Feeling ‘cotton balls’ a common sensation

Dear Dr. Roach: I’m a 63-year-old male diagnosed with chronic myelogenous leukemia, Type 2 diabetes and coronary heart disease. I am 5 feet, 11 inches and weigh 240 pounds. I have two stents and take Sprycel for the CML. My levels are good, and the coronary disease is under control.

For a few years I’ve had what feels like “cotton balls” under the skin in the area of the balls of my feet. Now it feels as if the feeling is migrating to the arch. While not too uncomfortable, it is almost impossible to walk barefooted. Some type of foot covering is needed to keep from noticing the feeling. My doctor says it’s the diabetes, and to lose weight or see a podiatrist. Other than losing the weight, do you have any feeling about this? — N.M.

Cotton-ball sensation is one way that many people describe the beginning of neuropathy, a general term for a variety of different conditions that affect the nerves of the body.

In a person with cancer (like CML, chronic myelogenous leukemia, a cancer of the bone marrow) and a new symptom, it is always wise to consider whether it could be due to the cancer, the treatment for the cancer or from something else. In your case, usually CML is not associated with neuropathy. However, the medicine you are taking, dasatinib (Sprycel), has been associated with a severe kind of reversible neuropathy. I read the case reports of this condition carefully, and I doubt that is what is going on with you.

People with longstanding diabetes frequently develop a particular disease of the nerves, diabetic neuropathy. This almost always begins with sensation changes in the feet. I agree with your doctor that diabetes is the most likely cause.

Seeing a podiatrist is absolutely a good idea and be sure your diabetes is under control.