Recently Diagnosed or Relapsed? Stop Looking For a Miracle Cure, and Use Evidence-Based Therapies To Enhance Your Treatment and Prolong Your Remission
Multiple Myeloma an incurable disease, but I have spent the last 25 years in remission using a blend of conventional oncology and evidence-based nutrition, supplementation, and lifestyle therapies from peer-reviewed studies that your oncologist probably hasn't told you about.
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Chronic Painful Neuropathy Therapies
Chronic painful neuropathy therapies are those treatments for serious chemotherapy-induced peripheral neuropathy (CIPN) that your oncologist won’t necessarily tell you about. The only prescribed therapies that I know of for chronic painful neuropathy are opioids or Gabapentin, aka Neurontin.
Though I don’t have to deal with CIPN personally, I do have to manage several different types of chronic pain caused by different conventional therapies that I underwent during my own active MM treatment.
I believe that most effective management of chronic pain results from undergoing many different non-conventional pain therapies at the same time. For example, my pain management consists of daily:
- Nutritional supplementation
- Cannabinoid Ointment
- Acupuncture
- Moderate, daily exercise
I can’t tell you that my pain is completely gone as a result of these efforts, but I will say that I keep my pain under control.
Here’s a comprehensive list of non-conventional (integrative and supportive) therapies for chemotherapy-induced peripheral neuropathy (CIPN) — drawn from clinical studies, meta-analyses, and integrative oncology guidelines.
🔹 Nutritional & Supplemental Therapies
| Category | Examples | Evidence Summary |
|---|---|---|
| Antioxidants / Mitochondrial Support | α-Lipoic acid (ALA) | Some small RCTs show symptom reduction (esp. oxaliplatin-induced CIPN); acts via antioxidant and mitochondrial protection. |
| Acetyl-L-carnitine (ALC) | May support nerve regeneration; results mixed — avoid during active chemo due to possible tumor growth concerns in breast cancer trials. | |
| Coenzyme Q10 | Preclinical and small human data suggest neuroprotection; minimal toxicity. | |
| B Vitamins | B1 (thiamine), B6 (pyridoxine), B12 (methylcobalamin) | Supportive evidence for nerve repair; B12 especially beneficial for sensory neuropathy. Avoid megadoses of B6 (>200 mg/day). |
| Vitamin E | 300–600 mg/day reduced oxaliplatin-induced neuropathy in some studies; inconsistent results in larger trials. | |
| Magnesium & Calcium infusions | Historically used before/after oxaliplatin; mixed data, but some centers still employ for neuroprotection. | |
| Omega-3 fatty acids (EPA/DHA) | RCTs in breast and colon cancer show reduced incidence and severity of CIPN; anti-inflammatory and membrane-stabilizing effects. | |
| Curcumin | Emerging evidence of neuroprotection and pain reduction via anti-inflammatory pathways; preclinical and early clinical data. | |
| N-acetylcysteine (NAC) | Antioxidant and glutathione precursor; small studies suggest neuroprotective effect against oxaliplatin- and paclitaxel-induced CIPN. |
🔹 Botanical & Phytochemical Therapies
| Botanical | Evidence Summary |
|---|---|
| Goshajinkigan (traditional Japanese Kampo formula) | Multiple RCTs show reduced oxaliplatin-induced neuropathy; used in Japan; modulates nerve conduction and oxidative stress. |
| Cannabinoids (CBD, THC, or combined extracts) | Some preclinical and small clinical data show analgesic benefit; human trials ongoing. |
| Evening primrose oil (γ-linolenic acid) | Demonstrated benefit in diabetic neuropathy; possible extrapolation to CIPN. |
| Green tea polyphenols (EGCG) | Neuroprotective and anti-inflammatory mechanisms in preclinical CIPN models. |
🔹 Physical & Neuromodulatory Therapies
| Therapy | Evidence Summary |
|---|---|
| Acupuncture / Electroacupuncture | Supported by several RCTs showing improved sensory symptoms, nerve conduction, and pain reduction (esp. paclitaxel- and oxaliplatin-induced). |
| Low-level laser therapy (photobiomodulation) | Randomized studies show improvement in sensory function and pain; non-invasive and safe. |
