Chemo Induced Peripheral Neuropathy - Participating in a Clinical Trial

   
Recently my friend, Lynn, shared with me what she had learned during the Foundation for Women's Cancer Ovarian Cancer Survivors Course held in October at the Summit Medical Group. One session on chemotherapy induce peripheral neuropathy was presented by Timothy Marshall, PhD a Professor of Physical Therapy at Kean University ( Union, N.J.). Knowing I have experienced neuropathy she thought I might be interested in a clinical trial he was running and she sent me his contact information.  I contacted Dr Marshall in November to learn more about his trial Chemotherapy-Induced-Peripheral Neuropathy (CIPN), Gait and Fall Risk.

Chemotherapy induced peripheral neuropathy can be numbness, tingling, pins and needles and pain in the toes and fingers. I experience this in my toes and have mentioned it in a few entries in this blog. Dr. Marshall sent me the Informed Consent form for the trial and we set a date to be evaluated in December. 

Last week I went to the Kean University Campus to take part in the trial. This was a relatively easy trial - as trials come -  to participate in. I shared with Dr. Marshall the chemotherapy drugs I had received, their dosage and the number of cycles I had during my initial and recurrence chemotherapy treatments. He asked about the level of exercise I currently take part in and measured my height and weight.

Then the actual evaluation started. The first test was to measure my hand grip strength.  I was asked to squeeze a handgrip dynanometer (3 times in each hand). 
Next after taking off my shoes and socks I was asked to sit on a table. and close and cover my eyes.  Dr. Marshall touched my feet and toes using a Jamar Microfilament - a very thin bendable wire, to assess sensation in my feet.   I was told to respond when I could feel the filament touch various parts of my foot. 

After putting my shoes and socks back on, a BTS G-Walk system was fitted to my waist. The BTS G-Walk system is a wireless tri- axial accelerometer. An accelerometer is an electromechanical device that measures acceleration forces. The system included EMGS placed on both my calves front and back. Electromyography (EMG) is a way to assess how well the muscles are working while I walk. I walked from one side of the room to the other a few times, all the time the Walk system was gathering data.  Lastly, I was asked to perform a ‘Timed-up and-Go' test, in which I had to stand up from a chair, walk about 9 feet, turn around and walk back to the chair and sit back down; this assessed fall risk. 

And in one hour the trial tests were complete.

I enjoyed talking to Dr. Marshall about his research including this study published in the Journal of Cancer Research and Practice Chemotherapy-Induced-Peripheral Neuropathy (CIPN), Gait and Fall Risk in older adults following cancer treatment. 

This trial is currently recruiting so if you are a physician and would like to refer a patient who is experiencing the impact of CIPN or a cancer patient/ survivor who continues to experience CIPN years after treatment or is experiencing CIPN while undergoing treatment, feel free to contact Dr. Marshall at marshati@kean.edu or call 908-737-6177. 

Thank you Dr. Marshall for doing research crucial to improving the survivorship of cancer patients. 

Dee
Every Day is a Blessing! 

Ovarian Cancer Research at the Cancer Survivorship Research Conference- Part 4

The focus of this conference was survivorship but I did find two posters that dealt with ovarian cancer survivorship in particular.

Impact of Chemotherapy-Induced Neuropathy on Quality of Life Among Ovarian Cancer Survivors: Results from the Population-Based Profiles Registry

This study was done in the Netherlands.  I had the opportunity to speak directly to Lonneke van de Poll-Franse, PhD one of the researchers . She told me that the number of women diagnosed with ovarian cancer in the Netherlands was 800 just slightly more than the number diagnosed each year in New Jersey. I thanked her for doing research on a subject so important to ovarian cancer survivors. The conclusion of the study as reported on the poster was that “Neuropathy symptoms were experienced by 51% of women with ovarian cancer who receive chemotherapy even up to 12 years after the end of treatment and seriously affect their health related quality of life.”

The second study, done in the United States is an ongoing GOG study. The GOG group is now part of NRG Oncology.

Baseline Characteristics of Ovarian Cancer Survivors Enrolled in a Lifestyle Intervention Trial: Lives Study

The LIVES study  is recruiting women with stage II –IV ovarian cancer from 230 GOG clinics. The study has recruited 20% of its goal . Women were randomized to the lifestyle intervention group or the control group.  In the lifestyle group the womenwill receive information about healthy lifestyle and nutrition and is delivered via the internet using a special interactive platform. More information can be found at http://ovarianlives.org/

Dee

Every Day is a Blessing!

ASCO Tuesday- Patient Care

As the meeting came to a close I attended a session called
Cancer : Getting on your Nerves

There were speakers on peripheral neuropathy  and depression
In a nutshell:

1. Duloxetine  was found to reduce the pain and tingling from peripheral neuropathy in cancer survivors in a phase III trial. 59% had a response and another 33% had a decrease in their pain score. (Smith - CRA9013)
2. Falls are common in patients with peripheral neuropathy. 12% in the study of 461 survivors reported falls, 60% physical limitations  and 25% reported functional losses due to peripheral neuropathy.(Mohile- 9014)
3. There is a machine called the Scrambler (approved Feb 9,2012) which sends impulses to areas of neuropathy and helps retrain the brain to normal. (Loprinzi)
4. There is an increased risk of suicide in young adult cancer patients compared to older patients. Risk was reduced when the patient had a better alliance ( relationship) with their oncologist.(Trevino-9015) 
5. Surveys of patients and physicians showed a prevalence of depression in cancer patients. Patients reported feeling sad, feeling distressed and having mood changes. (Manola -9016)

After the talks I was able to speak to Dr Mohile. I thanked her for her research on falling due to neuropathy. I know many OC survivors who have mentioned to me how they seem to trip and stumble more since having treatment and experiencing the neuropathy. This might be anecdotal evidence so I was pleased to see a study done in this area. I asked Dr Mohile  if her patients find that the numbness may be constant but the pain can intensify and then decrease. She told me that it is very common for that to occur with the Carbo Taxol treatments that we have received. 

Next post - ASCO in Manageable Pieces

Dee

Every Day is a Blessing!