What is neurotoxicity?

Neurotoxicity is the damage done to your nervous system when the brain is exposed to something toxic. The type of toxin depends on how that toxin is made. Toxins can be made naturally (like from plants or vegetables) or artificially (like medications or chemicals). Toxins change how the nervous system works, which leads to damage. Both chemotherapy and radiation can be neurotoxic.

Neurotoxic effects may start during or soon after treatment, or months to years after treatment. Effects that start early often get better on their own. Late effects that start months to years after treatment can cause permanent damage (they won’t go away). If you get both chemotherapy and radiation, there is a higher chance of neurotoxicity.

Many things other than chemotherapy and radiation therapy can cause neurotoxic effects, so it is hard to know exactly how many people have neurotoxicity. These things may increase the chance of neurotoxicity:

People can now be given higher doses of chemotherapy and radiation therapy since supportive care, like pain and nausea management, has gotten better. Patients can tolerate higher doses that would not have been given in the past.
Patients are living longer and having more late effects.
New treatments target the nervous system itself.

There are many ways neurotoxicity can affect you. Symptoms of neurotoxicity may be:

Anxiety.
Confusion.
Depression.
Having a hard time concentrating.
A lot of drowsiness.
Loss of vision, hearing, or taste.
Nausea and vomiting.
Ringing or other sounds in your ears.
Seizures.
Weird feelings like tingling and numbness.

How is it treated?

Treatment of neurotoxicity depends on your symptoms. Your care provider will work with you to make a plan. Your treatment may include medications, physical and occupational therapy (PT/OT), or changes to your chemotherapy/radiation dosing. The most important thing is to prevent neurotoxicity. Your treatment may be changed if you have signs of neurotoxicity.

When should I contact my care team?

Nervous system damage can cause a lot of different symptoms, based on what causes the damage and the part of the brain that is affected. Call your care provider right away if you have any new or worsening symptoms listed above.