Breast cancer patients treated with chemotherapy drug Taxol more likely to develop chronic neuropathic pain

Breast cancer patients treated with the chemotherapy drug Taxol (paclitaxel) are more likely to develop chronic neuropathic pain, according to research published in The Journal of Pain, the peer review publication of the American Pain Society.

Researchers from the University of Texas MD Anderson Cancer Center conducted a survey of breast cancer patients who participated in clinical trials of Taxol from 1994 to 2001. There were 240 respondents. The purpose of the study was to determine the association between chemotherapy-induced peripheral neuropathy (CIPN) and neuropathic pain in breast cancer patients treated with Taxol. The authors noted that few studies have examined the extent to which breast cancer survivors who experience CIPN during chemotherapy go on to develop chronic neuropathic pain.

Though survival rates for breast cancer have increased significantly, chemotherapy agents that make survival possible can cause structural damage to peripheral nerves, causing chronic pain from the resulting dysfunction in the nervous system. Dose-limiting toxicity for many chemotherapeutic agents is peripheral neuropathy.

The study results showed that breast-cancer patients who had experienced CIPN during their treatment with Taxol were three times more likely to eventually be diagnosed with chronic neuropathic pain. Taxol-treated patients, therefore, should be regularly monitored for neuropathic pain beyond treatment.

The authors pointed out that the same cellular mechanism altered by Taxol to kill tumors can be toxic to normal tissue. They explained further that patients at MD Anderson given weekly doses of Taxol are monitored closely for symptoms of worsening CIPN. In some cases, physicians and patients should review the risks and benefits for continuing Taxol if worsening neuropathy is likely.

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