Surgical gloves to prevent neuropathies – RoseUp Association

Imagine having to immerse your hands in the snow for an hour. Does this seem unbearable to you? Yet this is what patients who are asked to put on refrigerated gloves during their chemotherapy sessions must endure to reduce their risk of neuropathies. Unsurprisingly, the majority give it up. “This solution is not satisfactory for patient comfortagrees Aurélia Joureau-Chabert, health executive at the Léon Bérard Center (Lyon). It is also not in terms of effectiveness since refrigerated gloves do not prevent all neuropathies and they are sometimes contraindicated. This is the case, for example, in patients with digestive cancers taking Oxaliplatin because this treatment causes intolerance to cold.” Despite these drawbacks, few alternative solutions have been developed to date.

Disabling pain

However, neuropathies are not trivial. This pain, caused by damage to peripheral nerves and which is characterized by a burning or tingling sensation in the fingertips, can have serious consequences. “Many patients who develop neuropathies retain this disability at the end of treatment and this handicaps them in their daily life. This can range from difficulty carrying out simple actions such as buttoning your shirt to being an obstacle to returning to work..” explains Aurélia Joureau-Chabert. It was very frustrating for our nurses not to be able to offer better”.

Compress to protect

So when an oncologist from the center told her about a new approach presented at a conference, the former nurse took a keen interest in it. “This was a Japanese study in which researchers tested the wearing of surgical gloves. The cohort was small but the results were encouraging” she remembers. The idea: apply compression with the gloves to prevent the chemotherapy from reaching the fingers. “We started doing tests in 2019 with nurses with different sizes of gloves and we were accompanied by a lymphedema specialist to ensure that it was not harmful.”

Chilled glove on one hand, surgical glove on the other

Over 3 years, this new approach was tested at the Léon Bérard Center in 96 patients affected by breast cancer treated with Paclitaxel and 81 patients with digestive cancer treated with Oxaliplatin. “Because these are 2 chemotherapies known to cause neuropathies” explains the health executive.

Each patient was his or her own witness. Two surgical gloves were worn on the dominant hand, one on top of the other, either a refrigerated glove for patients on Paclitaxel, or nothing for patients on Oxaliplatin who were intolerant to cold. “Gloves were to be worn 10 minutes before chemotherapy, during its administration and 15 minutes after” specifies Aurélia Joureau-Chabert.

A more effective and better tolerated solution

At the end of their protocol, 18.1% of patients had developed grade 2 neuropathy¹ with surgical gloves compared to 27.7% with refrigerated gloves. As for the patient’s perception of pain, it was 0.8 on a scale of up to 10 with surgical gloves compared to 4/10 with refrigerated gloves. “They were also better tolerated: while some of our patients abandoned the refrigerated gloves along the way, they all kept the surgical gloves until the end of their chemotherapy protocol. The other advantage of surgical gloves: the fingers are separated, unlike refrigerated gloves which are in fact mittens. Patients can therefore use their hands during their treatment, to read a book for example.” adds Aurélia Joureau-Chabert.

Results that interest other centers

The results of this study were presented at the ESMO European Congress in Berlin in breast cancer, then in Barcelona in digestive cancers. “They were very well received by the doctors. It must be said that this protocol is easy to implement because all establishments have access to this type of gloves.” recognizes Aurélia Joureau-Chabert.

Although surgical gloves are now routinely offered to patients monitored at the Léon Bérard Center, their adoption in other establishments is not for tomorrow.Our results will not lead to a change in practice immediately because it is a feasibility study.recalls Dr Renard, specialist in pain management at the Léon Bérard Center. We need to carry out a larger study, in particular to specify the optimal compression and duration of glove wearing, to draw conclusions and for its indication to be broadened.” What can we say to patients who would like to benefit from this device without waiting for the results of a new clinical trial? “As with any complementary approach, talk to your referring oncologist, he will give you his informed opinion on the matter.” replies Dr. Renard.