Chemo Linked to Long-Term Neuropathy in Breast Cancer Survivors

More than half of breast cancer patients undergoing chemotherapy may experience moderate to severe neuropathy – nerve damage causing pain, numbness, and weakness – for years after treatment concludes, according to research published March 25, 2026. The study, appearing in JCO Oncology Practice, highlights the lasting impact of chemotherapy on quality of life and underscores the necessitate for proactive management of this often-debilitating side effect. The findings reveal a significant disparity based on the type of taxane chemotherapy administered, with paclitaxel linked to a higher incidence of long-term neuropathy compared to docetaxel.

Chemotherapy’s Lasting Effects on Nerve Health

The research, led by Sharon H. Giordano, MD, MPH, FASCO, of The University of Texas MD Anderson Cancer Center, analyzed data from nearly 1,500 breast cancer survivors diagnosed between 2012 and 2013. Participants, aged 65 and older, completed questionnaires between April 2018 and October 2019 detailing their experiences with neuropathy, balance problems, and falls. The study builds on prior research indicating that over 40% of individuals treated with chemotherapy develop chemotherapy-induced peripheral neuropathy (CIPN), as previously reported by Healio. However, this new work focuses specifically on the long-term persistence of these symptoms – beyond six months after treatment completion – a timeframe often understudied.

The study revealed that over 60% of breast cancer survivors who received chemotherapy experienced long-term neuropathy, compared to 36% of those who did not. Taxane chemotherapy, a common component of breast cancer treatment regimens, was strongly associated with increased risk. Individuals treated with taxanes had three times the odds of reporting neuropathy compared to those who did not receive chemotherapy. This finding emphasizes the need for careful consideration of chemotherapy regimens and potential mitigation strategies.

Taxane Choice and Neuropathy Risk

The research pinpointed a notable difference between paclitaxel and docetaxel, two commonly used taxane drugs. Survivors treated with paclitaxel had a significantly higher likelihood of experiencing neuropathy (73.3%) than those who received docetaxel (55.7%). This suggests that, for patients at high risk of neuropathy or where minimizing this side effect is a priority, docetaxel may be a preferable option. Healio previously reported on considerations for docetaxel use in other cancer types, highlighting its potential benefits in specific clinical scenarios.

“It’s really important for clinicians to realize that the majority of older patients they’re treating with chemotherapy are going to be left with long-term, moderate to severe neuropathy,” Giordano told Healio. This underscores the importance of open communication between patients and their healthcare providers regarding potential side effects and strategies for managing them.

Beyond Neuropathy: Impact on Balance and Falls

While the study found a strong link between chemotherapy and neuropathy, it did not demonstrate a significant association between neuropathy and an increased risk of falls. This was somewhat unexpected, as neuropathy can impair balance and coordination. Giordano noted that while the study didn’t uncover a direct link to falls, the presence of neuropathy likely still impacts balance in subtle ways. The researchers hypothesize that other factors, such as overall physical fitness and pre-existing conditions, may play a role in fall risk.

Racial Disparities and Access to Intervention

The study also revealed disparities in neuropathy experience and access to care. Black patients had significantly higher odds of experiencing neuropathy compared to white survivors. Conversely, Hispanic patients were more likely to receive interventions from clinicians regarding falls or balance problems. These findings highlight the need for targeted interventions to address health inequities and ensure that all patients receive appropriate care.

What In other words for Patients and Clinicians

The findings emphasize the importance of proactive neuropathy management throughout cancer treatment and beyond. This includes regular monitoring for symptoms, early intervention with pain management strategies, and referral to physical therapy or other supportive care services. Patients should openly discuss any concerns about neuropathy with their healthcare team. Recent research on GLP-1s and breast cancer highlights the evolving landscape of cancer treatment and the need for ongoing evaluation of potential side effects.

The study also points to a potential missed opportunity for intervention. A significant proportion of survivors treated with taxanes did not discuss falls or balance problems with their clinicians, despite experiencing neuropathy. This suggests a need for improved communication and proactive screening for these issues.

Looking Ahead: Research and Prevention

Giordano and her colleagues acknowledge limitations of the study, including the potential for misclassification of chemotherapy regimens based on Medicare claims data. Future research should investigate the prevalence of long-term neuropathy in younger cancer survivors and explore potential interventions to prevent or treat this debilitating side effect. The researchers “expect” similar rates of neuropathy and balance issues in older patients treated with chemotherapy for other malignancies. The goal is to optimize cancer treatment while minimizing long-term side effects and improving quality of life for survivors.

For more information:

Sharon H. Giordano, MD, MPH, FASCO, can be reached at [email protected].