Transcranial Magnetic Stimulation (TMS) in Cancer Care: A Scoping Review of Safety and Efficacy

Cancer remains a growing global health burden, with many survivors experiencing significant psychological symptoms such as fatigue, pain, anxiety, and depression. Noninvasive brain stimulation techniques such as rTMS have gained attention for their potential to modulate neural circuits implicated in pain perception, mood regulation, and fatigue. This scoping review aims to explore the current application, safety, and effectiveness of Transcranial Magnetic Stimulation (TMS) as a potential intervention to alleviate cancer-related and treatment-induced psychological symptoms. This scoping review followed Arksey and O'Malley's 5-stage framework and adhered to PRISMA-ScR guidelines. The review identified, selected, and charted data from eligible studies across 5 databases to explore the effects of repeated transcranial magnetic stimulation on individuals living with cancer. Between 2010 and 2025, 17 studies investigated rTMS in cancer populations, including single-arm trials, sham-controlled RCTs, case studies, and retrospective observational studies, with sample sizes ranging from 1 to 66 participants (total n=406). Participants were predominantly female (65.9%) and had diverse cancer types, stages, and treatment statuses, including completed treatment, active therapy, and palliative care. rTMS protocols varied in duration (5 d to 6 wk), session frequency, intensity (70% to 120% RMT), and coil placement, targeting motor cortex, dorsolateral prefrontal cortex, or frontoparietal networks. Safety outcomes were favorable, with no serious adverse events reported and only mild, transient side effects, though one case of postoperative seizure was noted. rTMS was generally feasible and well-tolerated, with participants reporting positive experiences and high adherence. Key efficacy findings included improvements in depression, anxiety, pain, quality of life, motor function, and chemotherapy-induced neuropathy, although follow-up periods and outcome measures were heterogeneous across studies. rTMS appears safe and promising for managing cancer-related symptoms, but larger, standardized, sham-controlled trials with long-term follow-up are needed to confirm its clinical value.