A Guide to Nervous System Health After Cancer Treatment

Cancer survival rates have dramatically improved, with nearly half of patients living more than 10 years after diagnosis. While this is incredible news, it also means we're seeing more long-term side effects, including a significant one:

Nervous System Dysregulation. This isn't just a minor issue; it's a profound challenge that can affect a survivor's quality of life for years.

What is Nervous System Dysregulation?

Think of your nervous system as your body's communication network. It's a complex web of the brain, spinal cord, and nerves that controls everything from your heart rate and breathing to movement and sensation. After cancer treatment, this delicate network can become unbalanced or damaged, leading to communication problems throughout your body. This dysregulation can affect different parts of the nervous system:

• Autonomic Nervous System (ANS): This controls involuntary functions. Symptoms of ANS dysfunction can include irregular heart rates, blood pressure changes, digestive issues, and problems with sweating.

• Central Nervous System (CNS): This includes the brain and spinal cord. Problems here often show up as "chemobrain," or cognitive issues like memory loss, difficulty with concentration, and trouble with complex tasks.

• Peripheral Nervous System (PNS): This covers all the nerves outside the brain and spinal cord. This is where we see peripheral neuropathy, which affects 30-40% of patients during or after chemotherapy and causes numbness, tingling, and weakness, usually starting in the hands and feet.

  
  

Common Symptoms to Watch: For many survivors feel like their symptoms are just "part of the package," but it’s crucial to recognize them as real medical issues that need attention.

• Persistent Fatigue and Weakness: This isn't just normal tiredness; it's an unpredictable exhaustion that doesn't go away with rest or sleep. About 40-70% of people with cancer experience this, which is significantly higher than the general population.

• Brain Fog and Cognitive Issues: Symptoms of "chemo brain" are widespread, affecting up to 75% of patients during treatment. They include trouble with memory, focusing, and finding words. While it can improve over time, these challenges can persist and impact daily life.

• Changes in Heart Rate and Blood Pressure: Nervous system problems can show up as a rapid heartbeat (tachycardia) or fluctuating blood pressure.

• Numbness, Tingling, and Pain: These are classic signs of peripheral neuropathy. Long-term neuropathic pain can be particularly challenging, with increased sensitivity to touch.

  
  

How We Can Help: Osteopathic and Integrative Approaches

Diagnosing nervous system problems often requires specialized testing, such as Heart Rate Variability (HRV) testing, which measures the time between heartbeats to assess the balance between your sympathetic and parasympathetic nervous systems. Thankfully, you don't have to navigate these issues alone. A multidisciplinary approach is key to recovery.

Here are some of the most effective strategies for managing nervous system dysregulation:

1. Lifestyle and Exercise: Physical activity is one of the best non-drug treatments. Regular, planned exercise—including resistance, balance, and sensorimotor skills—can help reduce fatigue, improve cardiopulmonary function, and even promote nerve fiber growth. The American Cancer Society recommends 150-300 minutes of moderate activity per week.

2. Mind-Body Practices: Your nervous system's health is directly tied to your mental and emotional state. Practices like meditation, deep breathing exercises (like box breathing), and yoga can help activate the "rest-and-digest" part of your nervous system. These methods are proven to lower heart rate and reduce anxiety.

3. Cognitive Rehabilitation: For brain fog and memory issues, modern programs like RehaCom can help train attention, memory, and executive functions that may have been affected by chemotherapy. Cognitive rehabilitation can include both "brain training" to restore function and "strategy training" to teach coping skills.

4. Osteopathic Manipulative Treatment (OMT): OMT is uniquely suited to help with many of these symptoms. OMT focuses on the interconnectedness of the body's systems. By gently addressing somatic dysfunctions—impaired or altered function of the body's framework—we can improve circulation, reduce muscular tension, and support the body's natural healing processes. This can be particularly helpful in managing neuropathic pain and improving biomechanics that may be affected by fatigue and weakness.

5. Craniosacral Therapy: CST's effectiveness for nervous system dysregulation is linked to its ability to influence the autonomic nervous system (ANS), specifically the vagus nerve. The vagus nerve is a key component of the parasympathetic nervous system, responsible for the "rest-and-digest" functions that calm the body and promote recovery.

   Chronic stress, which is a common experience for cancer patients, can lead to an overactive sympathetic "fight-or-flight" state. CST uses gentle manipulations to stimulate the parasympathetic nervous system, helping to restore balance and reduce stress. Research, including a systematic review and meta-analysis of studies on heart rate variability (HRV), suggests that CST may lead to a short-term increase in parasympathetic activity, which is associated with better stress resilience.

Taking an Active Role in Your Recovery

Your recovery is a team effort. Here’s what you can do:

• Track Your Symptoms: Keep a symptom journal. Note what symptoms you're experiencing, their intensity, and any potential triggers. This provides valuable information for your healthcare providers.

• Communicate with Your Team: Don't hesitate to report new or worsening symptoms to your doctor. Your providers can only help with issues they know about.

• Build a Multidisciplinary Team: Beyond your oncologist, consider working with a physical therapist, osteopath, craniosacral therapist, occupational therapist, or mental health professional to address your specific needs.

Living with nervous system changes after cancer can be a tough journey, but it is manageable. By prioritizing your nervous system health and working with a supportive team, you can find a new normal and improve your quality of life.