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

Supportive Care in Cancer volume 27, pages 3905–3912 (2019)Cite this article

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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Fig. 1

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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

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

Authors
  1. Melisa L. Wong
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  2. Bruce A. Cooper
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  4. Gary Abrams
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  5. Kimberly Topp
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  8. Melissa Mazor
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  9. Mark A. Schumacher
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  10. Yvette P. Conley
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  12. Christine Miaskowski
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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

Keywords

  • Chemotherapy-induced peripheral neuropathy
  • Age
  • Cancer survivor
  • Chemotherapy
  • Patient-reported outcomes