title: Case report of a patient with chemotherapy-induced peripheral neuropathy treated with manual therapy (massage).
abstract: OBJECTIVE
  Chemotherapy-induced peripheral neuropathy (CIPN) is a common, miserable, potentially severe, and often dose-limiting side effect of several first and second-line anti-cancer agents with little in the way of effective, acceptable treatment. Although mechanisms of damage differ, manual therapy (therapeutic massage) has effectively reduced symptoms and improved quality of life in patients with diabetic peripheral neuropathy.
  
  
  METHODS
  Here, we describe application of manual therapy (techniques of effleurage and petrissage) to the extremities in a patient with grade 2 CIPN subsequent to prior treatment with docetaxel and cisplatin for stage III esophageal adenocarcinoma. Superficial cutaneous temperature was monitored using infrared thermistry as proxy for microvascular blood flow.
  
  
  RESULTS
  By the end of the course of manual therapy without any change in medications, CIPN symptoms were greatly reduced to grade 1, with corresponding improvement in quality of life. Improvements in superficial temperature were observed in fingers and toes.
  
  
  CONCLUSIONS
  Manual therapy was associated with almost complete resolution of the tingling and numbness and pain of CIPN in this patient. Concurrently increased superficial temperature suggests improvements in CIPN symptoms may have involved changes in blood circulation. To our knowledge, this is the first report of using manual therapy for amelioration of CIPN.
authors.affiliation: Hollings Cancer Center, and Division of Biostatistics and Epidemiology, Department of Medicine, College of Medicine, Medical University of South Carolina, Charleston, SC 29425, USA. cunninj@musc.edu
authors.forename: Joan Elizabeth
authors.initials: JE
authors.lastname: Cunningham
authors.forename: Teresa
authors.initials: T
authors.lastname: Kelechi
authors.forename: Katherine
authors.initials: K
authors.lastname: Sterba
authors.forename: Nikki
authors.initials: N
authors.lastname: Barthelemy
authors.forename: Paul
authors.initials: P
authors.lastname: Falkowski
authors.forename: Steve H
authors.initials: SH
authors.lastname: Chin
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects* / Q000627:therapeutic use; D002945:Cisplatin / Q000008:administration & dosage; D000077143:Docetaxel; D004938:Esophageal Neoplasms / Q000188:drug therapy; D006801:Humans; D008297:Male; D008405:Massage / Q000379:methods*; D008875:Middle Aged; D020258:Neurotoxicity Syndromes / Q000209:etiology / Q000628:therapy*; D010523:Peripheral Nervous System Diseases / Q000139:chemically induced / Q000628:therapy*; D011788:Quality of Life; D043823:Taxoids / Q000008:administration & dosage
chemical_list: D043823:Taxoids; D000077143:Docetaxel; D002945:Cisplatin