Neuropathy| Cancer Related


  • Cancers can cause neuropathy thru a number of mechanisms
  • Chemotherapy induced (e.g. vincristine)
  • Direct invasion of cancer into PNS
  • Cancer induced vasculitis
  • Paraneoplastic, where cancer induces antibodies against PNS
  • 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 - though can be w/others
  • Para-protein associated: Waldenstroms lymphoma, Multiple Myeloma, POEMS


  • Neuropathic pain, often distal
  • Can also have weakness when motor system involved
  • Gait/balance problems - related to sensory neuropathy; autoimmune can sometimes affect cerebellum
  • 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