title: Subclinical peripheral neuropathy is a common finding in colorectal cancer patients prior to chemotherapy.
abstract: OBJECTIVE
  Of the numerous complications associated with cancer and cancer treatment, peripheral neuropathy is a deleterious and persistent patient complaint commonly attributed to chemotherapy. The present study investigated the occurrence of subclinical peripheral neuropathy in patients with colorectal cancer before the initiation of chemotherapy.
  
  
  METHODS
  Fifty-two patients underwent extensive quantitative sensory testing (QST) before receiving chemotherapy. Changes in multiple functions of primary afferent fibers were assessed and compared with a group of healthy control subjects. Skin temperature, sensorimotor function, sharpness detection, and thermal detection were measured, as was touch detection, using both conventional (von Frey monofilaments) and novel (Bumps detection test) methodology.
  
  
  RESULTS
  Patients had subclinical deficits, especially in sensorimotor function, detection of thermal stimuli, and touch detection that were present before the initiation of chemotherapy. The measured impairment in touch sensation was especially pronounced when using the Bumps detection test.
  
  
  CONCLUSIONS
  The patients with colorectal cancer in this study exhibited deficits in sensory function before undergoing chemotherapy treatment, implicating the disease itself as a contributing factor in chemotherapy-induced peripheral neuropathy. The widespread nature of the observed deficits further indicated that cancer is affecting multiple primary afferent subtypes. Specific to the finding of impaired touch sensation, results from this study highlight the use of newly used methodology, the Bumps detection test, as a sensitive and useful tool in the early detection of peripheral neuropathy.
authors.affiliation: Department of Psychology, York College, York, Pennsylvania, USA.
authors.forename: Jessica A
authors.initials: JA
authors.lastname: Boyette-Davis
authors.forename: Cathy
authors.initials: C
authors.lastname: Eng
authors.forename: Xin S
authors.initials: XS
authors.lastname: Wang
authors.forename: Charles S
authors.initials: CS
authors.lastname: Cleeland
authors.forename: Gwen
authors.initials: G
authors.lastname: Wendelschafer-Crabb
authors.forename: William R
authors.initials: WR
authors.lastname: Kennedy
authors.forename: Donald A
authors.initials: DA
authors.lastname: Simone
authors.forename: Haijun
authors.initials: H
authors.lastname: Zhang
authors.forename: Patrick M
authors.initials: PM
authors.lastname: Dougherty
mesh_terms: D015179:Colorectal Neoplasms / Q000150:complications*; D005260:Female; D006801:Humans; D008297:Male; D010147:Pain Measurement / Q000379:methods; D010523:Peripheral Nervous System Diseases / Q000175:diagnosis / Q000209:etiology*; D012677:Sensation; D012881:Skin Temperature