Case report of a patient with chemotherapy-induced peripheral neuropathy treated with manual therapy (massage)
- 1.1k Downloads
Chemotherapy-induced peripheral neuropathy (CIPN) is a common, miserable, potentially severe, and often dose-limiting side effect of several first and second-line anti-cancer agents with little in the way of effective, acceptable treatment. Although mechanisms of damage differ, manual therapy (therapeutic massage) has effectively reduced symptoms and improved quality of life in patients with diabetic peripheral neuropathy.
Here, we describe application of manual therapy (techniques of effleurage and petrissage) to the extremities in a patient with grade 2 CIPN subsequent to prior treatment with docetaxel and cisplatin for stage III esophageal adenocarcinoma. Superficial cutaneous temperature was monitored using infrared thermistry as proxy for microvascular blood flow.
By the end of the course of manual therapy without any change in medications, CIPN symptoms were greatly reduced to grade 1, with corresponding improvement in quality of life. Improvements in superficial temperature were observed in fingers and toes.
Manual therapy was associated with almost complete resolution of the tingling and numbness and pain of CIPN in this patient. Concurrently increased superficial temperature suggests improvements in CIPN symptoms may have involved changes in blood circulation. To our knowledge, this is the first report of using manual therapy for amelioration of CIPN.
KeywordsChemotherapy-induced peripheral neuropathy Manual therapy Massage Taxane Platin
Chemotherapy-induced peripheral neuropathy
Food and Drug Administration
We wish to thank Dr. Elizabeth Snoderly, DO, for her early encouragement of Mr. Falkowski's work using manual therapy to help patients with diabetic peripheral neuropathy. No funding was received for the work represented in this report.
Conflict of interest
The authors declare that they have no financial conflicts of interest pertaining to this report other than that one coauthor is the director/president of the non-profit organization Integrative Cancer Care. The authors also declare that they have full control of all primary data, and that they agree to allow the journal to review the data if requested. Institutions and corporations involved in the work which led to the creation of this report are the Medical University of South Carolina and the Integrative Cancer Care, Charleston, SC, USA.
- 3.Dworkin RH, O'Connor AB, Backonja M, Farrar JT, Finnerup NB, Jensen TS, Kalso EA, Loeser JD, Miaskowski C, Nurmikko TJ, Portenoy RK, Rice ASC, Stacey BR, Treede R-D, Turk CD, Wallace MS (2007) Pharmacologic management of neuropathic pain: evidence-based recommendations. Pain 132:237–251PubMedCrossRefGoogle Scholar
- 7.Wampler M (2006) Chemotherapy-induced peripheral neuropathy fact sheet (Revised 09/12/06). http://www.oncologypt.org/mbrs/factsheets/CIPN-Factsheet.pdf. Accessed 29 April 2010
- 11.Argyriou AA, Polychronopoulos P, Iconomou G, Koutras A, Makatsoris T, Gerolymos MK, Gourzis P, Assimakopoulos K, Kalofonos HP, Chroni E (2007) Incidence and characteristics of peripheral neuropathy during oxaliplatin-based chemotherapy for metastatic colon cancer. Acta Oncol 46:1131–1137PubMedCrossRefGoogle Scholar
- 14.Bullinger KL, Nardelli P, Quingbo W, Rich MM, Cope TC (2011) Oxaliplatin neurotoxicity of sensory transduction in rat proprioceptors. J Neurophysiol. doi: 10.1152/jn.00083.2011
- 15.National Cancer Institute (2010) Transforming the NCI Clinical Trials Enterprise. http://transformingtrials.cancer.gov/steering-committees/symptom-management. Accessed 02 February 2011
- 20.Valtonen EJ, Lilius HG (1973) Syncardial massage in diabetic and other neuropathies lower extremities. Dis Nerv Sys 34:192–194Google Scholar
- 22.Edwards BG, Palmer J (2010) Effects of massage therapy on African Americans with type 2 diabetes mellitus: a pilot study. Compl Health Pract Rev 15(3):149–155Google Scholar
- 24.Castro-Sánchez AM, Moreno-Lorenzo C, Matarán-Peñarrocha GA, Feriche-Fernández-Castanys B, Sánchez Labraca N, Sánchez Joya Mdel M (2009) [Efficacy of a massage and exercise programme on the ankle-brachial index and blood pressure in patients with diabetes mellitus type 2 and peripheral arterial disease: a randomized clinical trial] [Article in Spanish]. Med Clin (Barc) 134(3):107–110, Epub 2009 Oct 12CrossRefGoogle Scholar