Transcranial Magnetic Stimulation (TMS) for Smoking Cessation in Cancer Survivors: A Path Forward

Area of Science:

• Oncology
• Neuromodulation
• Addiction Medicine

Background:

• Cigarette smoking post-cancer diagnosis worsens outcomes, including mortality and treatment toxicity.
• Sustained smoking cessation is a significant challenge for cancer survivors.
• Cancer survivors often have comorbid conditions like depression and anxiety, which TMS can treat.

Purpose of the Study:

• To propose a framework for adapting transcranial magnetic stimulation (TMS) protocols for smoking cessation in cancer survivors.
• To address the unique clinical needs of cancer populations for effective smoking cessation interventions.
• To outline a roadmap for developing optimized TMS interventions for this group.

Main Methods:

• Proposing a stakeholder-engaged adaptation framework involving patients, clinicians, and specialists.
• Discussing procedural adaptations like flexible dosing and accelerated protocols.
• Considering secondary outcomes, implementation, and potential barriers.

Main Results:

• A systematic framework for adapting TMS protocols for cancer survivors is proposed.
• Key considerations for protocol adaptation, including flexible scheduling and outcome measures, are outlined.
• Anticipated barriers and solutions for integrating TMS into oncology care are identified.

Conclusions:

• A stakeholder-engaged framework is essential for adapting TMS for cancer survivor smoking cessation.
• Optimized TMS protocols are needed to improve cessation rates in this vulnerable population.
• This framework provides a roadmap for developing equitable and effective TMS interventions.