Can immunotherapy cause numbness as a side effect?

Yes, immunotherapy can sometimes affect the nerves in the hands and feet, leading to numbness or tingling (peripheral neuropathy). Some immune-based treatments, including checkpoint inhibitors, have been associated with nerve-related side effects that may feel like pins-and-needles, burning, reduced sensation, or weakness in the fingers and toes. ^[1] These symptoms can be temporary, but in some cases they may persist longer, and your care team can offer treatments to ease them. ^[2]

What this numbness feels like

• Tingling, numbness, burning, or pain in the fingers or toes (sometimes both). ^[3]
• Trouble with fine motor tasks, such as buttoning a shirt or holding a pen. ^[3]
• Balance or walking difficulties, including trouble feeling the ground. ^[3]

If you’re receiving CAR‑T cell therapy, neurologic side effects can also occur; while confusion, word-finding issues, tremors, or seizures are more typical, numbness in hands and feet has been reported as part of neurologic toxicity in some settings. ^[4]

Why it happens

Immune therapies can, in some people, inflame or disrupt nerve function, leading to peripheral neuropathy (nerve damage outside the brain and spinal cord). ^[5] This is less common than with certain chemotherapies, but it is a recognized immune‑related adverse event. ^[5]

When to contact your care team

• Worsening tingling or numbness or symptoms spreading. ^[6]
• New difficulty with daily tasks (grasping, buttoning, typing). ^[6]
• Trouble walking or keeping balance or not feeling the ground. ^[6]
  Prompt reporting allows your team to grade severity and adjust treatment or prescribe medications to control symptoms. ^[2]

How to cope day to day

• Stay active with gentle exercise. Regular movement can help circulation and nerve health. ^[7]
• Avoid alcohol and stop smoking to reduce nerve stress. ^[7]
• Keep hands and feet warm with gloves and thick socks in cold weather. ^[7]
• Protect your skin from burns. Use oven mitts, test water temperature, and be cautious with heating pads. ^[7]
• Choose supportive, non‑slip footwear to reduce fall risk when sensation is decreased. ^[8]
• Ask about acupuncture as an adjunct option for symptom relief. ^[8]

Your clinician may also offer medications (for example, those used for neuropathic pain) to ease tingling, burning, or discomfort. ^[2]

Safety tips at home

• Use night lights, non‑slip mats, and handrails to prevent falls. ^[8]
• Inspect feet daily for blisters or injuries you might not feel due to numbness. ^[7]
• Moisturize hands and feet to maintain skin integrity and reduce cracking. ^[9]

Treatment adjustments and medical management

If neuropathy is suspected to be immune‑related, clinicians generally:

• Assess severity, rule out other causes (diabetes, vitamin deficiencies, spine issues), and grade the toxicity. ^[5]
• Modify or pause immunotherapy depending on severity and functional impact. ^[5]
• Initiate supportive medications for neuropathic symptoms, and in selected immune‑mediated cases, consider anti‑inflammatory strategies based on clinical guidelines. ^{[2] [5]}

Quick reference table

Topic	What to watch for	What you can do
Early symptoms	Tingling, numbness, burning in fingers/toes	Report changes early to your team; start gentle exercises
Function changes	Trouble buttoning, writing, or walking	Use assistive devices, choose supportive shoes, fall-proof your home
Comfort	Cold sensitivity in hands/feet	Wear gloves/warm socks, avoid alcohol, stop smoking
Safety	Risk of burns or injuries you can’t feel	Test water temp, use oven mitts, inspect skin daily, use non-slip mats
Medical help	Worsening or spreading symptoms	Ask about medications, physical therapy, and whether treatment needs adjustment

Bottom line

• Immunotherapy can cause numbness or tingling due to nerve effects in some people. Early recognition and communication with your care team are important. ^[1]
• There are practical self‑care steps and medical treatments that can help you feel safer and more comfortable, and your team can guide if therapy adjustments are needed. ^{[7] [2] [5]}