Cold Compression May Prevent Chemo-Induced Neuropathy

A combination of compression and cold called cryocompression may help to prevent chemotherapy-induced peripheral neuropathy, according to research that was recently presented at the 2023 Society for Gynecologic Oncology Annual Meeting.

“There aren’t many good measures to prevent neuropathy,” study author Dr. Mary Katherine Montes de Oca, a resident a Duke University Medical Center in Durham, North Carolina, said in an interview with OncLive®, a sister publication of CURE®.

“There has been some data showing that cryotherapy — or putting cold temperatures on the hands and feet during chemotherapy — can prevent neuropathy. However, sometimes people can’t tolerate the cold. … So I did a study looking at the combination of compression socks, tight surgical gloves and bags of ice on the hands and feet to see if it prevents neuropathy.”

Chemotherapy-induced peripheral neuropathy occurs when the cancer-fighting drugs damage nerves in the hands and feet. As a result, patients may experience pain, tingling or numbness, which can affect daily activities such as the ability to use zippers, write with a pen and walk comfortably. According to the National Cancer Institute, approximately 30% to 40% of patients who are treated with neurotoxic chemotherapy experience this side effect.

“The primary goal of this study was to improve patients’ quality of life. That such an important part of this field,” Montes de Oca said. “We’re often focused on the different treatments or different surgeries, but we also have to think about if we’re helping patients survive longer; we have to make sure that they have a good quality of life. Neuropathy is one of the most common side effects that our patients experience, so being able to prevent that is really important.”

In an effort to decrease the number of patients who experience neuropathy, Montes de Oca’s study included patients (most of whom had ovarian cancer) who were treated with six cycles of neurotoxic chemotherapy.

On one hand and foot, study participants received no intervention to prevent chemotherapy-induced peripheral neuropathy, while on the other hand and foot, patients wore the compression garments and ice (which could be taken off and put back on depending on the patients’ tolerance) 15 minutes before and then during the hour-long chemotherapy infusion.

Findings showed that after each chemotherapy session, symptoms tended to be better in the hand/foot that had cryocompression. Seventy percent of patients who experienced sensations during cryocompression said that it was tolerable, while 80% reported that they agreed or strongly agreed that cryocompression was acceptable and planned to use it during future chemotherapy sessions.

While patients reported a decrease in symptoms, there was no difference seen in the monofilament test, which involves poking patients with a small needle and asking if they can feel it.

“We didn't find any significant differences in the objective tests, the monofilament test, which was not very surprising to me, because I do think that we could look at a few different types of objective measures to see if maybe temperature sensation or others objective measures of neuropathy may be significant,” Montes de Oca said.

This is not the first oncology setting in which cold therapy was explored to prevent side effects. In fact, in 2018 and in 2021, the Food and Drug Administration approved cooling caps to reduce chemotherapy-induced hair loss.

READ MORE: Scalp Cooling Is a Feasible Way to Preserve Hair During Cancer Treatment

“I know that cold caps … prevent hair loss during chemotherapy, and a lot of insurance companies will provide cold caps to patients. It would be neat for insurance companies to cover devices to prevent neuropathy as well,” Montes de Oca said.

Looking ahead, Montes de Oca said that she hopes to conduct another study where patients receive cryocompression on both sides of their body. She also hopes to find an easy and affordable device to deliver cryocompression.

“Obviously, we used a pretty inexpensive and easy method with a compression sock, a tight glove and a bag of ice,” she said. “But we could find better ways to apply the cryocompression, either just one device that they slide their hand into, their foot into and something that stays cooler longer,” she said. “The bag of ice would often melt during the three-and-a-half-hour session. But if we could find something that could stay cold longer, that could allow for our patients to not have to switch out the bags of ice.”

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