|
This section has been reviewed and approved by the PLWC Editorial
Board, 02/05
The nervous system is made up of the central nervous system (CNS) and the
peripheral nervous system (PNS). The CNS is made up of the brain and
spinal cord. The PNS is made up of the nerves outside of the CNS that
carry information back and forth between the body and the brain. The PNS
is involved in movement, sensing (touching, hearing, seeing, tasting, and
smelling), and functioning of the internal organs, (for example, the
stomach, lungs, and heart).
Nervous system disturbances are common side effects of cancer and cancer
treatments and can affect any part of the nervous system. This article
will outline nervous system disturbances, possible causes, and
management. For information on cognitive problems related to cancer and
cancer treatments, read Managing Side Effects: Cognitive Problems.
Types of nervous system disturbances
Some of the different types of nervous system disturbances that may
result from cancer or cancer treatment include the following:
- Hearing loss and/or
tinnitus (ringing in the ears
- Vision loss and/or
vision disturbances (such as blurred or double vision)
- Speech difficulties,
such as slurred speech
- Changes in
taste and smell
- Problems with balance,
dizziness, vertigo (feeling like the room is spinning), and nausea
- Problems with
coordination (known as ataxia) and movement, including problems with
posture, walking, or holding objects; clumsiness
- Generalized weakness
(known as asthenia), characterized by an overall lack of bodily
strength; drowsiness
- Paralysis of different
parts of the body, ranging from paralysis of one side of the body
(known as hemiplegia) to paralysis of a
smaller area, such as the facial muscles
- Seizures
- Changes in the
functioning of organs, resulting in symptoms, such as constipation,
incontinence (inability to control bodily elimination), and erectile
dysfunction (also called impotence or an inability to achieve or
maintain an erection)
- Pain, resulting from
damage to the nerves
- Peripheral neuropathy, a
condition caused by damage or irritation to the peripheral nerves
causing symptoms, such as numbness, tingling ("pins and
needles"), or burning pain in the arms, hands, legs, or feet;
decreased ability to sense hot and cold; difficulty lifting the feet
or toes; difficulty picking up small objects; decreased muscle
strength; vision or hearing changes; and/or constipation
Causes
Nervous system disturbances can be caused by many different factors,
including cancer, cancer treatments, medications, or other disorders.
Symptoms that are caused by disruption or damage to the nerves caused by
cancer treatment (such as surgery, radiation treatment, or chemotherapy)
can appear soon after treatment or many years later. Possible causes
include the following:
- Cancers that affect the
nervous system, such as brain cancer and sarcomas
of the nerves (for example, neurofibrosarcoma,
malignant peripheral nerve sheath tumor, peripheral primitive neuroectodermal tumor)
- Cancerous tumors growing
in other parts of the body that press on nerves
- Cancers that metastasize
(spread) to the brain
- Chemotherapy
medications, such as vincristine (Oncovin), vinblastine
(Velban), paclitaxel
(Taxol), cisplatin
(Platinol), carboplatin
(Paraplatin), oxaliplatin
(Eloxatin), fluorouracil (5-FU), cytarabine (Ara-C)
- Radiation treatment,
especially to the head and neck or total body irradiation
- Surgery—nerves may be
damaged or disrupted during surgery to remove cancerous tumors or
perform biopsies
- Medications, including
some antinausea drugs, antibiotics, heart
medications, diuretics, and nonsteroidal
anti-inflammatory drugs
- Infections causing
swelling or inflammation of the brain, spinal cord, or inner ear
- Other conditions or symptoms
related to cancer or cancer treatments, including anemia,
dehydration, fatigue, stress, and depression
- Other conditions or
disorders not related to cancer, such as diabetes, multiple
sclerosis, and nerve injury
Management
Nervous system disturbances can be very distressing for patients and, in
serious cases, can make it difficult for patients to complete normal,
daily activities. Some symptoms caused by cancer treatment will resolve
after treatment ends, but some may continue indefinitely. Although nerve
damage and nervous system disturbances may not be preventable, most are
effectively treated if diagnosed early. Early treatment can also prevent
symptoms from becoming more problematic. It is important to tell your
doctor immediately if you experience any symptoms that could indicate a
nervous system disturbance. Once diagnosed, management of nervous system
disturbances may include the following:
- Medications, such as antinausea/antivertigo drugs (for example, meclizine [Antivert, Bonine], prochlorperazine
[Compazine], scopolamine patch [Transderm-Scop], antibiotics, and
corticosteroids (to reduce inflammation and swelling)
- Pain medications,
including opioid (strong) pain killers, as
well as tricyclic antidepressants (for
example, nortriptyline [Pamelor, Aventyl], amitriptyline [Elavil,
Endep]) and/or seizure medications (for
example, gabapentin [Neurotonin])
used to treat peripheral neuropathy and other types of nerve pain
(known as neuropathic pain)
- Nerve blocks and transcutaneous electric nerve stimulation
(TENS), which provide pain relief
- Occupational therapy, to
enhance motor skills needed for daily activities, such as getting
dressed, picking up small objects, writing, or doing household
chores
- Physical therapy, to
enhance physical strength, balance, coordination, and mobility
- Changes to the home
environment to increase safety, such as installing hand rails in the
bathroom, using nonskid rugs, adding extra lighting, and checking
water temperature with the elbow rather than the hands
More Information
PLWC: Managing Side Effects
Cancersymptoms.org: Peripheral Neuropathy
Back
to Top
|
