Chemotherapy-Induced Peripheral Neuropathy Colorectal Cancer

Chemotherapy-Induced Peripheral Neuropathy in Colorectal Cancer

Chemotherapy-Induced Peripheral Neuropathy in Colorectal Cancer- Oxaliplatin, Nerve Damage, and Evidence-Based Ways to Reduce Symptoms.

I have written many posts about CIPN and my cancer over the years. This post is directed specifically to colorectal cancer patients and survivors who experience chemotherapy-induced peripheral neuropathy. I do 4 of the 5 integrative therapies listed below.

I’ve linked the video below for two reasons. First, the speaker talks about the prevention of CIPN. Secondly, the oncologist admits that there are few, if any, effective treatments for CIPN—meaning, few FDA-approved treatments that your oncologist can prescribe. Exercise, supplements, etc., are not FDA-approved conventional therapies.

If your CIPN resolves once treatment ends, great. Consider yourself lucky. However, if your CIPN continues, then this post is for you.

My recommendation is to undergo therapies to reduce or eliminate CIPN as soon as possible. Even before you feel any numbness or tingling. Meaning, eat nutritiously, supplement (see below), exercise daily, undergo cryotherapy, and begin HBOT treatments as soon as possible.

You might find my other recommendation to be frustrating. And that is to prepare your body to withstand the toxicity of conventional treatments as best you can. Research shows that the therapies below can reduce or even eliminate side effects.

Be sure to watch each of the videos about:

I am a long-term cancer survivor of an incurable blood cancer. Nutritional supplementation has been an important part of my therapy plan for decades.

I rely on a third-party organization to evaluate nutritional supplements. I use an organization called Consumerlab.com.

One more thing. I have my blood tested once a year or so for various things. Blood levels of specific vitamins, like vitamin D or testosterone, are important. I use Life Extension Foundation for their blood testing. Much cheaper than going to my doctor.

Scroll down the page and post questions or comments. Please hang in there, and be sure to read the study at the very end of this post.

Good luck,

David Emerson

Treatment strategies for chemotherapy-induced peripheral neuropathy

What is CIPN in Colorectal Cancer?

Chemotherapy-induced peripheral neuropathy (CIPN) is nerve damage caused by chemotherapy drugs—most commonly oxaliplatin, a standard treatment for colorectal cancer. Symptoms include numbness, tingling, pain, and sensitivity to cold, often affecting the hands and feet. CIPN can persist for months or years after treatment and may limit chemotherapy dosing.

What Causes Neuropathy in Colorectal Cancer?

The primary cause of CIPN in colorectal cancer is oxaliplatin-based chemotherapy (e.g., FOLFOX, CAPOX).

Oxaliplatin is highly neurotoxic, damaging peripheral nerves
Neuropathy can occur during treatment or worsen after treatment ends (“coasting”)
Symptoms may persist long-term in a large percentage of survivors

Key Insight

Up to 85% of patients experience neuropathy during treatment
About 55–80% report chronic symptoms months later
Neuropathy is a leading cause of dose reduction or treatment discontinuation

How Common is CIPN in Colorectal Cancer?

CIPN is one of the most common and disabling side effects of colorectal cancer treatment.

~58% of patients have CIPN at 6 months
~45% at 12 months
~32% at 2 years
~24% at 3 years

Even years later, symptoms can persist and impact:

Balance and coordination
Daily functioning
Quality of life

Symptoms of Neuropathy

Colorectal cancer survivors often report:

Numbness or tingling in hands/feet
Burning or shooting pain
Sensitivity to cold (classic oxaliplatin effect)
Weakness or difficulty with fine motor skills
Balance problems and increased fall risk

These symptoms are typically “stocking-glove” distribution, meaning they begin in the extremities.

Why CIPN Matters: Long-Term Survivorship Impact

CIPN is not just a temporary inconvenience—it is a chronic survivorship issue.

Can last for years after treatment
Reduces physical activity and independence
Associated with fatigue, depression, and reduced quality of life
May limit the ability to receive full-dose chemotherapy

Conventional Management of CIPN

There is no universally effective medical treatment for CIPN.

Standard approaches include:

Dose reduction or discontinuation of oxaliplatin
Pain medications (limited effectiveness)
Duloxetine (moderate evidence for symptom relief)

However, research consistently shows that prevention and integrative strategies are critical.

Evidence-Based Integrative Therapies for CIPN in Colorectal Cancer

Below are non-conventional therapies with supporting evidence, consistent with the PeopleBeatingCancer approach.

1. Exercise (Resistance + Aerobic)

Improves nerve function and reduces CIPN severity
May reduce dose-limiting toxicity in colon cancer patients

Recommendation:

3–5 sessions/week
Include strength + balance training

2. Nutritional Optimization

Higher dietary quality is associated with lower CIPN risk
Vitamin deficiencies (e.g., B6) may worsen neuropathy

Focus on:

Whole foods, anti-inflammatory diet
Omega-3 fatty acids
Adequate B vitamins

3. Acupuncture

Evidence suggests improvement in:

Pain
Nerve conduction
Functional outcomes

Often used in integrative oncology clinics.

4. Cryotherapy (Cold Therapy)

Cooling hands/feet during infusion may reduce nerve exposure to chemotherapy
Particularly relevant for oxaliplatin

5. Supplements with Evidence

Commonly studied:

Alpha-lipoic acid
Acetyl-L-carnitine (mixed evidence)
Glutamine
Omega-3 fatty acids

Important: Always coordinate with your oncologist.

6. Mind-Body Therapies

Meditation
Yoga
Stress reduction

These may reduce the perpetuating factors of CIPN such as depression and inactivity

Emerging Research Directions

Research into CIPN is ongoing, focusing on:

Genetic risk factors
Neuroprotective agents
Anti-inflammatory therapies
Microbiome influence on toxicity

Currently, no definitive cure exists, reinforcing the importance of early prevention and integrative care

Key Takeaways for Colorectal Cancer Patients

CIPN is extremely common with oxaliplatin chemotherapy
Symptoms may persist long after treatment ends
Early intervention is critical
Integrative therapies can:
- Reduce severity
- Improve function
- Enhance quality of life

To learn more about managing your colorectal cancer

Core Pillar Links

Cluster Content

Evidence Appendix (PubMed / Peer-Reviewed)

Simultaneous hyperbaric oxygen therapy during systemic chemotherapy reverses chemotherapy-induced peripheral neuropathy by inhibiting TLR4 and TRPV1 activation in the central and peripheral nervous system

Results: The mechanical and thermal behavior tests revealed that HBOT intervention during PAC treatment led to the early alleviation of CIPN symptoms and inhibited CIPN deterioration. IF staining revealed that TLR4, TRPV1, and microglial activation were all upregulated in PAC-injected rats and exhibited early and significant downregulation in SHBOT-treated rats.

Conclusion: This study is the first to demonstrate that the use of SHBOT during PAC treatment has potential for the early suppression of CIPN initiation and deterioration, indicating that it can alleviate CIPN symptoms and may reverse CIPN in patients undergoing systemic chemotherapy…