Electrotherapy in Oncology Rehabilitation: Current Evidence, Safety Considerations, and Future Perspectives

Background/Objectives: As cancer survival improves, rehabilitation has become an increasingly important component of comprehensive oncology care, addressing the growing burden of treatment-related impairments. Although electrotherapy modalities are widely used in Physical and Rehabilitation Medicine, their application in oncology remains controversial because of persistent concerns regarding safety and potential interactions with tumor biology. This narrative review critically evaluates the current evidence regarding the clinical applications, safety, contraindications, and therapeutic potential of electrotherapy modalities in oncology rehabilitation. Methods: A structured literature search was performed in PubMed, Scopus, and Web of Science for studies published between January 2000 and March 2026. Evidence from randomized controlled trials, observational studies, systematic reviews, meta-analyses, clinical practice guidelines, consensus statements, and narrative reviews was analyzed. Results: The strongest clinical evidence supports transcutaneous electrical nerve stimulation (TENS), photobiomodulation (PBM)/low-level laser therapy (LLLT), neuromuscular and functional electrical stimulation (NMES/FES), Deep Oscillation Therapy, and extracorporeal shock wave therapy (ESWT) for selected supportive indications in oncology rehabilitation. Therapeutic ultrasound, pulsed electromagnetic field therapy (PEMF), repetitive transcranial magnetic stimulation (rTMS), Multiwave Locked System (MLS) laser, and shortwave diathermy show promising but still limited clinical evidence, whereas oncology-specific evidence remains insufficient for interferential currents, diadynamic currents, high-intensity laser therapy (HILT), Super Inductive System (SIS), and transfer of capacitive and resistive energy (TECAR) therapy. Conclusions: Electrotherapy in oncology rehabilitation should be considered a prescription-based therapeutic intervention rather than a group of interchangeable physical modalities. As with pharmacological therapy, treatment efficacy and safety depend on selecting the appropriate modality, establishing the correct indication, and prescribing appropriate dosimetry and treatment parameters. Current evidence supports an individualized, evidence-informed approach that integrates the biological effects of each modality with the patient's oncological status, rehabilitation goals, and overall clinical condition, with the ultimate aim of improving function, symptom control, and quality of life.