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Updated: Nov 12, 2025

Nerve Excitability Assessment in Chemotherapy-induced Neurotoxicity
Published on: April 26, 2012
CE: Chemotherapy-Induced Peripheral Neuropathy
1Robert Knoerl is an instructor in medicine at the Phyllis F. Cantor Center for Research in Nursing and Patient Care Services, Dana-Farber Cancer Institute, Boston. Contact author: robert_knoerl@dfci.harvard.edu . The author acknowledges Grace Kanzawa-Lee, PhD, RN, and Marilyn J. Hammer, PhD, DC, RN, FAAN, for their critical review of the manuscript. The author and planners have disclosed no potential conflicts of interest, financial or otherwise.
Abstract:
Chemotherapy-induced peripheral neuropathy (CIPN) occurs in more than 68% of patients receiving the neurotoxic chemotherapy agents commonly used to treat breast, gastrointestinal, gynecologic, and hematologic malignancies. CIPN, often experienced initially as numbness, tingling, or pain in the upper or lower extremities, may progress to the point where the resultant decline in physical function requires a reduction in the chemotherapy dose. This article provides nurses with strategies to use in assessing, managing, and educating patients who are at risk for or who are already experiencing CIPN. Currently, the American Society of Clinical Oncology endorses only one treatment for CIPN: duloxetine 60 mg/day. Discussing CIPN with patients before chemotherapy is initiated and throughout the course of treatment promotes its early identification and management, which may minimize its impact on physical function and chemotherapy dosing, reducing the patient's risk of experiencing chronic symptoms after chemotherapy ends.
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