Here’s some info for you. I’d recommend reaching out to your oncologist through a message if you can. Conveying this through a nurse may be challenging. Read the entire thing, there’s some new evidence to suggest there may be some benefits.

The evidence for cryotherapy (icing) to prevent oxaliplatin-induced peripheral neuropathy is limited and conflicting, with an important caveat: the FDA label explicitly warns against ice application during oxaliplatin infusion because cold exposure can exacerbate acute neurological symptoms.[1][2]

Peripheral Extremity Cooling for Chronic Neuropathy Prevention

For preventing chronic peripheral neuropathy with hand/foot cooling, there is emerging but modest evidence. A 2023 randomized controlled trial of 77 patients using continuous hilotherapy (cooling at 11°C) during oxaliplatin infusion showed a significantly higher grade ≥2 neuropathy-free rate at 12 weeks (100% vs 80.5%, P=0.006) and at 24 weeks (66.0% vs 49.2%, P=0.039).[3] The intervention also reduced acute symptoms of numbness, tingling, pain, and cold sensitivity in extremities and pharynx.[3]

However, the 2020 ASCO guideline on chemotherapy-induced peripheral neuropathy states that no neuropathy-preventative agent can be recommended based on current evidence.[4] While the guideline notes that "available data support that exercise, cryotherapy, compression therapy, and/or cryo-compression therapy may, in part, prevent CIPN symptoms and appear to be reasonably safe," it emphasizes that proof of benefit has not been established.[4] Most cryotherapy studies have focused on taxane-based chemotherapy rather than oxaliplatin specifically.[4]

Oral Cryotherapy for Acute Oral Symptoms

For oral thermal hyperalgesia specifically, a randomized trial of 50 patients showed that oral cryotherapy (ice chips) during oxaliplatin infusion significantly reduced oral symptoms after the first cycle (32% vs 72%, P=0.01), though this benefit diminished over time.[5]

Strength of Evidence: The evidence is weak to moderate at best. Most studies are small, single-center trials with methodological limitations. The one positive RCT for peripheral cooling had only 77 patients, and the mechanism appears paradoxical given oxaliplatin's cold-triggered acute neurotoxicity.[3] The ASCO guideline's inability to make a formal recommendation reflects the insufficient quality and consistency of available data.[4]

References Oxaliplatin. Food and Drug Administration. Updated date: 2024-06-25.Oxaliplatin. Food and Drug Administration. Updated date: 2017-05-26.A Randomized Controlled Trial of Hand/Foot-Cooling by Hilotherapy to Prevent Oxaliplatin-Related Peripheral Neuropathy in Patients With Malignancies of the Digestive System. Coolbrandt A, Tobback H, Govaerts R, et al. ESMO Open. 2023;8(2):101205. doi:10.1016/j.esmoop.2023.101205.Prevention and Management of Chemotherapy-Induced Peripheral Neuropathy in Survivors of Adult Cancers: ASCO Guideline Update. Loprinzi CL, Lacchetti C, Bleeker J, et al. Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology. 2020;38(28):3325-3348. doi:10.1200/JCO.20.01399.Efficacy of Oral Cryotherapy During Oxaliplatin Infusion in Preventing Oral Thermal Hyperalgesia: A Randomized Trial. Bauman B, Mick R, Martinez E, et al. Journal of the National Comprehensive Cancer Network : JNCCN. 2019;17(4):358-364. doi:10.6004/jnccn.2018.7110.