Further optimizing cryotherapy may improve patient's quality of life
Imagine not being able to pick up a spoon, zip up your jacket, or go on a walk due to debilitating symptoms of a life-saving treatment. Many patients receiving chemotherapy experience these common side effects which are extremely disruptive to daily life.
A UCI study describes how paclitaxel, a chemotherapy medication commonly used for treatment of breast and gynecological cancers, causes peripheral neuropathy, or severe numbness, tingling, pain and weakness in the hands and feet, in nearly 77% of patients.
“Some patients have so much pain, they can’t even function. It impedes daily activities such as eating, dressing and walking resulting in poorer quality of life. Clinicians may also need to reduce the medication dosage which may impact the treatment outcome,” said Alexandre Chan, PharmD., MPH, Founding Chair and Professor of Clinical Pharmacy at UCI and study’s author.
Dually board certified in Pharmacotherapy and Oncology Pharmacy, Chan’s research expertise lies in supportive care, survivorship and improvement of neurological side effects in cancer patients.
“Knowing that neuropathy can really affect a patient’s quality of life, we need to think of innovative strategies to prevent neuropathic symptoms before they start to affect patients,” said Chan.
One strategy is cryotherapy– the process of exposing the body to extremely cold temperatures. This method of cryotherapy is delivered through use of frozen gloves or socks while the patient is undergoing chemotherapy treatment. The goal is to stop the chemotherapy drug from traveling through the bloodstream to the nerves, thus preventing the development of neuropathy.
In the study that was published in the journal Frontiers in Neurology, researchers conducted a randomized controlled trial to investigate the benefit of cryotherapy in preventing and treating the chemotherapy-induced numbness and tingling. Since the sensation is most prevalent in fingertips and toes, they used frozen gloves and socks that were commercially available.
“Patients were recruited from the National Cancer Centre Singapore and randomized to receive either cryotherapy or usual care,” wrote Quinton Ng, study’s first author and first year PhD Student at UCI School of Pharmacy and Pharmaceutical Sciences. “The results were collected with a combination of self-reported questionnaires and objective measurement tools to determine the severity of symptoms and nerve function. Utilizing both tools reduced the placebo effect and ensured robust findings,” said Quinton.
Quinton regularly met with patients to discuss their experience with cryotherapy and collect data for the study, “Patient experience is important, and we need feedback from them about their tolerability towards the low temperatures of the frozen gloves and socks, so we can work toward improving the process.”
The study yielded two prominent findings:
One: “cryotherapy leads to an improvement of autonomic symptoms, such as dizziness and low blood pressure. There may also be a possible protective effect against small fiber neuropathy,” said Chan.
Two: Although current cryotherapy mechanisms did not lead to statistically lower incidence and severity of the sensory and motor symptoms in this study, further optimizing cryotherapy may improve the effectiveness of cryotherapy.
Ultimately, this research revealed the potential autonomic benefits of cryotherapy and shed light on the importance of optimizing the technology while laying the foundation for future studies to improve care in cancer survivors.
By: Nedda Bozorgmehri, UCI School of Pharmacy and Pharmaceutical Sciences