Assessment and grading of cancer chemotherapy-induced neuropathic pain

Toxicities to chemotherapy are common and skilled oncologists are trained to prevent, identify, and manage these adverse effects in a timely fashion. Unfortunately, chemotherapy-induced peripheral neuropathy (CIPN) presents several unique challenges that complicate effective prevention, early detection, and management (Paice, 2011). Risk factors for CIPN, aside from obvious comorbidities such as age, alcoholism, and diabetes, remain poorly understood. Additionally, like other pain syndromes, there is no simple laboratory value that can be frequently measured and monitored to detect CIPN. As a result, patient report remains vital, and yet, many of the existing assessment tools fail to capture early changes and, in general, do not adequately describe the patient experience of CIPN. Furthermore, existing grading scales are not sensitive and are of little assistance in guiding treatment for individual patients or in providing aggregate data about the experience of those receiving a particular agent or regimen.