A simple question helped spark a research project at the Nassif Community Cancer Center that is now helping support cancer patients during chemotherapy treatment.
Over the past several months, a collaborative team involving the Nassif Community Cancer Center, UnityPoint Health – St. Luke’s Palliative Care and students from Coe College studied whether cryotherapy — the use of frozen gloves and socks during chemotherapy infusions — could help reduce chemotherapy-induced peripheral neuropathy (CIPN), a common side effect of certain chemotherapy drugs.
A Question That Sparked an Idea
The idea for the study originated with Maureen McEvoy, BSN, RN, CHPN, manager of Palliative Care, Cancer Services and Genetics & Risk Assessment for UnityPoint Health – St. Luke’s Hospital, after a family member experienced CIPN during treatment.
“I had a family member undergoing breast cancer treatment out-of-state and she was using interventions that may help reduce CIPN,” said McEvoy. “This raised the question, could we implement similar interventions here to help patients manage CIPN?”
At the same time, the palliative care team was seeing how difficult neuropathy symptoms could be for patients.
“Our palliative care team was also seeing a number of patients with CIPN,” she continued. “This symptom was difficult to manage and was impacting our patients’ quality of life and functional status. We wanted to try to prevent this from occurring in the first place.”
McEvoy brought the idea to Rose Hedges, DNP, RN, who led the generate Innovation Lab at St. Luke’s at the time and now serves as Nursing Innovation program manager for the UnityPoint Health system. Existing literature suggested cryotherapy may help reduce CIPN symptoms. Since it wasn’t being offered locally, Hedges led the effort to turn the clinical question into a formal research project.
“This project was driven by a real patient care need and became an opportunity to add to the body of knowledge while evaluating whether cryotherapy could be feasible and beneficial in our setting,” Hedges said.
Understanding Chemotherapy-Induced Peripheral Neuropathy
Chemotherapy-induced peripheral neuropathy is a common side effect associated with certain chemotherapy drugs. Symptoms include numbness, tingling, pain, weakness and difficulty with balance or fine motor skills. In some cases, symptoms can persist long after treatment ends.
Existing research suggests cryotherapy may reduce blood flow to the hands and feet during chemotherapy infusions, potentially decreasing exposure of peripheral nerves to chemotherapy agents. However, no established preventative standards of care currently exist.
“The gap we hoped to address was simple,” Hedges said. “If patients were asking about this intervention, could we generate local evidence to determine whether it was a safe, feasible and potentially beneficial supportive option?”
How the Study Worked
The pilot study involved 25 adult patients receiving paclitaxel chemotherapy through infusion centers affiliated with UnityPoint Health and Physicians’ Clinic of Iowa.
Participants wore cryotherapy gloves and socks beginning 15 minutes before chemotherapy, throughout the infusion, and for 15 minutes afterward.
Researchers evaluated patients using a 15-question neuropathy survey and Semmes-Weinstein monofilament testing to measure sensation changes over time.
Encouraging Early Findings
While some neuropathy symptoms increased over time — as expected during chemotherapy treatment — the study still showed promising results.
“What stood out most was that although some neuropathy symptoms increased over time, the rates remained below national averages reported for paclitaxel-associated neuropathy,” Hedges said.
Researchers also saw preservation of sensation during testing, with hand sensation remaining intact across participants and foot sensation remaining stronger than national comparison values despite slight declines, according to Hedges.
The findings were encouraging enough that the Community Cancer Center now offers cryotherapy as an optional supportive intervention for eligible chemotherapy patients.
“This project helped move us from asking, ‘Should we consider this?’ to being able to offer patients an additional evidence-informed option,” Hedges said.
Collaboration Across Disciplines
Collaboration played a major role throughout the study.
Through St. Luke’s generate Innovation Lab, the team partnered with Coe College students to support the study as patient participation and data collection expanded.
“Once we realized the scope of onboarding and supporting patients for the study, we recognized additional help would be valuable,” Hedges said.
Students assisted with patient onboarding, data collection and other study support activities while gaining experience.
“It became a great example of interdisciplinary collaboration where students gained hands-on research experience while contributing to work that could directly impact patient care,” Hedges said.
Looking Ahead
Researchers emphasize that additional studies with larger patient groups and longer follow-up periods are still needed. But the project has already shown how frontline clinical questions can evolve into research efforts that directly impact patient care.
“I think what we are most proud of is demonstrating that frontline clinical questions can become meaningful research efforts that influence care,” Hedges said. “Innovation and evidence-based practice often start with curiosity,” she added. “This project was a great example of turning curiosity into something that could positively impact patient care.”
