Neuropathy| Cancer Related

Your Path

  • Neuropathy| Cancer related


  • Cancers can cause neuropathy thru a number of mechanisms
  • Chemotherapy induced (e.g. vincristine)
  • Direct invasion of any cancer into PNS
  • Neurolymphomatosis: invasion of lymphomas cells into connective tissue around nerves
  • Cancer induced vasculitis
  • Paraneoplastic, where cancer induces antibodies against PNS
  • Para-protein production (e.g. multiple myeloma, MGUS)
  • Nutritional deficiencies or metabolic processes related to the cancer, or other co-existent issues (e.g. DM)

Risk Factors

  • Paraneoplastic: small cell lung cancer in particular; also breast, lymphoma, others
  • Para-protein associated: Waldenstroms, lymphoma, Multiple Myeloma, POEMS, MGUS
  • Neurolymphomatosis: an ucommon complication of lymphoma (5% of lymphomas) - in particular large B-cell lymphoma (DLBC most common)


  • Neuropathic pain, often distal; numbness
  • Can also have weakness when motor system involved
  • Gait/balance problems - related to sensory neuropathy; autoimmune can sometimes affect cerebellum
  • With neurolymphomatosis, can affect PNS or Cranial Nerves; pain is the most common Sx
  • Symptoms related to underlying cancer - though neuropathy can appear before cancer detected

Physical Exam Findings

  • Decreased distal sensation
  • Inappropriate pain upon even light touch
  • Impaired reflexes
  • Sometimes weakness
  • Findings related to underlying cancer