Controlled cooling therapy for the prevention of chemotherapy-induced peripheral neuropathy: a service evaluation

Chemotherapy-induced peripheral neuropathy (CIPN) is a frequent side effect of certain chemotherapy medicines and can impair patients’ quality of life and potentially disrupt the delivery of chemotherapy. Cooling therapies such as the application of specially designed devices to patients’ hands and feet during chemotherapy have been proposed as a preventative strategy for CIPN. This service evaluation examined the feasibility, tolerability and outcomes of a nurse-led controlled cooling device delivered in a medical day unit. Twelve patients with breast, gynaecological or gastrointestinal cancer were offered the therapy during their chemotherapy course. Eight patients adhered fully to the cooling device, with four developing grade 1 CIPN and four remaining neuropathy free. Three months post-treatment, seven patients had no CIPN and one was still experiencing grade 1 CIPN. Most of the patients reported good tolerability to the cooling device; however, prolonged mitten use affected adherence in some. Overall, the controlled cooling device demonstrated the potential to reduce the severity of CIPN and maintain patients’ chemotherapy dose. Larger comparative studies are required to confirm these benefits and inform wider clinical implementation.