Patient Guide: Cold Therapy (Cryotherapy) to Hands/Feet

Keeping hands and feet cold during some types of chemotherapy infusions may help reduce the risk of pain/numbness/tingling that some people may experience as a side effect from the medication. This may also help reduce the risk of nail changes that can occur. 

ONLY use cryotherapy if instructed by your care team.

SUPPLIES NEEDED:

1) Cold packs or gel mittens/socks.
These can be purchased online or at local stores depending on product.
(Mittens/socks not typically available locally.) 

a. Elasto-Gel cold therapy mitts and socks 

b. NatraCure mitts and socks

c. SuzziPad mitts and socks

d. Reusable gel ice packs

e. Frozen bags of peas

f. Crushed ice in storage bags *(may not be available at all clinics/all cycles).

2) Lightweight material to provide barrier between ice pack and skin directly. 

3) Cooler/ice to keep extra set of supplies cold.
You will need to change after approximately 45 minutes to keep them cool enough, may need to purchase a few to switch out during treatment. 

Some examples pictured below for reference (not an endorsement and does not have to be one of these)

Cryotheraphy.webp

 

STEPS:

1) Hands/feet should be kept cold/covered from wrist to fingers and ankles to toes on both sides of hands/feet. 

2) Begin using ice packs 15 minutes before chemotherapy that can cause this side effect (discuss with your nurse before treatment and they will let you know when to begin) and continue until 15 minutes after it is finished. 

3) Change cold packs after approximately 45 minutes to ensure they are cold enough. 

4) Stop therapy if you feel any signs of frostbite. Pain, burning, itching, pink/red/white fingers/toes, waxy looking skin.  

Do NOT use cryotherapy if you have any of the following diagnosis: Raynaud’s, cryoglobulinemia, cold agglutin, peripheral arterial ischemia, or severe cold intolerance. 

 

 

References: Ruddy, Kathryn J et al. “Randomized controlled trial of cryotherapy to prevent paclitaxel-induced peripheral neuropathy(RU221511I); an ACCRU trial.” Breast (Edinburgh, Scotland) vol. 48 (2019): 89-97. doi:10.1016/j.breast.2019.09.011

Peyton, L., & Fischer-Cartlidge, E. (2019). Extremity Cooling: A Synthesis of Cryotherapy Interventions to Reduce Peripheral Neuropathy and Nail Changes From Taxane-Based Chemotherapy. Clinical journal of oncology nursing, 23(5), 522–528. https://doi.org/10.1188/19.CJON.522-528

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