Effective Neuropathy Treatment with Tango in Cancer Patients Who Undergo Chemo
Following Chemo, cancer survivors could get a prescription to Tango for an effective Neuropathy treatment.
Chemotherapy is a powerful tool that extends the lives of cancer patients, but until recently, added time was measured in months, not years. Now, more Americans are living with cancer or defeating it entirely – something I couldn't have imagined 20 years ago. Those survivors have reason to celebrate, but some also face new challenges from the treatments that saved their lives.
Chemo drugs destroy cancer cells, but they can also damage some healthy ones in the process. Nerve cells in the extremities get hit especially hard, and as the feet and hands lose sensation, balance becomes difficult. At the hospital, we'll see a patient leave free of cancer, only to return a week later having suffered a fall at their celebration dinner.
The nerve damage is a condition called chemotherapy-induced peripheral neuropathy, and it affects nearly 70 percent of chemo patients immediately after their treatments end. While many improve, nearly one in three survivors continue to struggle with weakened balance and other effects long after the cancer is defeated.
Now, research done by myself and colleagues at both The Ohio State University Wexner Medical Center’s Neurological Institute and The Ohio State University Comprehensive Cancer Center suggests that learning dance may reverse that trend, potentially cutting the risk for falls by more than 50 percent.
Tango for Neuropathy Treatment
Nerve damage is not easily reversed — in most cases, it's not even possible — but physical therapy can help cancer survivors regain control of their bodies despite limited sensation, and restore muscle tone lost as the illness progressed. Unfortunately, some patients find physical therapy frustrating and isolating. They want to do the work, but they need motivation and distraction. Dance is the perfect solution.
As a biomechanist and rehabilitation scientist, I study the math and science of movement, and as a dancer I study movement as an art. It's a natural combination, as both art and science are creative endeavors. A few years ago, I shared some of my work from the rehabilitation lab with students at Ohio State’s Department of Dance, where I had once trained. After the presentation, I met Mimi Lamantia, a dance student with aspirations for a similar medical career path to my own.
Mimi soon joined me in the lab, and began researching the problem of cancer survivors struggling to regain balance after developing neuropathy. We decided to design a small study to see if we could improve those patients' recoveries using dance, with Mimi earning a fellowship from Pelotonia—an organization well known for supporting highly creative cancer research— that covered the expenses.
When determining which dance to test, Argentine tango emerged as the clear answer. It's a walking dance and a wide range of studies suggest it's a powerful tool for improving balance among the elderly and among individuals with Parkinson’s disease.
The movements involve a lot of swaying, walking forward and walking backward, walking side to side. It's exactly what you would want to practice in physical therapy for balance. As importantly, it can be done with a partner, someone who can encourage the patient to never give up.
It's ok to start with two left feet
Learning dance can be difficult enough for some people, but if you're unable to sense your feet as they touch the ground, any movement can seem impossible.
Then consider what it would be like to stand on one seemingly "missing" foot – we take it for granted every day, but walking and dance alike require us to place all of our weight on a single foot, constantly. Through Argentine tango, and its slow, walking movements, patients learn to be aware of their entire bodies, from head to toe, within the context of many new sensations.
Studies have shown that doctors can predict how likely a person is to suffer from falls by evaluating how well that person — with their eyes closed — can control movement during quiet standing, something we call medialateral sway.
At the start of our research, balance issues plagued our patients. They could not recover from swaying, as their brains were not getting enough information from the nerves in the bottoms of their feet. Our patients could be walking down the sidewalk, and if they get jostled, they can't come back to center and control the sway, leading to falls.
To gauge how bad the initial problem was for each study participant, we gathered data from a device we call a force platform. It has four strain gauges, one on each corner, and it rises only about an inch off the ground. The patient stands on the platform, closing both eyes for 30 seconds to a minute, while computers record how much the person sways. The sway can be quite large.
Filling out the dance card
Then, for the next 20 weeks, Mimi taught our study participants the Argentine tango. Lessons started simply, but this was the real dance, not something modified for treatment. Ultimately improvising their own movements from the dance's varied steps, the patients were now students, and when the study ended, they took their new skills with them.
After just 5 weeks, one patient had already improved his/her balance by an average of 56 percent. After 20 weeks of Argentine tango, patients were much more able to control their medialateral sway. There are many studies pointing out how emotional well-being improves cancer recovery, and our quantified data appear to add weight to that evidence. For our dancers, the transformation was more than better stability – they also reported having more energy after class, commonly using the word “invigorated” to describe what it felt like to practice Argentine tango.
The research results are promising, and while more data will help us better understand what we've seen, it is rare to have the opportunity to bring together a team of oncologists, rehabilitation experts and professionally trained dancers to complete an analysis of how art and expression impact cancer recovery. We were able to show, quantitatively, that Argentine tango lessons led to a change in the way patients control their bodies and the way they respond to the unexpected.
We have just returned from presenting the results at the American Congress of Rehabilitation Medicine conference in early November. Hopefully, the findings will convince other rehabilitators that creativity is as critical for medicine as it is for art, and when those disciplines come together, the results can be life-changing.
Lise Worthen-Chaudhari is a physical rehabilitation specialist at The Ohio State University Wexner Medical Center.