MENTHOL GEL FOR THE MANAGEMENT OF CHEMOTHERAPY-INDUCED NEUROPATHIC PAIN – A CASE REPORT
Kokki Hannu1, Kokki Merja2
1 School of Medicine, University of Eastern Finland, Kuopio, Finland
2 Department of Anaesthesia and Intensive Care, Kuopio University Hospital, Kuopio, Finland

Background 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. 1

Recent interest on menthol in pain management has risen since 2002 when the menthol sensing channel transient receptor potential melastatin 8 (TRPM8) was identified. 2

Here 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.

References
1. Seretny M et al. Pain 2014
2. McKemy DD, et al. Nature 2002
3. Allardt E. Research Reports No. 1. University of Helsinki, 1973.
4. Fallon MT, et al. Support Care Cancer. 2015

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