Transcutaneous electric nerve stimulation (TENS) for cancer pain in adults

Abstract

Background Cancer-related pain is complex and multi-dimensional but the mainstay of cancer pain management has predominately used a biomedical approach. There is a need for non-pharmacological and innovative approaches. Transcutaneous Electric Nerve Stimulation (TENS) may have a role for a significant number of patients but the effectiveness of TENS is currently unknown. Transcutaneous electric nerve stimulation (TENS) for cancer pain in adults (Review)

Pilot Trial of a Patient-Specific Cutaneous Electrostimulation Device (MC5-A Calmare®) for Chemotherapy-Induced Peripheral Neuropathy

“…25 Placebo was no different from TENS in the two randomized trials for cancer pain treatment. 26 The 59% reduction in pain scores observed here with the MC5-A Calmare ® is much larger than the improvement reported in the aforementioned placebo-controlled trials and is similar to the other trials of MC5-A Calmare ® therapy 17,18 (Marineo et al, unpublished data,) that observed with direct nerve stimulation, 11–15 and that observed with the infusion of a local anesthetic plus opioid into the spinal fluid. 22 There are no data from nonspecific TENS in CIPN; 27 hence, we cannot make any comparisons.…”

Pilot Trial of a Patient-Specific Cutaneous Electrostimulation Device (MC5-A Calmare®) for Chemotherapy-Induced Peripheral Neuropathy

“…25 Placebo was no different from TENS in the two randomized trials for cancer pain treatment. 26 The 59% reduction in pain scores observed here with the MC5-A Calmare ® is much larger than the improvement reported in the aforementioned placebo-controlled trials and is similar to the other trials of MC5-A Calmare ® therapy 17,18 (Marineo et al, unpublished data,) that observed with direct nerve stimulation, 11–15 and that observed with the infusion of a local anesthetic plus opioid into the spinal fluid. 22 There are no data from nonspecific TENS in CIPN; 27 hence, we cannot make any comparisons.…”

Acupuncture for cancer pain: a scoping review of systematic reviews and meta-analyses

“…The included reviews comprised the following study designs: RCT(18/25) ( 24 – 26 , 28 , 29 , 31 , 33 , 36 – 45 , 47 ), RCT and qRCT (7/25) ( 15 , 27 , 30 , 32 , 34 , 35 , 46 ). 22 reviews did not show the specific cancer pain diagnosis standard, and only 3 reviews presented disease diagnosis standard ( 25 , 36 , 41 ). As the type of cancer, 23 reviews showed multi-type cancer, and only 2 reviews referred to specific cancer, lung cancer and liver cancer ( 28 , 46 ).…”

“…In this scoping review, 25 systematic reviews of acupuncture for cancer pain management were included, which evaluated numerous primary studies with various study designs and qualities. They were published from 2005 to 2021: 18 were conducted in China, 5 in the UK ( 24 , 31 , 33 , 40 , 41 ), 2 in Korea ( 32 , 42 ), and 1 in the USA ( 30 ). And, 24 out of 26 included reviews that covered multi-types of cancer; 1 included liver cancer from 2005 to 2021 ( 28 ), and 1 systematic review of lung-cancer-only reported negative results, without positive results from others ( 31 ).…”

“…As for interventions, a few systematic reviews sought a broad definition of acupuncture, and many sorts of acupuncture interventions were included: 20 reviews targeted at intervention compounded of two or more sorts of acupuncture, and only 6 systematic reviews confined to single interventions ( 24 , 30 , 31 , 39 – 41 ). Some reviews reported that compounded intervention of acupuncture has superior effectiveness than a single intervention ( 32 , 44 , 48 ).…”

Dose-specific Effects of Transcutaneous Electrical Nerve Stimulation (TENS) on Experimental Pain

“…6 Moderate evidence was also found regarding the lack of effect of inappropriate TENS doses where parameters included just perceptible intensities or had a small pulse duration. This finding underpins the importance of appropriate parameter selection 22,118 and may underlie the results of negative trials (including clinical trials) that, although methodologically robust, use inadequate stimulation dosages of TENS.…”

Pilot Trial of a Patient-Specific Cutaneous Electrostimulation Device (MC5-A Calmare®) for Chemotherapy-Induced Peripheral Neuropathy

“…25 Placebo was no different from TENS in the two randomized trials for cancer pain treatment. 26 The 59% reduction in pain scores observed here with the MC5-A Calmare ® is much larger than the improvement reported in the aforementioned placebo-controlled trials and is similar to the other trials of MC5-A Calmare ® therapy 17,18 (Marineo et al, unpublished data,) that observed with direct nerve stimulation, 11–15 and that observed with the infusion of a local anesthetic plus opioid into the spinal fluid. 22 There are no data from nonspecific TENS in CIPN; 27 hence, we cannot make any comparisons.…”

Acupuncture for cancer pain: a scoping review of systematic reviews and meta-analyses

