A man in his 70s with stage III colon cancer presented to a new primary care clinician to establish care. His only symptoms were numbness and occasional tingling in his fingers and toes. Eight months before, he had completed 3 months of adjuvant chemotherapy with capecitabine and oxaliplatin. His symptoms had started during the last month of chemotherapy, worsened for 2 months, and remained stable since. He had trouble tying his shoes and putting up delicate Christmas ornaments with his grandchildren. His only medication was losartan. He had no other neurological deficits.