Side Effect: Tremors

What are Tremors?

Tremors are rhythmic, involuntary shaking or movement of body parts, such as from the hands, arms, head, or legs. Tremors can be mild or severe and can affect a person’s daily activities and quality of life.

What do Tremors look like?

Common symptoms of tremors may include:

• Rhythmic shaking of the hands, arms, head, legs, or torso
• Shaky voice
• Trouble with using a pen or pencil to write
• Problems with holding or controlling items such as a cup, tools, utensils or other items that require dexterity

Who gets Tremors?

Patients with cancer can develop tremors as a result of chemotherapy treatment or the disease itself. Chemotherapy drugs that cause peripheral neuropathy are a common cause of tremors. Tremors can also be a symptom of another type of movement disorder called tardive dyskinesia which can be caused by medications commonly prescribed for mood, nausea, such as Compazine (prochlorperazine), or from Pseudopephedrine (Sudafed®) found in cold and allergy medication.

Other causes of tremors include:

• Exposure to heavy metals, pesticides or organic solvents
• Too much caffeine
• Overactive thyroid
• High or low blood sugars
• Stress, anxiety, or fatigue

How to prevent Tremors

• Preventing tremors in patients with cancer depends on the cause of the tremor. Managing underlying comorbidities such as overactive thyroid and diabetes can help reduce the risk of tremors.
• Patients may also benefit from lifestyle modifications such as reducing caffeine intake, getting enough sleep, and practicing relaxation techniques during times of stress and anxiety.
• Patients who have tremors from certain medications should list these on their “Allergy/intolerance” list at their doctor’s office to avoid being prescribed similar medications.

How to treat Tremors

Treating tremors in patients with cancer depends on the cause.

• If tremors are causes by a medication, switching to a different medication or adjusting the dosage may help.
• Tremors that are caused by chemotherapy-induced peripheral neuropathy can be managed with certain medications such as gabapentin (Neurontin ®) and pregabalin (Lyrica ®).
• In some cases, beta-blockers, benzodiazepines, and antiseizure medications may be used to treat tremors.
• Physical therapy and occupational therapy may be recommended to help manage tremors and improve quality of life.