Beyond Tumor Treating Fields: Multimodal Antitumor Action and the Clinical Potential of Pulsed Electromagnetic Fields

Pulsed electromagnetic fields (PEMFs) are a noninvasive, safe, and well-tolerated physical therapy modality with established applications in musculoskeletal disorders. Their potential role in oncology has attracted increasing interest. This review synthesizes current evidence on the antitumor mechanisms and experimental effects of PEMFs across diverse cancer models. Reported biological effects include the induction of apoptosis, regulation of intracellular calcium homeostasis, inhibition of angiogenesis, modulation of immune responses, induction of oxidative stress, regulation of autophagy and cellular metabolism, and enhancement of sensitivity to radiotherapy and chemotherapy. Preclinical studies suggest that PEMFs can selectively suppress proliferation and promote cell death in malignant cells while exerting comparatively limited cytotoxicity in normal cells. Evidence has been reported in models of breast cancer, glioma, hepatocellular carcinoma, melanoma, and other malignancies. Although clinical investigations remain preliminary, studies conducted over the past two decades support a favorable safety profile and suggest potential therapeutic efficacy, particularly in combination with chemotherapy, radiotherapy, or immunotherapy. Artificial intelligence and machine learning may facilitate parameter optimization and the development of individualized treatment regimens. Ultimately, the integration of PEMFs into routine oncology practice will require well-designed, large-scale randomized controlled trials to standardize treatment protocols, define clinical indications, and establish their role in multimodal cancer care.