What is your strategy to help prevent paclitaxel-related neuropathy?

There are no proven strategies for prevention of CIPN and the use of these supplements is not recommended. Some supplements such as acetyl carnitine can actually worsen neuropathy outcomes and some supplements such as B12, vitamin C, and others may negatively interact with chemotherapy and worsen disease outcomes (SWOG S0221, Ambersone et al., PMID 31855498). Please also refer to ASCO Neuropathy guidelines (Hershman et al., PMID 24733808, Loprinzi et al., PMID 32663120).

Regarding cooling and com...

Acupuncture and complementary medicine.

None. There is not yet data to support. If patients ask about them, I would say low likelihood of harm therefore I don't specifically recommend against, but I want to be mindful that there is the potential of financial toxicity - many CAM methods add up in price.

ASCO guideline for reference: Loprinzi et al. PMID 32663120.

Also, Dr. @Dr. First Last gave a great presentation at SGO 2022 (on Demand lecture) covering the topic, consistent with the info in the ASCO guideline.