Mentolova krema Ice Power pri upravljanju bolečin zaradi kemoterapije!

Many drugs used in oncology can cause peripheral neuropathy as a result of chemotherapy (CIPN).

This neuropathy occurs in 58-78% of patients receiving carboplatin and paclitaxel, and one-third of patients still have symptoms for 6 months after chemotherapy. Much interest in the use of menthol in pain management has emerged since 2002, when the transient receptor potential of melastatin 8 and TRPM8, respectively, was identified. The following is a case study of the use of menthol cream in the treatment of pain due to peripheral neuropathy.

Methods

The 49-year-old underwent cytoreductive surgery for ovarian cancer and peritoneal carcinoma in July 2017. After surgery, she had chemotherapy with carboplatin and paclitaxel, the last doses she received in July 2018. In August 2018, she showed no signs of recurrence of the cancer, but had severe pain in her arms and feet. With the help of ibuprofen, oxycodone and naloxone, and venlafaxine, her pain was reduced by about 30%. According to the pain intensity scale, she rated the average pain with a score of 4/10, the lowest pain with a score of 2/10, and the highest pain with a score of 6/10. The pain affected her daily functioning, mood, and normal daily activities. In August 2018, she was prescribed menthol cream (Ice Power Fysioline Ltd .. Tampere. Finland), which should be applied 2-4 times a day.

Results

After 4 weeks of using menthol cream, she was able to stop using analgesics. In December 2018, or after 4 months of using the menthol cream, she did not feel any pain or any symptoms of neuropathy in her hands and feet. Her satisfaction with life on the scale also improved, as she was significantly lower before using the cream compared to the life satisfaction scale used than after using the cream.

Discussion and conclusions

Some chemotherapeutic drugs, such as platinum drugs, taxanes, proteasome inhibitors, and vinca alkaloids, can cause peripheral neuropathy, which is more intense at higher doses, multiple cycles of chemotherapy, and in combination chemotherapy. Our patient received carboplatin in combination with paclitaxel and several cycles of both compounds. Consistent with other reports, the findings suggest that in this case, topical menthol was extremely effective in peripheral neuropathy as a consequence of chemotherapy. One of the proposed pathophysiological mechanisms of peripheral neuropathy as a consequence of chemotherapy is the accumulation of chemotherapeutic drugs in the dorsal root ganglia and dorsal horn of the spinal cord. TRPM8 channels are expressed through the somatosensory system and through the dorsal root ganglia and dorsal horn.23 Thus, we hypothesize that the high analgesic efficacy of menthol in peripheral neuropathy as a consequence of chemotherapy may be based on peripheral mechanisms as well as a reduction in neuronal irritability in the central nervous system.

Ice Power cream contains menthol and relieves the feeling of pain and stimulates blood circulation.

Ice Power Cream is a unique cooling cream that contains menthol and relieves the sensation of aches and pains in the muscles and stimulates blood circulation. Topical menthol is very effective in many nociceptive and neuropathic pain conditions. The cream is skin-friendly and thus suitable for long-term use.

Flannu Kokki, Merja Kokki Faculty of Medicine University of Eastern Finland, Kuopio. Finland; Department of Anesthesia and Intensive Care.