Editing Chemotherapy (section)

=== Peripheral neuropathy ===
{{further|Chemotherapy-induced peripheral neuropathy}}
Between 30 and 40 percent of people undergoing chemotherapy experience [[chemotherapy-induced peripheral neuropathy]] (CIPN), a progressive, enduring, and often irreversible condition, causing pain, tingling, numbness and sensitivity to cold, beginning in the hands and feet and sometimes progressing to the arms and legs.<ref name = NCI>{{cite journal | vauthors = del Pino BM | date = 23 February 2010 | journal = NCI Cancer Bulletin | volume = 7 | issue = 4 | page = 6 | title = Chemotherapy-induced Peripheral Neuropathy | url = http://www.cancer.gov/cancertopics/research/chemotherapy-induced-peripheral-neuropathy}}</ref> Chemotherapy drugs associated with CIPN include [[thalidomide]], [[epothilone]]s, ''vinca'' alkaloids, taxanes, [[proteasome inhibitor]]s, and the platinum-based drugs.<ref name = NCI /><ref>{{cite journal|url=http://www.kup.at/kup/pdf/10376.pdf |archive-url=https://web.archive.org/web/20120812155252/http://www.kup.at/kup/pdf/10376.pdf |archive-date=2012-08-12 |url-status=live| vauthors =Grisold W, Oberndorfer S, Windebank AJ|journal=European Association of Neurooncology Magazine|title=Chemotherapy and polyneuropathies|year=2012|volume=12|issue=1}}</ref> Whether CIPN arises, and to what degree, is determined by the choice of drug, duration of use, the total amount consumed and whether the person already has [[peripheral neuropathy]]. Though the symptoms are mainly sensory, in some cases [[motor nerve]]s and the [[autonomic nervous system]] are affected.<ref name=Beijers>{{cite journal | vauthors = Beijers AJ, Jongen JL, Vreugdenhil G | title = Chemotherapy-induced neurotoxicity: the value of neuroprotective strategies | journal = The Netherlands Journal of Medicine | volume = 70 | issue = 1 | pages = 18–25 | date = January 2012 | pmid = 22271810 | url = http://www.njmonline.nl/njm/getarticle.php?v=70&i=1&p=18 }}</ref> CIPN often follows the first chemotherapy dose and increases in severity as treatment continues, but this progression usually levels off at completion of treatment. The platinum-based drugs are the exception; with these drugs, sensation may continue to deteriorate for several months after the end of treatment.<ref name= Windebank>{{cite journal | vauthors = Windebank AJ, Grisold W | title = Chemotherapy-induced neuropathy | journal = Journal of the Peripheral Nervous System | volume = 13 | issue = 1 | pages = 27–46 | date = March 2008 | pmid = 18346229 | doi = 10.1111/j.1529-8027.2008.00156.x | s2cid = 20411101 }}</ref> Some CIPN appears to be irreversible.<ref name= Windebank /> Pain can often be managed with drug or other treatment but the numbness is usually resistant to treatment.<ref name=Savage>{{cite journal | vauthors = Savage L | title = Chemotherapy-induced pain puzzles scientists | journal = Journal of the National Cancer Institute | volume = 99 | issue = 14 | pages = 1070–1 | date = July 2007 | pmid = 17623791 | doi = 10.1093/jnci/djm072 | doi-access = free }}</ref>