What approaches can help you manage neurological symptoms?
We present many approaches to reducing neurological symptoms and summarize the evidence regarding their effectiveness.
Top practices and therapies for managing neurological symptoms
Therapies and practices we have reviewed
The effects of these practices and therapies are described below on this page.
Self-care practices
Complementary therapies
Further therapies
Therapies recommended in clinical practice guidelines; see guidelines ›
Cold or heat
Hypnosis
Transcutaneous electrical nerve stimulation (TENS)
Other therapies
Other therapies have some evidence of benefit. The benefit may be meaningful or even substantial, but our reviews show the evidence so far is preliminary. These therapies are listed below.
Conventional approaches
Several pharmaceutical treatments are often prescribed for neurological symptoms. Ask your oncology team what may be best for you.
Self-care practices and complementary therapies
We present self-care practices and complementary therapies supported by evidence for managing neurological symptoms. Those with the best evidence are presented first.
A therapy may show a stronger effect or have more evidence in some situations than in others. The evidence supporting the effects for each therapy is listed in the full reviews available through the image links.
Good or modest evidence of benefit
Good evidencesignificant effects in one large or several mid-sized and well-designed clinical studies (randomized controlled trials (RCTs) with an appropriate placebo or other strong comparison control or observational studies that control for confounds) (this is the CancerChoices definition; other researchers and studies may define this differently) indicates a relatively high degree of confidence that the therapy is linked to the outcomes as noted. Modest evidencesignificant effects in at least three small but well-designed randomized controlled trials (RCTs), or one or more well-designed, mid-sized clinical studies of reasonably good quality (RCTs or observational studies), or several small studies aggregated into a meta-analysis (this is the CancerChoices definition; other researchers and studies may define this differently) means several smaller or at least one large study have found the effect described.
Acupuncture: good evidence
Fewer symptoms and pain related to chemotherapy-induced neuropathy among people treated with acupuncture (good evidence)
Recommended in practice guidelines for treating neurological symptoms; see guidelines ›
Astragalus: good evidence
Less chemotherapy-induced neurotoxicity among people treated with herbal mixtures containing astragalus (good evidence)
Cannabis and cannabinoids: modest and weak evidence
Lower neuropathic pain scores among people with pain treated with THC/CBD or THC alone (modest evidence)
Relief from unmanageable (refractory) seizures in one person with recurrent glioma treated with CBD (weak evidence)one or more case studies, supported by animal evidence OR small treatment effects of limited clinical significance OR studies with no controls OR weak trends of effects (this is the CancerChoices definition; other researchers and studies may define this differently)
Melatonin: modest evidence
Less neurotoxicity during radio/chemotherapy among people treated with melatonin (modest evidence)
Moving More: good evidence
Better balance, nerve conduction velocity, quality of life, and neuropathy-induced symptoms, and quicker movement initiation among people with peripheral neuropathy participating in exercise interventions (good evidencesignificant effects in one large or several mid-sized and well-designed clinical studies (randomized controlled trials (RCTs) with an appropriate placebo or other strong comparison control or observational studies that control for confounds) (this is the CancerChoices definition; other researchers and studies may define this differently))
Tai chi or qigong: modest evidence
Less neuropathy among people with cancer practicing qigong (modest evidence)
Vitamin D
A link between lower 25(OH)D levels and more chemotherapy-induced peripheral neuropathy among people with cancer (modest evidence)
Preliminary or weak evidence of benefit
Preliminary evidencesignificant effects in small or poorly designed clinical studies OR conflicting results in adequate studies but a preponderance of evidence of an effect (this is the CancerChoices definition; other researchers and studies may define this differently) typically indicates that not much research has been published so far, although the outcomes may be meaningful. Weak evidenceone or more case studies, supported by animal evidence OR small treatment effects of limited clinical significance OR studies with no controls OR weak trends of effects (this is the CancerChoices definition; other researchers and studies may define this differently) may mean that the effects are small or that only very preliminary research has been published.
No evidence of benefit
- No evidence of benefit for chemotherapy-induced peripheral neuropathy among people treated with acupuncture
Non-aspirin non-steroidal anti-inflammatory drugs (NSAIDs) ›
- No evidence of an effectoverall, one or more studies did not demonstrate that a treatment or intervention led to an expected outcome; this does not always mean that there is no effect in clinical practice, but that the studies may have been underpowered (too few participants) or poorly designed. Larger, well-designed studies provide more confidence in making assessments. on chemotherapy-induced peripheral neurotoxicity among people with stomach cancer treated with celecoxib in a preliminary study
Further therapies used to manage neurological symptoms
These therapies are used to manage neurological symptoms, but we have not yet reviewed their effectiveness or safety. Those in bold are recommended in at least one clinical practice guideline; see guidelines ›
Alpha lipoic acid
Calcium and magnesium
Capsaicin
Cold or heat
Cryotherapy, using frozen gloves and socks on hands and feet
Cysteine and theanine
Glutamine and glutamic acid
Menthol
N-acetyl cysteine
Omega-3 fatty acids or fish oil ›
Transcutaneous electrical nerve stimulation (TENS)
Vitamin B12 (methylcobalamin)
Vitamin B complex
Vitamin E
Further therapies NOT recommended
Acetyl-L-carnitine: contraindicated for use with paclitaxel due to worsening of chemotherapy-induced peripheral neuropathy (CIPN)
Goshajinkigan: increased CIPN from treatment in one study
Vitamin B6: reduced neurotoxicity when used for preventing cisplatin-include CIPN, but also decreased response duration
Personal story
CancerChoices Senior Clinical Consultant Laura Pole, RN, MSN, OCNS: Janie Brown is an oncology nurse and co-founder of a cancer retreat program and center in Vancouver, British Columbia.
Her story is a treasure trove of helpful information. She describes how her partner with breast cancer and her team made decisions about chemotherapy, wove in useful complementary therapies to prevent and minimize treatment side effects, and created a caring community. The integrative plan staved off usual chemotherapy side effects including peripheral neuropathy.