Chemotherapy induced Peripheral Neuropathy (CIPN): A look into the Eastern & Western understandings of the condition.

Introduction:

Chemotherapy-induced peripheral neuropathy (CIPN) is a prevalent and challenging complication associated with many widely used anti-cancer treatments. Its increasing prevalence can be attributed to several factors, including a rising incidence of cancer and improved survival and cure rates.

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Chemotherapy is very often a vital component of cancer treatment. Whilst helping to fight off cancer cells, it can also affect otherwise healthy cells resulting in a number of potential side effects. 

Some of these side effects, such as damage to the vital organs and the incidence of infection, are potentially life threatening; understandably they command more recognition and emphasis. Consequently, CIPN is often overlooked and accepted as an inevitable outcome of chemotherapy. Many struggle to describe the sensation. I’ve heard a range of descriptions from patients, some depict it as like “wearing a very tight sock”, others experience burning pain, cramps, numbness and tingling.Commonly, CIPN resolves with the finishing of chemotherapy. However, in many cases, symptoms can become chronic - persisting months, years and sometimes permanently.Peripheral neuropathy is a prominent subject in the conversation of integrative oncology, particularly the integration of acupuncture towards the treatment of cancer related side effects. 

One of the main difficulties in propounding acupuncture as a solution to a neurological condition is an in-adjacency of rationale. The classical frameworks that still inform so much of modern acupuncture were assembled in a time where anatomical understanding did not recognise the function of nerves that we observe today. The brain - instead of being a central hub of nervous activity, was seen as a sea of marrow, an extension of the kidneys. The spinal cord - instead of a highly myelinated highway of rapidly communicated nervous signals, was thought of as a canal through which this marrow ascended and descended between the two structures. Many of the nervous structures, even anatomically sizeable such as the sciatic nerve had little, if any, recognition at all.

Yet, in spite of this seemingly glaring misalignment between the classical understanding and modern knowledge, the models of Chinese Medicine hold a surprising degree of purchase in the treatment of neurological conditions. For example, conditions like leprosy and beri-beri were described and treated effectively in ancient Chinese medical practice. Additionally, general anaesthesia was employed in orthopaedic surgery as early as the 14th century, and the isolation of ephedrine from the Chinese herb ma Huang marked a significant breakthrough in modern neuropharmacology.

Neuropathy implicitly describes a cessation or impairment of sensitivity. In Chinese Medicine, to understand sensitivity, one must first understand the concept of Shen: Shen is simply once’s capacity for consciousness/ the mind. The eastern model of consciousness, instead of being a cerebral experience that is assembled by neurological processes in the brain, is a ubiquitous and autonomous life force that is facilitated by various structures and substances within the body.

The Shen was thought, principally, to be housed within the heart, much as the dynastic emperor would reside in a palace. As important as it is to be appropriately situated, an emperor’s edict must venture beyond these boundaries, percolating into every nook and cranny of the empire, and equally, collecting and reporting feedback. The vector through which this information was transported was attributed to the blood. It is thought within Chinese Medicine to escort the receptive and illuminating capacity of the Shen from the heart to each of the tiny capillaries in the extremities. If a clinical case was encountered where a patient was experiencing an impairment of sensitivity, this would be ascribed to a disharmony of the quality or movement of the blood. Acupuncture has been demonstrated in contemporary research to have a profound impact on the movement of blood, promoting circulation and regulating inflammatory responses. 

Through utilising this influence on the blood, acupuncture can be useful in restoring blood flow to areas that are insufficient and therefore re-introducing the receptive, feeling capacity of Shen, which reports back to the mind/heart. Distorted, tingling and numb sensations become lucid again.

From a Western perspective, by increasing circulation to the small blood vessels that supply nutrients and oxygen to the nerves, acupuncture can help flush out harmful substances and support the repair of damaged nerve tissues. This process creates a healthier environment for the nerves, which could play a role in modulating the symptoms of CIPN. This would work contemporaneously on eastern and western paradigms of blood and nervous activity. I believe that this cross pollination of ideas and concepts has the potential to mutually unlock enhanced clinical results.

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Conclusion:

CIPN is a growing challenge as more people survive cancer, yet effective treatments are hard to come by, leaving many patients to cope with ongoing pain, numbness, and other debilitating symptoms. Acupuncture is emerging as a powerful tool to address these issues, offering a unique way to improve blood flow, clear toxins, and support nerve repair. While Eastern medicine views neuropathy as a disruption in blood movement and its connection to consciousness (the Shen), Western medicine sees it as nerve damage and poor circulation. Despite these different perspectives, acupuncture’s effects align with both, providing real benefits.

Instead of focusing on the differences between these approaches, we should recognise acupuncture as a way to bridge the gap. It works on multiple levels, combining the strengths of Eastern and Western ideas to offer holistic, effective relief for CIPN. For many patients, it could mean not just managing and living with symptoms, but a productive and constructive option towards regaining a better quality of life.