What is it?
Neurotoxicity is the damage done to your nervous system when the brain is exposed to something toxic. Toxins can be natural (like from plants or vegetables) or artificial (like medications or chemicals). This toxin changes how the nervous system works, which leads to damage. Both chemotherapy and radiation can be neurotoxic.
Neurotoxic effects may start during or soon after treatment, or months to years after treatment. Effects that start early often get better on their own. Late effects that start months to years after treatment can cause permanent damage (they won’t go away). When chemotherapy and radiation therapy are combined, there is a higher chance of neurotoxicity.
Many things other than chemotherapy and radiation therapy can cause neurotoxic effects, so it is hard to know exactly how many people are affected by it. It is thought that the chance of neurotoxicity will increase due to three things:
- People can now be given higher doses of chemotherapy and radiation therapy since supportive care, like pain and nausea management, has gotten better. Patients can tolerate higher doses that would not have been given in the past.
- Patients are living longer and having more late effects.
- New treatments target the nervous system itself.
There are many ways neurotoxicity can affect you. Symptoms of neurotoxicity may be:
- Having a hard time concentrating.
- A lot of drowsiness.
- Loss of vision, hearing, or taste.
- Nausea and vomiting.
- Ringing or other sounds in your ears.
- Weird feelings like tingling and numbness.
How is it treated?
Treatment of neurotoxicity depends on the symptoms. Your care provider will work with you to make a plan. Your treatment may include medications, physical and occupational therapy (PT/OT), or changes to your chemotherapy/radiation dosing. The most important thing is to prevent neurotoxicity. Your treatment may be changed if you have signs of neurotoxicity.
When should I contact my care team?
Nervous system damage can cause a lot of different symptoms, based on what causes the damage and where is affected in the brain. Call your care provider right away if you have any new or worsening symptoms listed above.
Abeloff M, Niederhuber JE, Armitage JO, Doroshow, JH, Kastan MB, Tepper, JE. Abeloff’s Clinical Oncology. 5th edition. Philadelphia: Churchill Livingstone; 2014.
National Institute of Neurological Disorders and Stroke. Neurotoxicity Information Page. 2019. Found at: https://www.ninds.nih.gov/Disorders/All-Disorders/Neurotoxicity-Information-Page
Verstappen C, Heimans J, Postma T. Neurotoxic complications of chemotherapy in patient with cancer: Clinical signs and optimal management. Drugs 2003:63(15):1549-63.