Chemotherapy Care Needs Podiatry: Addressing CIPN for Better Outcomes

Chemotherapy Care Needs Podiatry: Addressing CIPN for Better Outcomes

Understanding Chemotherapy‑Induced Peripheral Neuropathy (CIPN)

Chemotherapy‑induced peripheral neuropathy, or CIPN, is a common complication that arises from certain chemotherapeutic agents. It manifests as numbness, tingling, burning sensations, or weakness in the feet and lower limbs. The condition can significantly impair gait, balance, and overall quality of life, placing patients at higher risk of falls, foot ulcers, and even amputations if thresholds of nerve damage are crossed.

Why CIPN Is a Hidden Gap in Oncology Care

While oncology teams often discuss nausea, fatigue, or hair loss as routine side effects, CIPN remains under‑identified and under‑treated. A 2025 study conducted by researchers at the University of South Australia (UniSA) examined data from 3,292 colorectal cancer patients. Ninety‑plus percent of these individuals received oxaliplatin, a platinum‑based drug widely associated with neurotoxicity.

The study’s findings were stark: less than 20 % of patients accessed podiatry services during or after chemotherapy, even though the disease cohort spanned five years. This gap means that many survivors are deprived of specialized foot care that could mitigate symptoms and improve mobility.

How Podiatrists Can Intervene Early

Registered podiatrists bring a skillset uniquely suited to managing lower‑limb complications. Early podiatric assessment can:

  • Reduce pain through customized footwear and orthotic prescriptions.
  • Identify and treat calluses, corns, and other pressure‑related lesions before they ulcerate.
  • Preserve muscle strength and joint function with targeted exercises.
  • Educate patients on proper foot hygiene and self‑monitoring techniques.
  • Collaborate with oncologists to adjust chemotherapy dosing when appropriate.

Integrating Podiatry Into Routine Oncology Workflows

Currently, Australian guidelines for CIPN management do not explicitly include podiatry. The absence of clear referral pathways is partly due to limited awareness among treatment teams and patients. To overcome this, the UniSA research group has published a set of clinical recommendations outlining:

  • Screening criteria for early identification of neuropathic changes.
  • Best‑practice protocols for foot care during chemotherapy cycles.
  • Multidisciplinary referral mechanisms that link oncologists, nurses, physiotherapists, and podiatrists.
  • Outcome measures to evaluate intervention efficacy.

Implementing these recommendations requires coordinated effort across hospital departments, but the potential improvements in patient safety and quality of life are compelling.

Case Study: A Survivor’s Journey

Jane, a 58‑year‑old colorectal cancer patient, began her treatment with oxaliplatin. After completing nine cycles, she reported numbness and burning in both feet. Her oncology team, unaware of podiatric options, scheduled a repeat assessment with her primary physician. Because CIPN symptoms progressed, Jane eventually stopped her chemotherapy to manage pain.

Once Jane consulted a podiatrist, she received custom orthoses, a gait training program, and education on footwear choice. Within weeks, her balance improved, and she resumed her daily walks. These non‑pharmacologic interventions also reduced her dependence on pain medication.

Jane’s experience illustrates how timely podiatric intervention can prevent treatment interruptions and enhance survivorship outcomes.

Barriers to Adoption and Proposed Solutions

The main obstacles to broader podiatry adoption in oncology include:

  • Limited awareness of podiatry benefits among oncology staff.
  • Insufficient funding for specialized foot care services in cancer centres.
  • Lack of standardized screening protocols within electronic health records.
  • Fragmented communication between multidisciplinary teams.

Targeted solutions involve:

  • Educational workshops for oncologists, nurses, and pharmacists that highlight CIPN epidemiology and podiatry roles.
  • Policy briefs urging health authorities to allocate resources toward foot‑care units.
  • Development of mobile health applications that allow patients to log foot symptoms for real‑time monitoring.
  • Implementation of referral templates within electronic health systems to facilitate automatic podiatry consults when neuropathy thresholds are met.

What Patients Should Ask Their Care Team

To ensure you receive comprehensive foot care during cancer treatment, consider raising these questions:

  1. Do you monitor for peripheral neuropathy as part of my chemotherapy plan?
  2. Is a podiatrist available to assess my foot health if I develop symptoms?
  3. What specific footwear or orthotic options can I use to protect my feet?
  4. Can you coordinate a multidisciplinary review that includes physical and occupational therapy?
  5. Will my insurance cover podiatry visits if they are medically necessary?

Next Steps for Health Systems and Professionals

Incorporating podiatry into oncology care involves layered actions:

  • Leverage UniSA’s evidence‑based guidelines to advocate for policy change.
  • Integrate foot‑health checklists into pre‑chemotherapy screening protocols.
  • Establish joint clinics where oncologists and podiatrists co‑manage shared patients.
  • Offer continuing education credits for multidisciplinary collaboration projects.
  • Utilize outcome data to refine referral patterns and adjust funding allocation.

Conclusion: Prioritizing Foot Health in Cancer Care

CIPN is a preventable, but largely overlooked, complication that demands proactive foot caring strategies. By embedding podiatry into oncology pathways, health care providers can reduce falls, prevent ulceration, and enable patients to maintain independence throughout and beyond treatment. This paper calls for institutions to adopt UniSA’s clinical recommendations and for patients to request dedicated foot‑health assessments while receiving chemotherapy.

Take Action

  • Speak with your oncology team about early neuropathy screening.
  • Schedule an appointment with a specialist podiatrist if you notice foot numbness or tingling.
  • Explore educational resources on CIPN prevention and management.

By addressing foot health proactively, we can help patients move forward with confidence and resilience.

Explore Related Topics

Have questions about integrating podiatry into your cancer treatment plan? Contact our media team for more information.

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