Background noise - The experience of chemotherapy-induced peripheral neuropathy

Background. A substantial portion of the 1.3 million persons diagnosed annually with cancer receive neurotoxic chemotherapy that may produce distressful symptoms and changes in functional ability. However, little is known about the symptom experience and daily life effects of chemotherapy-induced peripheral neuropathy (CIPN). Objective: To describe the CIPN symptom experience and the influence of symptoms on everyday life. Methods: This was a qualitative, exploratory, interpretive, descriptive study with semistructured. interviews. A purposive sample of 28 participants was recruited from a rural National Cancer Institute-designated comprehensive cancer center. Interviews were audiotaped, transcribed verbatim, and imported into Atlas.ti software. Content analysis and constant comparative method were used to analyze the data. Results: Participants represented diversity in age (46-81 years), cancer type, time since diagnosis (3-198 months), neuropathy severity, and neurotoxic chemotherapy agents received. Content analysis yielded a rich, thick description of CIPN symptoms and the influence of the symptoms on functional ability and everyday life. Further interpretive analysis provided a description of the symptom experience through an overarching metaphor, Background Noise, and four major themes: (a) Becoming Aware; (b) Learning New Lyrics; (c) Functional, Emotional, and Social Role Cacophony; and (d) Learning to Live With It. Participants described significant physical limitations, emotional distress, and social role impairments due to CIPN. Conclusions: Having CIPN results in diverse symptom patterns and degrees of physical symptom distress from mild to severe, emotional distress, alterations in functional ability, and social role impairment. Comprehensive clinical and research measures are needed to assess the full spectrum of CIPN effects on everyday life.