One of the common side effects reported from chemotherapy with Taxotere is neuropathy. In the trial used to receive FDA approval, TAX 327 which had 332 patients. In that trial the following percentage of men reported incidents of neuropathy:

Neuropathy Sensory- Nerve damage causing tingling or pain, usually in feet or hands:
Any Grade- 30.4%
Severe grade 3-4 — 1.8%

Neuropathy Motor – Weakness but no tingling, pain or numbness. Cramps or muscle twitching.
Any Grade- 7.2%
Severe grade 4-4 – 1.5 %

So, the question becomes what to do to either prevent of lessen the effect of neuropathy? Unfortunately, there is no compelling evidence for any type of therapeutic interventions to effectively and reliably prevent the problem. Researchers have looked at this problem trying many prevention, but in large part these have not proven to be very effective. Novel pharmacologic agents such as neuroprotective compounds (amifostine or WR-2721

[Ethyol]), glutamine and L-carnitine (amino acids), or glutathione (an antioxidant and product of glutamine metabolism), and/or neurotrophic factors (eg, nerve growth factor) are of limited benefit in preventing or reducing the severity of symptoms.

Neurotin (generic Gabapentin) at 200 mg twice a day for 5 days, then 200 mg three times a day for 5 days, followed by an increase to 300 mg three times a day. The effectiveness of Neurontin for neuropathy has been documented but in one study it was not effective. However, for diabetic neuropathy, Neurotin has been beneficial.

The bottom line for men with advanced prostate cancer and chemotherapy induced neuropathy is that we do not yet have a proven, effective safe treatment for you!

Joel T Nowak, M.A., M.S.W.