Research suggests mechanisms to combat chemotherapy side effects

Researchers from the Faculty of Medicine of the University of Porto (FMUP) have found that the effects of chemotherapy, known as peripheral neuropathy, can be mitigated and propose performing neuroimaging tests before and after treatment.

“It is recommended to conduct imaging studies of the brain before and after chemotherapy to see how the pain modeling centers in the brain are affected during treatment with cytostatics. [substância que se usa na quimioterapia que não é igual e depende do tipo de cancro] because we began to realize that there are many people suffering from neuropathy [lesão nos nervos] “induced by cytostatics,” described researcher Isaura Tavares.

Lusa, who is also responsible for training physicians in the Department of Pain Medicine at FMUP, noted that the most debilitating side effects associated with chemotherapy can affect up to 68% of cancer patients undergoing treatment, and these effects are “important to prevent and mitigate.”

Pain, tingling, burning and electric shock sensations, sensitivity to stimuli such as heat, cold or touch, and movement changes are some of the most debilitating side effects associated with chemotherapy.

“The study showed that the damage to the peripheral nerves caused by chemotherapy significantly affects the central nervous system, namely the brain and spinal cord (…). The nerves become ill because they were treated during chemotherapy, and this damage to the periphery, which is proven and very common, will affect the response of the central nervous system,” he explained.

To date, “there is no way to prevent or stop neuropathic pain,” unlike what happens with other symptoms (such as vomiting) that can negatively impact survival in cancer patients who require chemotherapy.

That’s why the team recommends that patients undergo imaging tests before starting treatment – a procedure already used in other countries.

“These studies will allow us to identify patterns of brain activation in response to chemotherapy. By understanding these patterns, we will be able to predict which patients are at greater risk of developing peripheral neuropathy,” said Isaura Tavares.

Peripheral neuropathy may require dose reduction or even discontinuation of chemotherapy due to side effects.

“There are patients who cannot wash their hands at room temperature because the water becomes painful. Others are left in a wheelchair,” the researcher added of the effects that can persist even after treatment, irreversibly, leading to a decrease in the quality of life of patients and increased health care costs.

Isaura Tavares stressed the importance of testing “cytostatics on yourself” because it is impossible to create a control group with people, as was done in the animal model, when some were treated with cytostatics and others were not.

In other words, the future could include stratifying cancer patients with imaging tests before starting chemotherapy, similar to what is already being done in orthopedics, for example.

The FMUP team conducted the research at the Alberto Sols Institute of Biomedical Research at the Autonomous University of Madrid in Spain.

In addition to Isaura Tavares, the team includes FMUP researchers and students such as Rita Oliveira, Joana Oliveira, Carolina Bacalhao, Mário Cunha, Isabel Martins, Paula Serrão and José Thiago Costa Pereira.