As
you can see from our previous blogs, TENS treatment is thought to deal with a
variety of cancer pains. To make a well-rounded conclusion on the benefits, we
researched a number of studies looking at the patient’s responses to the
treatments on different cancers, specifically breast and bone cancer. As well
as an interesting topic, it was insightful to look into the pain responses of
different people and how they responded to TENS after intense chemo, radiation
or surgery.
We
viewed this research in a way as to determine whether TENS improved the quality
of life in the patients. As the palliative cancer patients and their families
know they are unlikely to recover from the disease, therefore their remaining
time should be as pain free as possible. If there is a chance of recovery, we believe
their energy should be focused on fighting the disease rather than focusing on the
pain.
The
two most reported causes of cancer pain are pain radiating from the cancer
itself and pain following chemotherapy and radiotherapy treatments. Although
insufficient evidence has been obtained, research shows that TENS can help
reduce side effects and the pain associated with a variety of cancers,
improving their quality of life. This is incredibly important to those
suffering from cancer, especially the terminally ill.
The
use of non-pharamolgical interventions such as TENS, as a multidisciplinary
treatment can reduce pain in cancer patients. Although insufficient trials have
been studied to provide evidence of the possible side effects and long-term use
of TENS on patients, many in palliative care consider pain relief and quality
of life the higher priority.
An
excellent randomized controlled trial conducted by Karen Robb, has identified the improved
quality of life, due to decreased anxiety and pain in women diagnosed with
breast cancer. She shows how many women who undergo treatment and are diagnosed
with the disease have reported feeling that their pain has not been completely
recognized or treated. Not only do these women suffer from the pain of the
surgery but also secondary pain due to oedema, sensory disturbances, anxiety
and depression, with many refusing pharmalogical medication due to the fear of unwanted
side effects.
This
is the reason why using TENS is an appealing alternative treatment, with a
decrease in the overall pain and side effects in patients undergoing
chemotherapy. Its use is said to increase the release of beta-endorphins in the
body. These endorphins have an analgesic effect, numbing or dulling pains in
the effected areas. The best results however, are found when combining
both pharmacological and non-pharmacological treatments.
In
some instances TENS treatment is preferred: similar pain relief is found with
limited side effects. One of these side effects of the cancer and its
chemotherapy is nausea and vomiting. Research has shown that
ALTENS can help significantly reduce these symptoms by inhibiting gastric
acid secretion and normalising gastric dysrhythmia. As a cancer patient,
reducing these symptoms will dramatically improve their quality of life, a
major factor that we believe most, if not all patients would happily welcome.
Another
prevalent type of cancer that uses TENS as a treatment option is bone cancer. Bone metastases are common,
difficult to treat and the most painful cancer-related pain. These factors are
all responsible for reducing a person’s quality of life. Many available
treatment options have significant side effects and are currently not
considered universally effective. Research
has said that by stimulating the fibres, hyperexcitability is
reduced as well as dorsal horn changes, decreasing the perception of pain.
However, sufficient evidence is still lacking to completely understand the
benefits of treating bone cancer and its symptoms with a TENS machine.
The
main disadvantage found in trials, and personal outcomes of TENS machine use,
was the fact that the benefits were only temporary. It is not designed for
total, long lasting pain relief, but considering the immense pain that cancer
patients undergo every single day, any relief would be accepted with open arms.
Also considering that TENS use is simple, portable and cheap, this disadvantage
is not that clinically important because it is so easy to apply multiple
treatments to increase the pain relief duration.
Through
research,
many papers found that the use of TENS machine as treatment was more
effective in certain areas of the body. The upper extremity was shown to
suppress pain more effectively than the lower extremity, with the truncal
region showing the greatest reduction in pain. This is one reason why we would
recommend treatment for those displaying symptoms from breast cancer. Some
cancers however cannot or are difficult to control through the use of TENS. No
evidence has been found to show pain relief or reduction in symptoms with
cancers occurring in the pelvic region. Treatment with TENS for cancers in the
head and neck are also discouraged and seen as a contraindication as this
treatment is considered dangerous, with application putting the coratid sinus
at risk.
Palliative
care however is not just restricted to cancer patients. A
study by Hall and Sykes, outlines the similar principles for pain
reduction on non-malignant diseases. These studies show that cardiac failure
and COPD patients, surveyed similar pain intensities to those with cancer and
therefore should be considered for TENS treatment.