A patient who achieved minimal residual disease (MRD)-negative status for high-risk multiple myeloma in November 2023—a milestone reached by only 10% of over 20 participants in a Phase 2 clinical trial—continues to struggle with significant side effects from four years of cancer treatment. The patient received 16 total Velcade injections as part of the trial beginning in January 2021, which led to peripheral neuropathy primarily affecting the feet, characterized by overall numbness and lack of feeling.
Treatment Challenges and Previous Interventions
The patient previously attempted gabapentin for three months in 2021 without success and discontinued the medication. Ultrasound treatments provided some relief over a year-long course, but that provider closed their business. The numbness has created a sensation of swelling in the feet and leads to lack of confidence in balance and walking. According to Dr. Roach’s response, pregabalin—a medication related to gabapentin—may provide moderate effectiveness for these symptoms, though treating numbness is harder than treating pain or burning sensations. Duloxetine, an unrelated medication, can sometimes help with numbness, though effectiveness is variable.
Management Strategies
The most practical interventions focus on protective measures and rehabilitation. Protective shoes are recommended along with daily inspections of feet to look for injuries, which neuropathic patients may not detect due to reduced sensation. Physical therapy to help with balance, coordination, and strength is particularly important given how numbness affects the body’s proprioception and ability to know where feet are positioned. Dr. Roach noted that Himalayan salt, while marketed for various conditions, is “really just salt with tiny amounts of minerals” and has no evidence supporting its effectiveness for neuropathy, despite marketing claims.
This article is an AI-assisted summary. All facts and figures are drawn from the original report: https://www.arcamax.com/keithroach/s-4215783