Numbness in Breast Cancer Survivors: Causes and Solutions

Some issues faced by breast cancer patients?

Hello Doctor: I would like to ask about my mother, who is 53 years old.
Last year, she underwent a right mastectomy due to stage I breast cancer and had three lymph nodes removed.
She first received four cycles of Adriamycin chemotherapy, followed by four cycles of Taxol chemotherapy.
During the Taxol treatment, she was also prescribed a medication called Tamoxifen, which she is still taking (as instructed by her doctor to purchase from the pharmacy).
However, she completed her chemotherapy at the end of September, and it has been over four months, yet she continues to experience numbness in her hands and feet.
I would like to know how long this symptom might last.
The numbness started after the Taxol treatment, and she is no longer undergoing chemotherapy, but her doctor has prescribed her to continue taking the medication, which is Tamoxifen 10 mg/tab, branded as Tamoplex, to be taken twice daily after meals.
Could this numbness be related to the medication? The warning label on the medication does not mention numbness as a side effect.
Please help answer this question, thank you.

Jiu Jiu, 20~29 year old female. Ask Date: 2011/01/08

Dr. Xu Kaixi reply Surgery

Dear Dr.
Hsu Kai-Hsi of the Tainan Hospital, Department of Surgery, Executive Yuan Health Department,
One of the side effects of paclitaxel is peripheral neuropathy (numbness in the hands and feet), which may improve after discontinuation of the medication.
Taking vitamins may also be helpful.
Tamoxifen does not have numbness in the hands and feet as a side effect.

Wishing you good health and safety from the Tainan Hospital, Department of Surgery, Executive Yuan Health Department.

Reply Date: 2011/01/08

More Info

Numbness in breast cancer survivors, particularly those who have undergone chemotherapy and surgery, can be a concerning and distressing symptom. In your mother's case, it is important to understand the potential causes of her numbness and the implications of her treatment history.

Firstly, the numbness in your mother's hands and feet could be attributed to a condition known as peripheral neuropathy, which is a common side effect of certain chemotherapy drugs, including taxanes like paclitaxel (the "紫衫醇" you mentioned). Peripheral neuropathy occurs when the peripheral nerves, which transmit signals between the brain and spinal cord to the rest of the body, become damaged. Symptoms can include numbness, tingling, burning sensations, and weakness in the affected areas. This condition can arise during treatment and may persist even after chemotherapy has concluded, as nerve regeneration can take time.

In addition to chemotherapy, surgery to remove lymph nodes can also contribute to numbness. The removal of lymph nodes can lead to changes in the way nerves function, especially if there was any nerve involvement during the procedure. Furthermore, the healing process after surgery can sometimes lead to scar tissue formation, which may compress nearby nerves and result in numbness or tingling sensations.

Regarding the medication your mother is taking, tamoxifen (the "合利它命愛" you referred to) is primarily used as a hormonal therapy for estrogen receptor-positive breast cancer. While tamoxifen is generally well-tolerated, it can have side effects, but peripheral neuropathy is not commonly listed among them. However, individual responses to medications can vary, and it is essential to consider that the cumulative effects of chemotherapy, surgery, and hormonal therapy may contribute to her symptoms.

As for the duration of her symptoms, it is challenging to predict how long numbness will last, as recovery can vary significantly from person to person. Some individuals may experience gradual improvement over weeks to months, while others may have lingering symptoms for a longer period. It is crucial for your mother to communicate openly with her healthcare team about her symptoms. They may recommend supportive therapies, such as physical therapy, occupational therapy, or medications to help manage her symptoms.

In conclusion, while the numbness your mother is experiencing may be related to her previous chemotherapy and surgical interventions, it is essential to have a thorough evaluation by her healthcare provider. They can assess her symptoms, review her treatment history, and determine if any additional interventions are necessary. Encouraging her to stay active, maintain a healthy diet, and engage in gentle exercises may also help alleviate some of the discomfort associated with numbness. Regular follow-ups with her oncologist or primary care physician will be vital in monitoring her recovery and addressing any ongoing concerns.

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