Cancer treatment takes it out of you in so many ways. Hair loss, fatigue, weight fluctuations… is there anything chemotherapy doesn’t mess with?
In addition to its other frustrating side effects, chemotherapy can also affect your balance. It can actually cause a complication called chemotherapy-induced peripheral neuropathy (CIPN), which causes sensory and motor dysfunction. This particular complication doesn’t get talked about much, and while dealing with impaired balance is tough, it would be tougher to do so while not understanding why. Here are 10 things you need to know about how chemotherapy can affect your balance, and what to do about it.
1. What is Chemotherapy-Induced Peripheral Neuropathy?
Peripheral neuropathy refers to nerve damage that takes place to nerves outside the brain or spinal cord. These nerves are in charge of letting the brain know what’s happening and how it should respond. If the peripheral nerves are damaged, they will affect the brain’s understanding of what’s happening in and outside of a person’s body, and how to respond to that information. The brain’s lack of understanding can lead to poor balance, clumsiness, and a slower gait.
Chemotherapy-induced peripheral neuropathy can develop during cancer treatment or after, and sometimes months or years after. Someone with CIPN may notice tingling, burning, numbness, or weakness, often in the hands or feet. These complications make simple activities, like walking or putting on clothes, challenging and frustrating, and that frustration can take an emotional toll.
2. Other complications may affect balance
Apart from peripheral neuropathy, chemotherapy drugs or other treatments may affect the vestibular system of the inner ear and the rear part of the brain—both of which are essential to good balance. Cancers that directly affect the brain, head, neck, or nervous system can also negatively affect balance.
3. Just one treatment can have an impact
A 2017 study that followed 33 breast cancer patients undergoing taxane chemotherapy found that balance decreased after just one treatment. The effects increased with continued treatment and resulted in poorer balance (measured as increased side-to-side sway) and slower walking speeds.
4. Impaired balance affects more than just walking
Decreased balance affects more than just your ability to walk a straight line and hold a yoga pose. Balance impairment may manifest as an irregular step, the need for a cane, unusual clumsiness, lethargy that prevents you from performing usual tasks, dizziness, vertigo, and falls. If you experience these symptoms, be sure to reach out for the help that you need. You may not just be a klutz after all.
5. Impaired balance from chemo can increase your risk of falling
Cancer-induced peripheral neuropathy can increase a breast-cancer patient’s risk of falling even years after treatment is complete. In a study on over 500 women cancer survivors, 47% still had CIPN symptoms an average of 6 years after treatment, and they were nearly twice as likely to experience a fall than cancer survivors who hadn’t experienced CIPN. Falls can cause serious injuries and have significant physical and financial cost.
6. It can get better!
Some types of neuropathy can improve over time depending on the nerve damaged if the cause of damage is removed (such as stopping chemo treatments). Nerve cells can usually regenerate as long as they were not completely destroyed. A healthy diet and rehabilitation exercises may help reduce symptoms.
7. Medications and therapy can help
A diagnosis of CIPN (or another balance-compromising cancer complication) is not hopeless. A doctor can prescribe medications or topical treatments for pain, and a rehabilitation therapist may help you to strengthen muscles so that you can go about your daily life with more confidence and less risk, as well as reduce cramps and pain. They may also recommended specialized devices that can help with tasks that have become difficult.
8. You need to be extra careful to avoid injury
Damaged peripheral nerves (especially in the hands and feet) mean that you will be less able to receive pain signals. If there is a rock in your shoe, for instance, you may not notice it until it causes a wound. You may not be able to tell when your extremities are too hot or too cold.
It’s best to take precaution in cold weather by using warm socks and gloves. Test hot water with a thermometer, take warm (not hot) showers, and use gloves when washing dishes. Better safe than sorry!
9. It’s wise to establish a safe environment
There are a lot of simple steps you can take to decrease your risk of falling. Keep walkways in your home clear of clutter and use night-lights (especially in halls and bathrooms) so that you never have to stumble around in the dark. Handrails and safety treads can be helpful on stairs, and consider a handrail or skid-free mat in the bathtub. Finally, small rugs can be a slippery hazard, so keep rugs large or use a rug pad. Set yourself up for success!
10. No need to go it alone
Be clear and communicative with your medical care team. Share all your symptoms and concerns so that you can get the care you need, and explain to your family members what you are going through and what you need from them. You may have to be your own advocate, so be bold and confident so that you can get what you need.
Keep fighting, friends!
Katie Taylor started writing in 5th grade and hasn't stopped since. Her favorite place to pen a phrase is in front of her fireplace with a cup of tea, but she's been known to write in parking lots on the backs of old receipts if necessary. She and her husband live cozily in the Pacific Northwest enjoying rainy days and Netflix.