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.

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.

DiVFuSS formulation Learn moreSee Less
Eating Well Learn moreSee Less
Electroacupuncture Learn moreSee Less
Metformin Learn moreSee Less
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Vitamin C: intravenous use Learn moreSee Less
Yoga Learn moreSee Less

No evidence of benefit

Electroacupuncture ›

  • 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

Glutathione

Hypnosis

L-carnosine

L-glutamine

Low-level laser therapy

Massage ›

Meditation

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.

Helpful links

Authors

Nancy Hepp, MS

Lead Researcher and Program Manager
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Ms. Hepp is a researcher and communicator who has been writing and editing educational content on varied health topics for more than 20 years. She serves as lead researcher, program manager, and writer for CancerChoices. Her graduate work in research and cognitive psychology, her master’s degree in instructional design, and her certificate in web design have all guided her in writing and presenting information for a wide variety of audiences and uses. Nancy’s service as faculty development coordinator in the Department of Family Medicine at Wright State University also provided experience in medical research, plus insights into medical education and medical care from the professional’s perspective.

Nancy Hepp, MS Lead Researcher and Program Manager

Laura Pole, RN, MSN, OCNS

Senior Clinical Consultant
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Laura Pole is senior clinical consultant for CancerChoices. Laura is an oncology clinical nurse specialist who has been providing integrative oncology clinical care, navigation, consultation, and education services for over 40 years. She is the co-creator and co-coordinator of the Integrative Oncology Navigation Training at Smith Center for Healing and the Arts in Washington, DC. Laura also manages the “Media Watch Cancer News That You Can Use” listserv for Smith Center/Commonweal. In her role as a palliative care educator and consultant, Laura has served as statewide Respecting Choices Faculty for the Virginia POST (Physician Orders for Scope of Treatment) Collaborative as well as provided statewide professional education on palliative and end-of-life care for the Virginia Association for Hospices and Palliative Care.

For CancerChoices, Laura curates content and research, networks with clinical and organizational partners, brings awareness and education of integrative oncology at professional and patient conferences and programs, and translates research into information relevant to the patient experience as well as clinical practice.

Laura sees her work with CancerChoices as a perfect alignment of all her passions, knowledge and skills in integrative oncology care. She is honored to serve you.

Laura Pole, RN, MSN, OCNS Senior Clinical Consultant

Reviewer

Sarah Soles, ND

Naturopathic physician
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Dr. Sarah Soles completed her naturopathic medical training at the Canadian College of Naturopathic Medicine. During her internship on the adjunctive cancer care shift, she learned the immense value of combining naturopathic approaches with conventional cancer treatments. Dr. Soles went on to complete a two-year residency in naturopathic cancer care at the Integrated Health Clinic. She continues to help patients in all stages of their cancer journey—from screening and prevention to active treatment or maintaining a remission. She is also the research director for the Knowledge in Naturopathic Oncology Website and a contributing author to the Textbook of Naturopathic Oncology: A Desktop Guide to Integrative Cancer Care.

Sarah Soles, ND Naturopathic physician

Last update: January 8, 2024

Last full literature review: April 2022

CancerChoices provides information about integrativein cancer care, a patient-centered approach combining the best of conventional care, self care, and evidence-informed complementary care in an integrated plan cancer care. We review complementaryin cancer care, complementary care involves the use of therapies intended to enhance or add to standard conventional treatments; examples include supplements, mind-body approaches such as yoga or psychosocialtherapy, and acupuncture therapies and self carelifestyle actions and behaviors that may impact cancer outcomes; examples include eating health-promoting foods, limiting alcohol, increasing physical activity, and managing stress practices to help patients and professionals explore and integrate the best combination of conventionalthe cancer care offered by conventionally trained physicians and most hospitals; examples are chemotherapy, surgery, and radiotherapy and complementary therapies and practices for each person.

Our staff have no financial conflicts of interest to declare. We receive no funds from any manufacturers or retailers gaining financial profit by promoting or discouraging therapies mentioned on this site.