outcomes for symptom monitoring during routine cancer treatment. JAMA 318:197–198

    Article  PubMed  PubMed Central  Google Scholar 

  13. Miaskowski C, Mastick J, Paul SM, Topp K, Smoot B, Abrams G, Chen LM, Kober KM, Conley YP, Chesney M, Bolla K, Mausisa G, Mazor M, Wong M, Schumacher M, Levine JD (2017) Chemotherapy-induced neuropathy in cancer survivors. J Pain Symptom Manag 54:204–218 e202

    Article  Google Scholar 

  14. Victor TW, Jensen MP, Gammaitoni AR, Gould EM, White RE, Galer BS (2008) The dimensions of pain quality: factor analysis of the pain quality assessment scale. Clin J Pain 24:550–555

    Article  PubMed  Google Scholar 

  15. Karnofsky D, Abelmann WH, Craver LV, Burchenal JH (1948) The use of nitrogen mustards in the palliative treatment of carcinoma. Cancer 1:634–656

    Article  Google Scholar 

  16. Sangha O, Stucki G, Liang MH, Fossel AH, Katz JN (2003) The self-administered comorbidity questionnaire: a new method to assess comorbidity for clinical and health services research. Arthritis Rheum 49:156–163

    Article  Google Scholar 

  17. Posternak V, Dunn LB, Dhruva A, Paul SM, Luce J, Mastick J, Levine JD, Aouizerat BE, Hammer M, Wright F, Miaskowski C (2016) Differences in demographic, clinical, and symptom characteristics and quality of life outcomes among oncology patients with different types of pain. Pain 157:892–900

    Article  PubMed  PubMed Central  Google Scholar 

  18. Langford DJ, Schmidt B, Levine JD, Abrams G, Elboim C, Esserman L, Hamolsky D, Mastick J, Paul SM, Cooper B, Kober K, Dodd M, Dunn L, Aouizerat B, Miaskowski C (2015) Preoperative breast pain predicts persistent breast pain and disability after breast cancer surgery. J Pain Symptom Manag 49:981–994

    Article  Google Scholar 

  19. Postma TJ, Aaronson NK, Heimans JJ, Muller MJ, Hildebrand JG, Delattre JY, Hoang-Xuan K, Lantéri-Minet M, Grant R, Huddart R, Moynihan C, Maher J, Lucey R (2005) The development of an EORTC quality of life questionnaire to assess chemotherapy-induced peripheral neuropathy: the QLQ-CIPN20. Eur J Cancer 41:1135–1139

    Article  CAS  PubMed  Google Scholar 

  20. Cleeland CS, Ryan KM (1994) Pain assessment: global use of the brief pain inventory. Ann Acad Med Singap 23:129–138

    CAS  PubMed  Google Scholar 

  21. Jackson SE, Wardle J, Steptoe A, Fisher A (2016) Sexuality after a cancer diagnosis: a population-based study. Cancer 122:3883–3891

    Article  PubMed  PubMed Central  Google Scholar 

  22. Bell-Krotoski JA (2002) Sensibility testing with Semmes-Weinstein monofilaments. In: Hunter JM, Mackin EJ, Callahan ED (eds) Rehabilitation of the Hand and Upper Extremity. Mosby, Inc., St. Louis

    Google Scholar 

  23. Duke J, McEvoy M, Sibbritt D, Guest M, Smith W, Attia J (2007) Vibrotactile threshold measurement for detecting peripheral neuropathy: defining variability and a normal range for clinical and research use. Diabetologia 50:2305–2312

    Article  CAS  PubMed  Google Scholar 

  24. Papanas N, Ziegler D (2011) New diagnostic tests for diabetic distal symmetric polyneuropathy. J Diabetes Complicat 25:44–51

    Article  PubMed  Google Scholar 

  25. Viswanathan V, Snehalatha C, Seena R, Ramachandran A (2002) Early recognition of diabetic neuropathy: evaluation of a simple outpatient procedure using thermal perception. Postgrad Med J 78:541–542

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  26. Krok JL, Baker TA, McMillan SC (2013) Age differences in the presence of pain and psychological distress in younger and older cancer patients. J Hosp Palliat Nurs 15:107–113

    Article  Google Scholar 

  27. Mohile SG, Heckler C, Fan L, Mustian K, Jean-Pierre P, Usuki K, Sprod L, Janelsins M, Purnell J, Peppone L, Palesh O, Devine KA, Morrow G (2011) Age-related differences in symptoms and their interference with quality of life in 903 cancer patients undergoing radiation therapy. J Geriatr Oncol 2:225–232

    Article  PubMed  PubMed Central  Google Scholar 

  28. Cataldo JK, Paul S, Cooper B, Skerman H, Alexander K, Aouizerat B, Blackman V, Merriman J, Dunn L, Ritchie C, Yates P, Miaskowski C (2013) Differences in the symptom experience of older versus younger oncology outpatients: a cross-sectional study. BMC Cancer 13:6

    Article  PubMed  PubMed Central  Google Scholar 

  29. Schwartz CE, Bode R, Repucci N, Becker J, Sprangers MA, Fayers PM (2006) The clinical significance of adaptation to changing health: a meta-analysis of response shift. Qual Life Res 15:1533–1550

    Article  PubMed  Google Scholar 

  30. Gagliese L, Jovellanos M, Zimmermann C, Shobbrook C, Warr D, Rodin G (2009) Age-related patterns in adaptation to cancer pain: a mixed-method study. Pain Med 10:1050–1061

    Article  PubMed  Google Scholar 

  31. Ward PR, Wong MD, Moore R, Naeim A (2014) Fall-related injuries in elderly cancer patients treated with neurotoxic chemotherapy: a retrospective cohort study. J Geriatr Oncol 5:57–64

