10 November 2025
Irreversible nerve damage to the lower limbs is a common side effect of chemotherapy, yet up to 50% of patients are missing out on vital care that could significantly ease their symptoms, according to new research from the University of South Australia.
In the first study of its kind, UniSA researchers assessed the use of podiatry services by those at risk of developing Chemotherapy Induced Peripheral Neuropathy (CIPN) – a condition that causes numbness, tingling, pain, and weakness in the feet.
Despite its severe and often permanent impact on foot and lower limb health, fewer than one in five patients accessed podiatry services, even in the five years following treatment.
The study examined 3292 people with colorectal cancer, 82% of whom received the standard platinum-based chemotherapy drug, Oxaliplatin, a known cause of CIPN.
UniSA PhD candidate and podiatrist Sindhrani Dars says the findings highlight a serious and avoidable gap in cancer survivorship care.
“Colorectal cancer treatment is heavily dependent on neurotoxic chemotherapy, with CIPN a painful and debilitating side effect,” Dars says.
“Neurotoxic chemotherapy can cause permanent nerve damage in the feet, leading to numbness, burning, a loss of feeling, and a ‘pins and needles’ sensation. Because it reduces balance and muscle strength, it increases the risk of falls, foot injury and reduced quality of life.
“Sometimes, CIPN symptoms can be so severe that people choose to reduce or even cease their chemotherapy treatments, so there’s a clear need for additional care strategies.
“As registered allied health professionals, podiatrists are skilled in managing lower limb complications and are well placed to care for people undergoing or recovering from chemotherapy. Yet, as this research shows, too many cancer patients are unaware of how podiatrists can help.
“Given the high prevalence of CIPN among cancer patients receiving chemotherapy, it’s vital that podiatry is not only included in routine oncology care but promoted among patients and clinicians to manage the symptoms of neuropathy-related foot complications.”
With no evidence-based prevention strategies to prevent or reverse CIPN, researchers say podiatry must play a more prominent role in cancer survivorship care.
“Early podiatric assessment could prevent falls, prevent ulcerations preceding amputations, reduce pain, and improve mobility – all of which have a huge impact on recovery and wellbeing.”
Further, no Australian guidelines exist for CIPN management and the only published clinical pathway for its management does not include podiatry services.
“There is a significant lack of awareness among cancer patients and treatment teams about the role of podiatry in cancer care,” Dars says.
“The high incidence of CIPN is well established, but with fewer than 20% of chemotherapy patients accessing podiatry services, there’s a concerning gap.
“Podiatry must hold a more prominent role in cancer care, and we must establish better referral pathways in oncology settings to ensure this inclusion.”
With consensus from Australian podiatrists, the research team has developed clinical recommendations on how best to care for and manage symptoms in people with CIPN. These recommendations are available online here: https://jfootankleres.biomedcentral.com/articles/10.1186/s13047-023-00632-0
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Contact for interview: Sindhrani (Rani) Dars E: sindhrani.dars@mymail.unisa.edu.au
Media contact: Annabel Mansfield M: +61 479 182 489 E: Annabel.Mansfield@unisa.edu.au
