Saturday, April 7, 2018

ENCORE #85! – Diabetes = Peripheral Neuropathy, Chemotherapy = Neuropathy…What If You Have BOTH?


From the first moment my wife discovered she had breast cancer, there was a deafening silence from the men I know. Even ones whose wives, mothers or girlfriends had breast cancer seemed to have received a gag order from some Central Cancer Command and did little more than mumble about the experience. Not one to shut up for any known reason, I started this blog…That was four years ago – as time passed, people searching for answers stumbled across my blog and checked out what I had to say. The following entry appeared in September of 2015.

Today I’ll be referencing a number of different sources – let me state immediately and LOUDLY:

I AM NOT A DOCTOR. I AM READING THE SOURCES I NOTE BELOW AND SUMMARIZING, SOMETIMES CHANGING TECHNICAL TERMS INTO MORE COMMON ENGLISH DEFINITIONS. THIS IS NOT MEANT TO BE A DIAGNOSIS OR TREATMENT BLOG BUT A THOUGHT-PROVOKING ONE.

“Peripheral neuropathy is a set of symptoms caused by damage to the nerves that are away from the brain and spinal cord. These distant nerves are called peripheral nerves. They carry sensations (feeling) to the brain and control the movement of our arms and legs.”

Some of the symptoms of PN are: “pain that might be present all the time or come and go, like shooting or stabbing pain); burning; tingling; loss of feeling; it’s hard to pick up things and you drop things more often; balance problems; trouble with tripping or stumbling while walking; more sensitive to cold, heat, touch, or pressure; shrinking muscles; muscle weakness; trouble swallowing; constipation; trouble passing urine; blood pressure changes; as well as decreased or no reflexes.”

What causes PN?

Diabetes can. Chemotherapy with certain drugs can.

What if you have diabetes AND have been successfully treated for breast cancer?

Over a decade ago, it seems that the treatment was essentially: MORE DRUGS! (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2430688/)

Doctors today are taking a closer look at dealing with it: “In a recent…analysis…the…prevalence of [neuropathy caused by breast cancer chemotherapy] was 48%. Within the first month of completing chemotherapy, the prevalence of [neuropathy] was 68%; after 6 or more months of completing chemotherapy, the prevalence of [neuropathy] decreased to 30%.”

What’s the solution here?

There isn’t one yet. There are hopeful signs, however: “Clinical trials investigating… acupuncture and massage therapy are under way. A few small trials have investigated the use of Scrambler therapy, a device that provides noninvasive cutaneous electrostimulation, to treat [neuropathy]. The use of topical menthol...is also being investigated...”

That’s breast cancer.

How about diabetic neuropathy treatments?

Quite plainly: “There are currently no curative options for people with diabetic neuropathy; instead the condition is treated through pain relief or blood glucose control to stop the condition getting worse.

In the same article from which the above quote was taken, there seems to be some hope in using stem cells FROM THE PATIENT THEMSELVES (“Mesenchymal stem cells can be obtained from several sources in the body, including fat tissue, tendons, umbilical cord blood and bone marrow. The most successfully transplanted MSCs have been those from the bone marrow.”)

Currently, doctors treat diabetic neuropathy “...based on three major approaches: intensive glycemic control and risk factor management, treatments based on pathogenetic mechanisms, and symptomatic pain management. Clinical guidelines recommend pain relief...through the use of antidepressants…opioids and topical agents such as capsaicin…[other drugs are listed] [But]...there is a growing need for studies to evaluate the most potent drugs or combinations for the management of [neuropathy] to maximize pain relief and improve quality of life. A number of agents are potential candidates for future use in PDN therapy, including [a sodium ion channel that in humans is encoded by the SCN9A gene]antagonists, calcium channel blockers, NGF antibodies, and angiotensin II type 2 receptor antagonists.”]

So – drugs, drugs, and more drugs...

You DID notice that the treatments for chemotherapy-induced neuropathy and diabetic neuropathy DON’T have anything in common?

If you GOOGLE “diabetic neuropathy, chemotherapy-induced neuropathy, treatment”…you get nothing that includes both. With 11 million women in the US with diabetes (https://diabetessisters.org/women-diabetes) and 300,000 dealing with breast cancer in the US alone (http://www.cancer.org/acs/groups/content/@research/documents/document/acspc-042725.pdf), you’d think that someone, somewhere, would link the two and do a teensy bit of research.

Anyone care to join me in politely asking the medical community to “GET ON THE STICK!!!!!”


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