Cold Sensitivity & Chemotherapy
Well, after getting three inches of snow yesterday in the Atlanta, GA area, it seems appropriate to speak about cold sensitivity while undergoing chemotherapy. Many of the agents used to treat cholangiocarcinoma (as well as other cancers) are well known to result in cold sensitivity. This is the result of peripheral neuropathy, which is damage to sensory nerves, most commonly in the hands and feet. Some chemotherapeutic agents damage the axon part of the nerve cells, which interferes with signalling. This causes numbness and tingling in the fingers and toes and can also result in cold sensitivity. It has been well documented that platinum based agents cause cold sensitivity. This includes first generation (cisplatin), second generation (carboplatin) and third generation (oxaliplatin) platinum agents, all of which are used in treating cholangiocarcinoma. I am on a regimen that includes oxaliplatin IV and after 6 months of bi-weekly treatment, I have shown signs of cold sensitivity for the last month. We recently reduced the dose of the oxaliplatin; this was totally expected and I was forewarned by my oncology team to be on the look out for this side effect. One just has to use common sense and bundle up carefully when the temperature drops. Here are some tips I have found helpful in combatting the cold sensitivity due to chemo:
- Keep a log of your cold sensitivity and when you record it, rate in on a scale of zero (no symptoms) to 10 (extreme tingling and numbness, cold sensitivity, pain) and discuss this with your physician at each visit. Careful documentation will help the team decide if or when a dose reduction is necessary.
- Wear sox and fleece gloves to bed at night during cold weather.
- Don’t hesitate to wear gloves when the temperature drops or in wet weather – who cares what others think, I don’t!
- Check your fingers and toes regularly for cuts, bruises or any type of injury. Avoid going barefoot, even at home (wear slippers). This is common sense to diabetics and something you must get in the habit of when on these chemo agents.
- Be aware that cold sensitivity may last for a long time (up to many months) after cessation of therapy
There’s light (or in this case, warmth) at the end of the tunnel as peripheral neuropathy usually goes away with time. This is not normally associated with life-threatening complications, but it can be uncomfortable or disabling during and after treatment. Remember that the goal of your physician is to maintain adequate doses of the medication needed to fight the cancer while managing toxic side effects.