Chemotherapy: Adding to the risk of falls?

Abstract

Background: Falls significantly impact morbidity and mortality. The contributing factors to falls are multifactorial and apart from well-documented risk factors, such as age, gender, adverse effects from medications and other comorbidities, chemotherapy-induced peripheral neuropathy (CIPN) is overlooked as a contributing cause in cancer patients. Clinical details: We report a case involving a generally healthy 70-year-old woman who presented with a fall following several cycles of paclitaxel-based chemotherapy for early breast cancer. Outcomes: Currently there is insufficient data to recommend treatment for CIPN. The patient’s progressive worsening of paclitaxelinduced peripheral neuropathy and fatigue were deemed to be the main contributing factors to her fall. The scheduled paclitaxel was discontinued prematurely due to the negative impacts on the patient’s quality of life outweighing the benefits of completing the course of treatment. This case also highlights the use of a multi-disciplinary approach to optimise patient care and treatment outcome. Conclusion: CIPN may easily be overlooked, especially in the context of assessing risk of falls in patients at risk of CIPN. This could be monitored and managed effectively by the multidisciplinary team.