    Article  PubMed  Google Scholar 

  32. Kolb NA, Smith AG, Singleton JR, Beck SL, Stoddard GJ, Brown S, Mooney K (2016) The association of chemotherapy-induced peripheral neuropathy symptoms and the risk of falling. JAMA Neurol 73:860–866

    Article  PubMed  PubMed Central  Google Scholar 

  33. Kim JH, Lee KM, Jeon MJ, Seol ME, Lee SH, Park J (2013) Symptom and interference of activities of daily living of chemotherapy-induced peripheral neuropathy in patients receiving taxanes and platinums. Asian Oncol Nurs 13:145–151

    Article  Google Scholar 

  34. Tofthagen C, McAllister RD, Visovsky C (2013) Peripheral neuropathy caused by paclitaxel and docetaxel: an evaluation and comparison of symptoms. J Adv Pract Oncol 4:204–215

    PubMed  PubMed Central  Google Scholar 

  35. American Diabetes Association (2018) 10. Microvascular complications and foot care: standards of medical care in diabetes—2018. Diabetes Care 41:S105–s118

    Article  Google Scholar 

  36. da Silva Simao DA, Teixeira AL, Souza RS, de Paula Lima ED (2014) Evaluation of the Semmes-Weinstein filaments and a questionnaire to assess chemotherapy-induced peripheral neuropathy. Support Care Cancer 22:2767–2773

    Article  PubMed  Google Scholar 

  37. Griffith KA, Dorsey SG, Renn CL, Zhu S, Johantgen ME, Cornblath DR, Argyriou AA, Cavaletti G, Merkies IS, Alberti P, Postma TJ, Rossi E, Frigeni B, Bruna J, Velasco R, Kalofonos HP, Psimaras D, Ricard D, Pace A, Galie E, Briani C, Dalla Torre C, Faber CG, Lalisang RI, Boogerd W, Brandsma D, Koeppen S, Hense J, Storey DJ, Kerrigan S, Schenone A, Fabbri S, Valsecchi MG (2014) Correspondence between neurophysiological and clinical measurements of chemotherapy-induced peripheral neuropathy: secondary analysis of data from the CI-PeriNomS study. J Peripher Nerv Syst 19:127–135

    Article  PubMed  PubMed Central  Google Scholar 

  38. Boyette-Davis JA, Eng C, Wang XS, Cleeland CS, Wendelschafer-Crabb G, Kennedy WR, Simone DA, Zhang H, Dougherty PM (2012) Subclinical peripheral neuropathy is a common finding in colorectal cancer patients prior to chemotherapy. Clin Cancer Res 18:3180–3187

    Article  CAS  PubMed  PubMed Central  Google Scholar 

Download references

Acknowledgements

Dr. Miaskowski is supported by the American Cancer Society and NCI (CA168960). Dr. Wong is supported by the Conquer Cancer Foundation of the American Society of Clinical Oncology (ASCO)/Vicky Merryman Women Who Conquer Cancer Young Investigator Award, National Institute on Aging (AG044281), and National Center for Advancing Translational Sciences (NCATS, KL2TR001870). This project was supported by NCATS through UCSF Clinical and Transformational Science Institute (CTSI) (UL1TR000004). Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the NIH. Recruitment was facilitated by Dr. Susan Love Research Foundation’s Army of Women Program.

Funding

This study was funded by the National Cancer Institute (NCI, CA151692).

Author information

Authors and Affiliations

  1. Division of Hematology/Oncology, Department of Medicine, University of California, San Francisco, 1600 Divisadero Street, San Francisco, CA, 94115, USA

    Melisa L. Wong

  2. School of Nursing Office of Research, University of California, San Francisco, 2 Koret Way, San Francisco, CA, 94143, USA

    Bruce A. Cooper & Steven M. Paul

  3. Department of Neurology, University of California, San Francisco, 400 Parnassus Avenue, San Francisco, CA, 94143, USA

    Gary Abrams

  4. Department of Physical Therapy and Rehabilitation Science, University of California, San Francisco, 513 Parnassus Avenue, San Francisco, CA, 94143, USA

    Kimberly Topp

  5. Department of Physiological Nursing, University of California, San Francisco, 2 Koret Way, San Francisco, CA, 94143, USA

    Kord M. Kober, Melissa Mazor & Christine Miaskowski

  6. Osher Center for Integrative Medicine, University of California, San Francisco, 1545 Divisadero Street, San Francisco, CA, 94143, USA

    Margaret A. Chesney

  7. Department of Anesthesia and Perioperative Care, University of California, San Francisco, 513 Parnassus Avenue, San Francisco, CA, 94143, USA

    Mark A. Schumacher

  8. School of Nursing, University of Pittsburgh, 3500 Victoria Street, Pittsburgh, PA, 15261, USA

    Yvette P. Conley

  9. Department of Oral and Maxillofacial Surgery, University of California, San Francisco, 513 Parnassus Ave, San Francisco, CA, 94143, USA

    Jon D. Levine

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  1. Melisa L. Wong
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  9. Mark A. Schumacher
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Corresponding author

Correspondence to Melisa L. Wong.

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Conflict of interest

Dr. Wong has reported a conflict of interest outside of the submitted work (immediate family member is an employee of Genentech with stock ownership). The remaining authors have no conflicts to report.

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Wong, M.L., Cooper, B.A., Paul, S.M. et al. Age-related differences in patient-reported and objective measures of chemotherapy-induced peripheral neuropathy among cancer survivors. Support Care Cancer 27, 3905–3912 (2019). https://doi.org/10.1007/s00520-019-04695-3

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  • DOI: https://doi.org/10.1007/s00520-019-04695-3

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