Cold Application and Exercise on Development of Peripheral Neuropathy during Taxane Chemotherapy in Breast Cancer Patients: A Randomized Controlled Trial

Abstract

Objective: Chemotherapy-induced peripheral neuropathy (CIPN) is a common side effect of cancer treatment. There is no proven pharmacological application to prevent CIPN. This study was conducted to compare the effects of cold application and exercise on peripheral neuropathy development in patients with breast cancer who received taxane. Methods: This was a multicenter clinical trial. The study was conducted as a randomized controlled trial on breast cancer patients who had chemotherapy-induced peripheral neuropathy complaints between July 2017 and January 2018 in an outpatient chemotherapy unit of training-research and a university hospital. A standardized, home-based, 12-week exercise program involved progressive strengthening, stretching, and balance exercises. Cold packs were applied for the duration of all 12 taxane infusions and then continued at home. The standard care protocol (information about side effects) of the clinic was used for patients in the control group. Data were collected via Patient Identification Form and CIPN Assessment Tool. Demographic data were evaluated by number and percentage ratios, and the study groups' mean scores were compared by Kruskal–Wallis and Wilcoxon analyses. The data were collected at two time points including baseline (T1) and week 12 (T2). Results: The study was completed with a total of 90 patients, so that each of the study groups, exercise, cold application, and control groups, included 30 patients. The mean of pre- and posttest results in the cold applied group revealed an increase in hand numbness, weakness, and distress ( P < 0.05). However, no significant difference existed between the means of the pre- and the posttests in the exercise group ( P = 0.79–0.1). The mean scores of all the symptoms in the control group except the loss of balance increased significantly ( P < 0.05). Exercise reduced CIPN symptoms of numbness in hands ( P = 0.009) and in the feet ( P = 0.005) significantly compared to the cold application and control. Conclusions: It was found that exercise was more effective than cold application in the management of CIPN.

Wellbeing and Complementary Therapies in Breast Cancer Peripheral Neuropathy Care: A Scoping Review Focused on Foot Health

“…Most of the articles studied were published in the last 3 years ( n = 9) [ 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 ]. Six documents were published in the United States [ 18 , 25 , 26 , 27 , 28 , 29 ], and two were published in Turkey [ 17 , 21 ]. No authors published more than one article.…”

“…Concerning the type of work, four are pilot trials [ 17 , 23 , 25 , 29 ], and no document is a review article. Further to this, 12 papers are based on trials comparing two interventions or preventive measures for CIPN [ 17 , 18 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 29 , 30 , 31 ].…”

“…The majority of the studies focused only on people with breast cancer ( n = 9) [ 18 , 19 , 20 , 21 , 25 , 26 , 28 , 30 , 31 ]. The rest ( n = 7) included samples with this type of tumor and people with other types of tumors.…”

“…The rest ( n = 7) included samples with this type of tumor and people with other types of tumors. The most common chemotherapeutic agents were paclitaxel ( n = 10) [ 18 , 19 , 20 , 21 , 25 , 26 , 27 , 28 , 30 , 31 ] and paclitaxel and platinum ( n = 6) [ 16 , 17 , 22 , 23 , 27 , 29 ]. Only one article [ 24 ] included a wide variety of chemotherapy agents.…”

“…Another critical aspect to consider in relation to QoL and CIPN was analyzed by Simsek and Demir [ 21 ] and Griffiths et al [ 26 ]. What stands out in their results is the need to monitor the symptoms and develop effective strategies as a key way to contribute to people’s QoL.…”