Chemotherapy Induced Peripheral Neuropathy - A Review

ABSTRACT

Chemotherapy Induced Peripheral Neuropathy (CIPN) can be precipitated by many modern chemotherapeutic agents. CIPN affects the patient’s quality of life not only physically, but also functionally, psychosocially, spiritually and affects the family as well. If severe acute syndrome develops during chemotherapy, doses of drugs should be reduced or even stopped. CIPN is a neurological side effect occurring during chemotherapy treatment in cancer patient depending on many factors such as age, dose strength, complete total drug dose received, period of therapy, use of more than two groups of neurotoxic agents, concomitant neuropathies (for example, diabetic neuropathy), genetic vulnerability, and alcoholism. Pathophysiology of CIPN is not clearly understood. The pathological processes by which chemotherapy drugs harm the nervous system structures cause CIPN. It depends on several factors or causes which include microtubule disruption, oxidative stress and mitochondrial break, changes in ion channel activity, myelin sheath and DNA damage, and neuro inflammation. Clinical manifestations vary from patient to patient. It is classified into three types such as sensory, motor and autonomic. Presently there are no standard guidelines for the assessment of CIPN. It is considered both objective evidence of neurological dysfunction and assessment of symptoms reported by the patient. Nurses can play a very important role in the early identification of CIPN in cancer patients which can help to plan and in modification of treatment. This will help patients to enjoy a better quality of life. This review aims to give an update regarding CIPN and nursing aspect.