MENTHOL GEL FOR THE MANAGEMENT OF CHEMOTHERAPY-INDUCED NEUROPATHIC PAIN - A CASE REPORT

MENTHOL GEL FOR THE MANAGEMENT OF CHEMOTHERAPY-INDUCED NEUROPATHIC PAIN – A CASE REPORTKokki Hannu1, Kokki Merja21 School of Medicine, University of Eastern Finland, Kuopio, Finland2 Department of Anaesthesia and Intensive Care, Kuopio University Hospital, Kuopio, FinlandBackground and aims: Several drugs used in oncology may cause chemotherapy-induced peripheral neuropathy (CIPN). CIPN occurs in 58-78% of patients who receive eg. carboplatin and paclitaxel, and 1/3 of patients have symptoms 6 months after chemotherapy. 1Recent interest on menthol in pain management has risen since 2002 when the menthol sensing channel transient receptor potential melastatin 8 (TRPM8) was identified. 2Here we present a case report where menthol-cream was used in the treatment of refractory CIPN pain.Methods:A 49 years old women underwent debulking surgery for ovarian cancer and peritoneal carcinosis on 7/2017. After surgery, she had chemotherapy with carboplatin and paclitaxel. On 8/2018 she had no sings of recurrence of the cancer, but severe pain in the hands and feet. Ibuprofen, oxycodone-naloxone and venlafaxine provide only 30% pain relief. Her pain on NRS was on average 4/10, least 2/10 and most 6/10. Her pain interfere with several daily functions, mood and normal daily activities most severely affected.She was prescribed menthol-cream (Ice Power®, Fysioline Ltd., Tampere, Finland) to be used 2-4-times a day.Results:After 4 weeks use of menthol-cream she was able to stop other analgesics. On 12/2018, after 4 months use of menthol-cream, she had neither pain nor any other symptoms of neuropathy. Her life satisfaction (LS) on the 4-item LS-scale (4-20) 3 had improved, score before menthol-cream was 8/20 and after it 6/20.Conclusions:In consistent with other reports 4, in this case topical menthol was highly effective on CIPN.References1. Seretny M et al. Pain 20142. McKemy DD, et al. Nature 20023. Allardt E. Research Reports No. 1. University of Helsinki, 1973.4. Fallon MT, et al. Support Care Cancer. 2015