Transcutaneous electrical nerve stimulation for treatment of sarcoma cancer pain

SUMMARY

Pain is often the initial presenting symptom with sarcomas. Upon resection of a sarcoma, most patients experience a resolution of their pain. However, in those patients with continued pain, treatment often requires multiple medications with moderate benefit.

The authors present eight patients who suffer from continued sarcoma-related pain following resection of their initial cancer.

For each patient, we describe the use of transcutaneous electrical nerve stimulation (TENS) for the treatment of sarcoma-related pain. Each patient was brought to the pain clinic for an initial four-lead trial of TENS lasting 30 min to determine the TENS setting that provided greatest pain relief. Patients were educated about the application and use of their TENS unit, which they self-utilized at home. Patients' pain response was monitored prior to the initial TENS trial and after 2 months of TENS use.

Seven out of eight patients had a qualitative or quantitative reduction in their sarcoma-related pain. Three out of the seven patients demonstrated clinically significant (>30%) pain relief, while the other four patients demonstrated increased physical functionality and pain relief, during movement and rest. No patients experienced any adverse effects; however, TENS was stopped in one patient who had a beneficial response to TENS as that patient was found to have recurrent, widespread metastases of her sarcoma.

Initial results indicate that TENS provides an easy-to-use, inexpensive therapeutic tool that can be used an adjunct in the treatment of sarcoma-related cancer pain. Future studies consisting of a large, randomized trial will be necessary to validate the efficacy of TENS in this patient population.