Nerve damage from peripheral neuropathy (PN) can cause pain, weakness, and tingling, often in the hands and feet. It is common in people who have had diabetes for many years, but many people who undergo chemotherapy for colorectal cancer (CRC) also develop peripheral neuropathy, which can be referred to as chemotherapy-induced peripheral neuropathy (CIPN).

Because no studies compared PN in people with diabetes with PN in colorectal cancer survivors, a team of researchers in Taiwan sought to analyze the differences and build a base of knowledge about PN in these 2 patient populations. Their results were recently published in the Clinical Journal of Oncology Nursing.

The researchers conducted a secondary analysis of data obtained from 2 cross-sectional studies. One study examined risk factors among people with diabetes, whereas the second study examined the relationship between PN and quality of life in people with CRC who had undergone chemotherapy. They used data from 86 people in the diabetes study and 81 people in the CRC study.

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The severity and prevalence of PN was determined for both groups, using a combination of assessments, including the Total Neuropathy Score Clinical (TNSc), the Identification Pain Questionnaire (ID-PAIN), and the Douler Neuropathique 4 Questions (DN4). The patients with diabetes were found to have more severe PN and sensory PN, but the prevalence of PN and neuropathic pain was significantly higher in the colorectal cancer survivors.

The study did have some limitations: The data were obtained from existing studies. The patients with diabetes had all been admitted to the hospital from the emergency department because of discomfort, which may have resulted in higher PN levels. The TNSc cutoff level for peripheral neuropathy was different for the patients with diabetes than it was for the CRC survivors, and the tools for assessing pain also varied.

However, the researchers report their study results do have some important implications for practice. They recommended using the TNSc to screen and identify PN for both patients with diabetes and CRC survivors. And because nurses are well-positioned for evaluating patient’s needs and recommending interventions, they can educate patients on the importance of self-monitoring for PN symptoms and to schedule assessments for PN throughout the cancer treatment experience.

“Educating CRC survivors to recognize the symptoms of sensory PN may help the early detection of CIPN in those who do not have diabetes and to be aware of the progression of PN in those with diabetes,” the researchers concluded.

Disclosure: This research was supported by Far Eastern Memorial Hospital.


Wu CJ, Huang KJ, Tsai YC, Yeh TP, Hsieh CF, Wang YJ. Peripheral neuropathy: comparison of symptoms and severity between colorectal cancer survivors and patients with diabetes. Clin J Oncol Nurs. 2021;25(4):395-403. doi:10.1188/21.cjon.395-403