abstract: Further data supporting that paclitaxel-associated acute pain syndrome is associated with development of peripheral neuropathy - Reeves - 2012 - Cancer - Wiley Online Library

Blogger's Opinion: since this journal is a publication of the ACS then open access should be mandated

Further data supporting that paclitaxel-associated acute pain syndrome is associated with development of peripheral neuropathy

Abstract

BACKGROUND:

Paclitaxel causes an acute pain syndrome (P-APS), occurring within days after each dose and usually abating within days. Paclitaxel also causes a more classic peripheral neuropathy, which steadily increases in severity with increasing paclitaxel total doses. Little detail is available regarding the natural history of these 2 syndromes, or any relationship between them, although a recent publication does provide natural history data about weekly paclitaxel, supporting an association between the severity of P-APS and eventual peripheral neuropathy symptoms.

METHODS:

Patients entering this study were about to receive paclitaxel and carboplatin every 3 weeks. Daily questionnaires were completed for the first week after every chemotherapy dose, and European Organization for Research and Treatment of Cancer, Quality of Life Questionnaire, Chemotherapy-Induced Peripheral Neuropathy 20-item instruments were completed weekly.

RESULTS:

The P-APS severity peaked on day 4 after the initial chemotherapy dose, with 12%, 29%, 23%, and 36% of patients having maximal pain scores of 0, 1 to 4, 5 or 6, or 7 to 10 during the first week after the first dose of therapy, respectively. Patients with P-APS scores of 0 to 4 with the first dose of chemotherapy had less eventual sensory neuropathy than did patients with P-APS scores of 5 to 10 (P = 0.001). With regard to the more peripheral neuropathy, sensory neuropathy was more problematic than was either motor or autonomic neuropathy. Numbness and tingling were more common components of the sensory neuropathy than was pain.

CONCLUSIONS:

Patients with worse P-APS severities appear to have more eventual chemotherapy-induced peripheral neuropathy. This provides support for the concept that P-APS is a form of nerve pathology.

The Cause and Effect of Migraines

Blogger's Note:
due to hormonal flucuations and onset of female cancers, it is interesting that the migraine connection (eg symptoms, neurology, pathology (?)) has not been a topic of wider discussion/research/debate in cancer research
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The Cause and Effect of Migraines

"“Hormonal changes are a big contributor to the higher female incidence,” said Michael A. Moskowitz, MD, Professor of Neurology at Harvard Medical School at the Massachusetts General Hospital in Boston. “There are lines of evidence that support this from lab to clinical evidence and a decrease (although not abolished) incidence in post-menopausal females.”"

JCO: Neuropsychological Performance in Survivors of Breast Cancer More Than 20 Years After Adjuvant Chemotherapy (chemobrain)

Breast Cancer Neuropsychological Performance in Survivors of Breast Cancer More Than 20 Years After Adjuvant Chemotherapy
JCO published online on February 27, 2012; DOI:10.1200/JCO.2011.37.0189.

• [Abstract]
• [PDF]

Neurological side-effects caused by recently approved chemotherapy drugs - e-Grand Round - Cancer World (full access)

Update on Paraneoplastic Neurologic Disorders

Note:  very complicated condition/conditions/subsets of conditions and requires specialist consultation/s.

"When patients with cancer develop neurologic symptoms, common causes include metastasis, infections, coagulopathy, metabolic or nutritional disturbances, and neurotoxicity from treatments. A thorough clinical history, temporal association with cancer therapies, and results of ancillary tests usually reveal one of these mechanisms as the etiology. When no etiology is identified, the diagnosis considered is often that of a paraneoplastic neurologic disorder (PND). With the recognition that PNDs are more frequent than previously thought, the availability of diagnostic tests, and the fact that, for some PNDs, treatment helps, PNDs should no longer be considered diagnostic zebras, and when appropriate should be included in the differential diagnosis early in the evaluation."