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Recommendation
Treatment-related peripheral neuropathy – Assessment and management
Assess for peripheral neuropathy in relation to chemotherapy by asking patients about their symptoms, specifically symmetrical numbness and tingling in their hands and/or feet, and the characteristics of the symptoms. Physical activity and/or duloxetine may be helpful in the treatment of peripheral neuropathic pain, numbness, and tingling. Be aware that asymmetrical numbness of the hands may be due to carpal tunnel syndrome, which is more common in women with breast cancer on endocrine therapy and will require different management.
It is recommended that primary care clinicians should assess for peripheral neuropathy and contributing factors for peripheral neuropathy by asking the patient about their symptoms, specifically numbness and tingling in their hands and/or feet, and the characteristic of that symptom (Level of evidence – 0)
It is recommended that primary care clinicians should offer physical activity for neuropathy (No evidence level indicated)
It is recommended that primary care clinicians should offer duloxetine for patients with neuropathic pain, numbness and tingling (Level of evidence – 1B)
How this guidance was developed
This recommendation was adapted from the ACS/ASCO 2016 guidelines (US). Three source recommendations were merged, and language was used that is applicable to the Australian healthcare context, including making it action-specific, rather than clinician-specific. The source recommendations were based on a systematic review conducted to April 2015 and were not graded by the source guideline authors. The source recommendations were adapted by adding specificity regarding the importance of differentiating between peripheral neuropathy and carpal tunnel syndrome.
Related guidance by topic
Treatment-related peripheral neuropathy – Assessment and management
Recommendation
Assess for peripheral neuropathy in relation to chemotherapy by asking patients about their symptoms, specifically symmetrical numbness and tingling in their hands and/or feet, and the characteristics of the symptoms. Physical activity and/or duloxetine may be helpful in the treatment of peripheral neuropathic pain, numbness, and tingling. Be aware that asymmetrical numbness of the hands may be due to carpal tunnel syndrome, which is more common in women with breast cancer on endocrine therapy and will require different management.
Principles in action
Safe and quality care
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Supportive care
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Communication
This recommendation was adapted from the ACS/ASCO 2016 guidelines (US). Three source recommendations were merged, and language was used that is applicable to the Australian healthcare context, including making it action-specific, rather than clinician-specific. The source recommendations were based on a systematic review conducted to April 2015 and were not graded by the source guideline authors. The source recommendations were adapted by adding specificity regarding the importance of differentiating between peripheral neuropathy and carpal tunnel syndrome.
Related guidance by topic
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