Some cancers and cancer treatments have the potential to cause nerve damage (neuropathy). The most common type of cancer-related nerve damage causes numbness (lack of feeling) and tingling in the toes and fingers.1 Other problems include increased (or decreased) sensitivity to temperature, and more uncomfortable sensations such as burning or electric shock–type pain.2 Also, nerve damage can result in weakness of the limbs, balance problems and difficulty with fine muscle movements.2 The degree of damage may be related to the type and dose of treatment received. Nerve damage may recover completely or incompletely over time.
Vocational implications
The changes in sensation and strength associated with nerve damage can cause lack of dexterity executing tasks that require fine motor skills, such as handling small materials and typing. Decreased sensation in your hands puts you at a greater risk of injury. Lack of grip strength may make handling tools or climbing ladders more difficult. Changes in sensation may also affect your balance when standing still, and make it difficult to walk on uneven ground or stand for prolonged periods of time. Nerve damage may increase or decrease sensitivity making it harder to work in extreme temperatures (such as handling hot items while cooking food, or working in refrigerated environments or outdoors). Nerve sensitivity may also affect your pain levels.
What you can do
Speak to your healthcare team if you notice changes in sensation or other symptoms that may be due to nerve damage. Medications may be helpful in treating pain. Assistive devices, occupational therapy and physiotherapy may help with managing muscle weakness, gait (walking) disturbance and fine motor clumsiness.
- Keep your hands warm and comfortable, even when indoors (consider wearing thin, fingerless gloves). Use extra caution to keep your hands warm when working outside.
- Decreased sensation in your feet can disturb your balance. Wear well fitting, supportive footwear with a closed heel and rubber sole to maximize your stability. A mobility aid may also be helpful in improving your stability.
Find more information on how to manage cancer treatment–induced peripheral neuropathy:
- Managing Neuropathy after Cancer Treatment from the University Health Network (PDF)
- Symptom Management Guidelines: Chemotherapy-Induced Peripheral Neuropathy from the BC Cancer Agency (PDF)
- Communicate With Your Healthcare Team by Livestrong (video)
Job accommodations
Modify your work tasks and how you work:
Hands and fingertips:
- Decreased sensation in your hands puts you at a greater risk of injury. Request alternative duties to work tasks that involve the use of sharp objects or tools, or extreme temperatures (boiling water, freezers).
- Use safe electric tools in place of manual tools when possible (for example, an electric drill instead of a manual screwdriver, or food processor instead of a knife).
- Adapt the handles of commonly used equipment by covering surfaces with fabric textures or padding to increase comfort.
- Experiment with “building up” handles of tools with foam pipe insulation to increase the handle’s diameter, requiring less grip strength to hold on to.
- Use a headset if you are frequently on the telephone.
- For jobs that involve computer use where typing is difficult, consider using speech recognition software. Alternatives to mice and/or switches accessed by other body parts are options for very sensitive fingertips.
Toes and feet:
- Work in a standing position? Sit down when you’re able to. Use a stand-lean chair if possible; if not, keep a rest chair nearby.
- Use an anti-fatigue mat under surfaces where you frequently stand or add anti-fatigue surfaces to your shoes.
- Consider using a mobility aid (cane, hiking stick, walker) if you are having difficulties with balance.
- Diab-A-Sheet or other insoles may help manage discomfort in your feet while standing/walking.
Modify your work environment:
- Maintain adequate temperature: consider using space heaters, fans, portable air conditioners or humidifiers/de-humidifiers for comfort.
- Request parking close to your work entrance.
- Relocate your workstation closer to the washroom, break room or other frequently used space.
