Emotional Responses to Persistent Chemotherapy-induced Peripheral Neuropathy Experienced by Patients with Colorectal Cancer in Japan

OBJECTIVE: For patients who wish to continue treatment for persistent chemotherapy-induced peripheral neuropathy (PCIPN) while maintaining the quality of life (QOL), the only effective way appears to be the stop-and-go strategy. The objective of the present study was to analyze emotional responses of Japanese patients with colorectal cancer (CRC) experiencing PCIPN for the first time and to consider effective ways of providing supportive nursing care. METHODS: In all, 25 patients with metastatic CRC who had completed more than six courses receiving first-line therapy with modified FOLFOX6 were included. Data were collected through semi-structured interviews. RESULTS: Emotional responses to PCIPN experienced by patients with CRC fell into the following categories: (1) suffering from an inability to cope with the previously unknown sensation of numbness, (2) inability to perform daily living activities activities of daily living [ADL]/instrumental activities of daily living [IADL] independently and feeling fear for physical safety, (3) feeling a sense of relief at being able to live the same life as before, and (4) facing the threat of cancer and tolerating the numbness caused by the life-supporting treatment. Fear, helplessness, dismay and other uncomfortable feelings represented 72.5% of all emotional responses, probably reflecting the lack of effective intervention for PCIPN. CONCLUSIONS: These results suggest that both subjective and objective assessments of PCIPN and proper use of a stop-and-go strategy are essential for treatment continuation and maintenance of patient's QOL; therefore, an integrated approach is desirable.