| Transcutaneous electrical nerve stimulation (TENS) | Reduces neuropathic pain and improves function; used as adjunctive therapy. |
| Scrambler therapy (Calmare®) | Several phase II/III trials show meaningful pain reduction in refractory CIPN; mechanism involves neurosignal reprogramming. |
| Exercise (aerobic + resistance) | Meta-analyses show improved nerve function and reduced symptom severity; exercise may promote neurotrophic factor release. |
| Massage & Reflexology | Improve quality of life and perceived neuropathy severity; limited objective data. |
🔹 Mind–Body & Behavioral Approaches
| Approach | Evidence Summary |
|---|---|
| Mindfulness meditation / yoga | May modulate pain perception and improve coping with chronic CIPN symptoms. |
| Cognitive-behavioral therapy (CBT) | Helps manage pain-related anxiety and distress. |
| Tai chi / Qigong | Small studies show improved balance and neuropathy-related functional outcomes. |
🔹 Emerging / Experimental Modalities
| Modality | Description |
|---|---|
| Near-infrared phototherapy | Investigated for regenerating small fibers. |
| Neurotrophic peptides (e.g., NGF mimetics) | Experimental; not yet available clinically. |
| Microbiome-targeted therapies | Preclinical data suggest gut–nerve axis may influence CIPN susceptibility. |
Do you have chronic painful neuropathy? What therapies do you find most effective? Email me at David.PeopleBeatingCancer@gmail.com and I will reply to you ASAP.
Hang in there,
David Emerson
- MM Survivor
- MM Cancer Coach
- Director PeopleBeatingCancer
Global estimates of prevalence of chronic painful neuropathy among patients with chemotherapy-induced peripheral neuropathy: systematic review and meta-analysis of data from 28 countries, 2000–24
Abstract
Introduction Although the prevalence of chemotherapy-induced peripheral neuropathy (CIPN) has been reported, the proportion of patients with CIPN who report chronic painful neuropathy remains poorly understood, despite its significant impact on patients’ quality of life and treatment outcomes.
Methods A systematic review and meta-analysis were conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The primary outcome was the pooled prevalence of chronic (≥3 months) painful CIPN among patients diagnosed with CIPN.
Estimates from each study were transformed using double arcsine transformation and pooled in a meta-analysis using an inverse variance heterogeneity model. Subgroup analysis was conducted based on geographical region, sex, chemotherapy regimen, primary cancer type, and funding source; meta-regression analysis was conducted based on study design, human development index (HDI), and publication year.
Results 77 studies from 28 countries, encompassing 10 962 patients with CIPN, were included. Among patients diagnosed with CIPN, the pooled prevalence of those reporting chronic painful CIPN was estimated at 41.22% (95% CI 32.40 to 50.19; 95% prediction interval 23.71 to 61.28). Substantial heterogeneity was observed across studies (I²=95.27%; 95% CI for I2 94.58 to 95.86). Subgroup analysis revealed that patients treated with platinum based agents and taxanes had the highest prevalence of chronic painful CIPN (40.44% and 38.35%, respectively), and among primary cancers, those with lung cancer reported the highest prevalence of chronic painful CIPN (60.26%).
Study design, HDI, and publication year were non-significant moderators of prevalence estimates. Based on our GRADE (Grading of Recommendations, Assessment, Development and Evaluation) assessment, the certainty of evidence was considered very low.
Conclusion This study provides the first comprehensive global estimate of the prevalence of chronic painful CIPN, highlighting its significant burden on patients worldwide. The variation in prevalence across geographical regions, chemotherapy regimens, and primary cancers underscores the need for tailored pain management strategies and further research to address potential disparities.
Chronic painful neuropathy therapies Chronic painful neuropathy therapies Chronic painful neuropathy therapies