Chemotherapy-induced peripheral neuropathy (CIPN)

Chemotherapy-induced peripheral neuropathy is nerve damage caused by certain cancer drugs, producing numbness, tingling, burning pain and weakness that usually begins in the hands and feet.

Platinum compounds, taxanes, vinca alkaloids and proteasome inhibitors are the drug classes most often responsible. They injure the long sensory nerves first, so symptoms follow a stocking-and-glove pattern and may include loss of touch and vibration sense, difficulty with buttons or walking on uneven ground, and sensitivity to cold. Symptoms can appear during treatment or, with some drugs, worsen for months after it ends; many people improve slowly, while some have lasting damage.

Oncologists grade CIPN with standardized toxicity scales and patient questionnaires, and they may reduce or pause the responsible drug when it becomes severe. Duloxetine is the one medication with reasonable trial evidence for the pain, and physical therapy, balance training and foot care address function and safety. Cannabinoids have been studied for CIPN in animal models, where cannabidiol has drawn interest, and in a few small human studies, but results are preliminary and no cannabinoid has an approved use for this condition.