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Is there anything which may prevent the development of peripheral neuropathy???

Updated: Sunday, August 24, 2014 05:53:28 PM

Is there anything which may slow its progress or spread???

Prevention or reduction of the neurotoxicity which is responsible for neuropathy was achieved by those who took 680 mg of glutamate chloride three times a day, by mouth, every day, throughout the entire course of chemotherapy with Vincristine Sulfate (Oncovin). There were no side effects from the glutamate chloride (Amer.J.Med.1988, 84:1016-1022). Note: Although this result occurred with a different chemotherapy treatment than the ones used for ovarian cancer, the mechanism by which chemo causes neuropathy may possibly be the same. Glutamate chloride or glutamic acid can be purchased very inexpensively at health food stores. This is a routine order by an oncologist that one woman knows. However, some oncologists are reluctant to prescribe this for fear it will interfere with the effectiveness of the chemotherapy. In a study with rats, no interference was demonstrated (J.Pharmacol.Exp.Ther. 1996, 279:410-415).

Glutamine supplementation was effective in preventing the development of problems in those taking taxol. Each patient was given 10 grams of glutamine by mouth three times a day beginning 24 hours after a taxol infusion for a total of 5 days. (J.Clin.Oncol. 1998 (12):3918)

Glutathione (GSH) given with high doses of cisplatin and cytoxan was found to be protective in humans (Cancer Chemo.Pharmol. 1990 (25):355-355-360) and in rats (Int.J.Rad.Onc.Biol.Phys. 1994 (29):771-776) without effecting the activity of the chemotherapy drug.

The adrenocorticotropic hormone (ACTH) analog ORG 2766 used by those with ovarian cancer who were taking cisplatin reduced the severity of the neuropathy (NewEng.J.Med. 1990 (322): 89-94 and J.Neurol. 1994 (241):432-435) but it did not reduce the severity of already-present neuropathy. (Gyn.Onc. 1997 (67): 172-177).

Another study found that a higher dose of Taxol, infused over 3 hours, was just as safe and effective as the 24 hour infusions. However, the shorter duration was also associated with more neuropathy (J.Clin.Oncol. 1994(12):2654-66).

Taxol given over a shorter time period causes more neuropathy, which increases when Cisplatin is added. One way to decrease the incidence of neuropathy is to substitute Carboplatin for Cisplatin (Semin.Oncol. 1996;23 (6 supp 15): 2-4).

Taxol, when used as a high dose chemotherapy treatment followed by a stem cell transplant, will always cause neuropathy (Proc.Am.Soc.Clin.Oncol. 1997 (16):778).

Carboplatin is generally as effective as Cisplatin. Carboplatin is less toxic to the nerves, but it causes more bone marrow depression. Two large randomized studies found that neuropathy occurred more frequently with a Cisplatin/Cytoxan combination than with a Carboplatin/Cytoxan combination (J.Clin.Oncol. 1992; 10(5):706-717 and 718-726).

Cisplatin/Taxol combination produces more neuropathy than Cisplatin/Cytoxan (ASCO, 1999 abstract #1374, http://www.asco.org ).

Cisplatin/Taxol combination worked as well as Carboplatin/Taxol, but the Carboplatin/Taxol combination was better tolerated, had fewer side effects, such as neuropathy, and allowed better quality of life (ASCO, 1999 abstract #1374, http://www.asco.org ).

If each chemo drug can cause neuropathy alone, then using them together may cause peripheral neuropathy to occur sooner or more severely. Instead, it may be possible to use a combination in which only one drug in the combination has the potential to cause neuropathy.

Carboplatin is generally as effective as Cisplatin. Carboplatin is less toxic to the nerves, but it causes more bone marrow depression.

Other woman tested techniques prescribed by physicians to prevent neuropathy:

 

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