Evaluating the impact of chemotherapy-induced peripheral neuropathy symptoms (CIPN-sx) on perceived ability to work in breast cancer survivors during the first year post-treatment

Abstract

PurposeTo describe the impact of chemotherapy-induced peripheral neuropathy symptoms (CIPN-sx) on breast cancer survivors’ (BCS) perceived ability to work post-treatment.MethodsThe sample included 22 chemotherapy-treated (Ctx+) and 22 chemotherapy-naïve (Ctx−) female BCS. Data was collected at the following three time points: baseline (post-surgery, pre-chemotherapy), 1 month (1 M) post-chemotherapy, and approximately 1 year (1 Y) later. The presence, frequency, number, and severity of CIPN-sx were self-reported using the Functional Assessment of Cancer Therapy/Gynecologic Oncology Group–Neurotoxicity questionnaire (FACT/GOG-Ntx) version 4, a validated 11-item CIPN measure. Perceived ability to work was measured using an item from the Functional Well-Being subscale of the FACT/GOG-Ntx.ResultsAt 1 Y, more than 50 % of Ctx+ reported discomfort, numbness, or tingling in their hands or feet; weakness; or difficulty feeling small objects. The presence, number, and severity of these symptoms were correlated with being less able to work for Ctx+ at 1 M but not 1 Y. Results of a regression analysis using CIPN-sx to predict work ability found that models combining (1) hand numbness and trouble feeling small objects, (2) trouble buttoning buttons and trouble feeling small objects, (3) foot numbness and foot pain, (4) foot numbness and trouble walking, and (5) trouble hearing and hand pain each predicted survivors who were “not at all” able to work at 1 M.ConclusionsUnresolved CIPN-sx may play a role in challenges working for BCS post-treatment. These findings highlight the need for research to explore the impact that CIPN-sx have on BCS’ ability to work, as well as the development of interventions to improve work function in BCS with CIPN-sx.

Exploring the efficacy of an electronic symptom assessment and self-care intervention to preserve physical function in individuals receiving neurotoxic chemotherapy

“…Specifically, Kolb et al [ 6 ] reported that of 116 individuals receiving neurotoxic chemotherapy, individuals with sensory CIPN symptoms ( n = 32) were 2.7 times more likely to have a fall or near fall event than those without sensory CIPN symptoms. Decreased physical function due to unmanaged CIPN symptoms may result in 1) increased health care utilization (e.g., cost of care) [ 10 ], 2) the inability to return to work immediately following treatment [ 11 ], and 3) difficulty completing daily activities [ 12 ]. However, despite the known negative effects of unmanaged CIPN symptoms on physical function, CIPN is not routinely assessed in clinical practice [ 13 , 14 ].…”

Making Cancer Rehabilitation Services Work for Cancer Patients: Recommendations for Research and Practice to Improve Employment Outcomes

“…Moreover, chemotherapy‐induced peripheral neuropathy (CIPN) secondary to treatment with platinum compounds, taxanes, vinca alkaloids, thalidomide, and bortezomib can cause pain. Independent of pain, chemotherapy‐induced peripheral neuropathy−associated numbness and tingling in the hands and feet can interfere with physical functioning and has been shown to interfere with patients' ability to return to work and with work performance [31‐33].…”

Patient‐reported and clinician‐reported chemotherapy‐induced peripheral neuropathy in patients with early breast cancer: Current clinical practice

“…[6][7][8] In addition, cross-sectional, retrospective studies have surveyed patients at varying time periods after treatment regarding their recall of symptoms during chemotherapy [9][10][11][12] and the persistence of CIPN after treatment. [13][14][15][16] However, to the best of our knowledge, there are few prospective data regarding possible discrepancies in patient-reported CIPN toxicity experience compared with clinicianassessed CIPN severity gathered continuously throughout active treatment.…”