Cancer Drugs That Can Cause Neuropathy

Many people receiving chemotherapy notice changes in how their hands and feet feel. This is often called chemotherapy-related neuropathy. It happens when certain cancer drugs affect the nerves that help you feel, move, and control body functions.

This guide explains which cancer drugs are linked to neuropathy, what symptoms to watch for, and how to talk with your care team. It is for education only. Your oncology team knows your full medical picture and can guide you.

What is chemotherapy-related neuropathy?

Neuropathy means nerve damage or irritation. In cancer care, it most often affects the peripheral nerves. These nerves carry messages between your brain, spinal cord, and the rest of your body.

Neuropathy can start during treatment or after several cycles. It may improve when chemotherapy ends, but sometimes it lasts longer. Early reporting helps your team protect your nerves as much as possible.

What can it feel like?

Numbness, tingling, or “pins and needles,” usually in the fingers and toes
Burning, stabbing, or electric-shock pain
Sensitivity to touch, heat, or cold (oxaliplatin can cause strong cold sensitivity)
Trouble with fine motor tasks, like buttoning, writing, or picking up small items
Weakness, cramping, or feeling unsteady; changes in balance or walking
Less common: constipation, dizziness when standing, or bladder changes (autonomic nerve symptoms)

Is neuropathy an emergency?

Most chemotherapy-related neuropathy is not an emergency. You should still tell your care team about any new or worsening symptoms before your next treatment. This helps them keep you safe.

Depending on how severe your symptoms are, your team may adjust the dose, change the schedule, pause treatment, or switch drugs. These choices balance cancer control with your function and safety.

Which cancer drugs can cause neuropathy?

Not everyone on these medicines will get neuropathy. Risk depends on dose, schedule, other health conditions, and your unique biology. Talk with your team about your personal risk.

Taxanes: paclitaxel (including nab-paclitaxel), docetaxel, cabazitaxel. Neuropathy may start early and build with more cycles.
Platinum drugs: cisplatin, oxaliplatin, carboplatin. Oxaliplatin can cause acute cold-triggered symptoms and longer-term numbness with higher total doses.
Vinca alkaloids: vincristine (higher risk), vinblastine, vinorelbine. Can cause numbness and muscle weakness.
Other microtubule-targeting agents: ixabepilone, eribulin. Similar pattern to taxanes.
Proteasome inhibitors (used in multiple myeloma): bortezomib (risk may be lower with under-the-skin dosing), carfilzomib, ixazomib.
Immunomodulatory drugs (IMiDs): thalidomide (higher risk), lenalidomide, pomalidomide (lower risk).
Antibody–drug conjugates that carry nerve-affecting payloads: brentuximab vedotin, polatuzumab vedotin, enfortumab vedotin, ado‑trastuzumab emtansine (T‑DM1).
Rarely, immunotherapy (checkpoint inhibitors) can inflame nerves and cause neuropathy. This is less common but can be serious.

Other medicines, diabetes, alcohol use, vitamin deficiencies, or spine problems can also affect nerves. Let your team know about all your health conditions and medicines.

Who is more at risk?

Past or current neuropathy from any cause
Diabetes or prediabetes
High total doses of certain chemotherapy drugs
Older age
Heavy alcohol use
Vitamin B12 deficiency or thyroid problems
Kidney or liver problems that affect drug levels

How is neuropathy monitored during treatment?

Your team will ask about numbness, pain, strength, and balance at each visit.
They may do simple checks, like light touch, reflexes, and walking tests.
Grading scales help track changes over time.
Rarely, nerve tests are used if symptoms are severe or unclear.

If symptoms appear, your team may adjust the dose, change the schedule, pause treatment, or switch drugs. The goal is to treat the cancer while protecting your function and safety. These decisions are individual and need a careful discussion.

Practical ways to manage neuropathy symptoms

Protect your hands and feet. Wear well-fitting shoes with good grip. Use gloves for chores and in cold weather.
Prevent burns and injuries. Test water temperature with your elbow. Avoid heating pads on numb skin. Use oven mitts.
Be fall-safe. Keep floors clear, add night-lights, use handrails, and consider a shower chair or non-slip mats.
Care for your skin and nails. Check feet daily for cuts or blisters. Clean and cover any injuries. Tell your team if healing is slow.
Manage cold exposure with oxaliplatin. Avoid ice-cold drinks and very cold air for a few days after infusion. Use scarves, gloves, and sip room‑temperature liquids.
Stay active, gently. Light exercise, stretching, or balance work (as approved by your team) can help strength and coordination.
Ask about rehabilitation. Physical or occupational therapy can teach safety tips and ways to adapt tasks.
Limit alcohol and manage blood sugar. These steps can support nerve health.
Track your symptoms. Keep a simple diary of what you feel, when it started, and what affects it. Bring it to visits.
Check before taking vitamins or supplements. Some may help certain deficiencies, but others can interact with cancer treatment. Discuss with your team first.
Pain relief options. Some people use non-drug methods (relaxation, gentle massage, heat/cold with guidance). Certain prescription medicines for nerve pain may be considered. Ask your clinicians what is right for you.

Questions to ask your care team

Is the chemotherapy I am getting linked to neuropathy? What is my personal risk?
What symptoms should I report right away? How should I reach the team after hours?
If neuropathy starts, how will you adjust treatment to protect my nerves?
Are hand/foot cooling or compression during infusion offered here? Do they fit my plan?
Would physical or occupational therapy help me?
Which pain relief approaches are safe with my cancer treatment?

When should I call my care team?

New or quickly worsening numbness, tingling, or pain that affects walking, buttoning, or holding items
New weakness in hands or feet, foot drop, or trouble climbing stairs
Falls, near-falls, or feeling unsafe at home
Trouble breathing or swallowing, throat tightness, or severe muscle cramps during or after oxaliplatin
Severe burning or electric-shock pain not controlled by your current plan
Sores, infections, or burns you did not feel happening, or fever with a skin injury
Constipation lasting more than 3 days, or loss of bowel or bladder control
Fainting or dizziness when standing that does not improve

What happens after treatment ends?

Many people notice improvement in neuropathy within months of finishing chemotherapy. Nerves heal slowly, and recovery can take time. Some symptoms may linger, especially after higher doses or certain drugs.

Your team can support you with rehab, safety tips, and pain management. Keep reporting changes, even after treatment. If neuropathy limits your daily life or work, ask about supportive services and resources.

Where to learn more

Last reviewed: 2025-09-18