“…The included reviews comprised the following study designs: RCT(18/25) ( 24 – 26 , 28 , 29 , 31 , 33 , 36 – 45 , 47 ), RCT and qRCT (7/25) ( 15 , 27 , 30 , 32 , 34 , 35 , 46 ). 22 reviews did not show the specific cancer pain diagnosis standard, and only 3 reviews presented disease diagnosis standard ( 25 , 36 , 41 ). As the type of cancer, 23 reviews showed multi-type cancer, and only 2 reviews referred to specific cancer, lung cancer and liver cancer ( 28 , 46 ).…”

“…In this scoping review, 25 systematic reviews of acupuncture for cancer pain management were included, which evaluated numerous primary studies with various study designs and qualities. They were published from 2005 to 2021: 18 were conducted in China, 5 in the UK ( 24 , 31 , 33 , 40 , 41 ), 2 in Korea ( 32 , 42 ), and 1 in the USA ( 30 ). And, 24 out of 26 included reviews that covered multi-types of cancer; 1 included liver cancer from 2005 to 2021 ( 28 ), and 1 systematic review of lung-cancer-only reported negative results, without positive results from others ( 31 ).…”

“…As for interventions, a few systematic reviews sought a broad definition of acupuncture, and many sorts of acupuncture interventions were included: 20 reviews targeted at intervention compounded of two or more sorts of acupuncture, and only 6 systematic reviews confined to single interventions ( 24 , 30 , 31 , 39 – 41 ). Some reviews reported that compounded intervention of acupuncture has superior effectiveness than a single intervention ( 32 , 44 , 48 ).…”

Dose-specific Effects of Transcutaneous Electrical Nerve Stimulation (TENS) on Experimental Pain

“…6 Moderate evidence was also found regarding the lack of effect of inappropriate TENS doses where parameters included just perceptible intensities or had a small pulse duration. This finding underpins the importance of appropriate parameter selection 22,118 and may underlie the results of negative trials (including clinical trials) that, although methodologically robust, use inadequate stimulation dosages of TENS.…”

Pilot Trial of a Patient-Specific Cutaneous Electrostimulation Device (MC5-A Calmare®) for Chemotherapy-Induced Peripheral Neuropathy

“…25 Placebo was no different from TENS in the two randomized trials for cancer pain treatment. 26 The 59% reduction in pain scores observed here with the MC5-A Calmare ® is much larger than the improvement reported in the aforementioned placebo-controlled trials and is similar to the other trials of MC5-A Calmare ® therapy 17,18 (Marineo et al, unpublished data,) that observed with direct nerve stimulation, 11–15 and that observed with the infusion of a local anesthetic plus opioid into the spinal fluid. 22 There are no data from nonspecific TENS in CIPN; 27 hence, we cannot make any comparisons.…”

Acupuncture for cancer pain: a scoping review of systematic reviews and meta-analyses

“…The included reviews comprised the following study designs: RCT(18/25) ( 24 – 26 , 28 , 29 , 31 , 33 , 36 – 45 , 47 ), RCT and qRCT (7/25) ( 15 , 27 , 30 , 32 , 34 , 35 , 46 ). 22 reviews did not show the specific cancer pain diagnosis standard, and only 3 reviews presented disease diagnosis standard ( 25 , 36 , 41 ). As the type of cancer, 23 reviews showed multi-type cancer, and only 2 reviews referred to specific cancer, lung cancer and liver cancer ( 28 , 46 ).…”

“…In this scoping review, 25 systematic reviews of acupuncture for cancer pain management were included, which evaluated numerous primary studies with various study designs and qualities. They were published from 2005 to 2021: 18 were conducted in China, 5 in the UK ( 24 , 31 , 33 , 40 , 41 ), 2 in Korea ( 32 , 42 ), and 1 in the USA ( 30 ). And, 24 out of 26 included reviews that covered multi-types of cancer; 1 included liver cancer from 2005 to 2021 ( 28 ), and 1 systematic review of lung-cancer-only reported negative results, without positive results from others ( 31 ).…”

“…As for interventions, a few systematic reviews sought a broad definition of acupuncture, and many sorts of acupuncture interventions were included: 20 reviews targeted at intervention compounded of two or more sorts of acupuncture, and only 6 systematic reviews confined to single interventions ( 24 , 30 , 31 , 39 – 41 ). Some reviews reported that compounded intervention of acupuncture has superior effectiveness than a single intervention ( 32 , 44 , 48 ).…”

Dose-specific Effects of Transcutaneous Electrical Nerve Stimulation (TENS) on Experimental Pain

“…6 Moderate evidence was also found regarding the lack of effect of inappropriate TENS doses where parameters included just perceptible intensities or had a small pulse duration. This finding underpins the importance of appropriate parameter selection 22,118 and may underlie the results of negative trials (including clinical trials) that, although methodologically robust, use inadequate stimulation dosages of TENS.…”