title: Pilot study of cranial stimulation for symptom management in breast cancer.
abstract: OBJECTIVE
  To examine the feasibility, relationships among variables, and preliminary outcomes of a self-directed complementary modality, cranial electrical stimulation (CES), for symptom management in women receiving chemotherapy for breast cancer.
  
  
  METHODS
  Biobehavioral pilot feasibility study.
  
  
  METHODS
  Two university-based cancer centers.
  
  
  METHODS
  36 women with stage I-IIIA breast cancer scheduled to receive chemotherapy.
  
  
  METHODS
  Data were collected via interview, questionnaires, and interactive voice technology (IVR). Biomarkers were measured from a blood sample taken prior to the initial chemotherapy.
  
  
  METHODS
  Symptoms of depression, anxiety, fatigue, pain, and sleep disturbances; biomarkers (proinflammatory cytokines interleukin-6, tumor necrosis factor alpha [TNF-alpha], interleukin-1 beta) and C-reactive protein [CRP]); and CES.
  
  
  RESULTS
  CES appears to be a safe and acceptable modality during chemotherapy. Recruitment and retention were adequate. IVR was associated with missing data. Symptoms of depression, anxiety, fatigue, and sleep disturbances were highly correlated with each other, and most symptoms were correlated with CRP at baseline. Depression and TNF-alpha had a positive, significant relationship. Levels of depression increased over time and trended toward less increase in the CES group; however, the differences among groups were not statistically significant.
  
  
  CONCLUSIONS
  The data support the feasibility of CES. Further testing in larger samples is needed to examine the efficacy of CES for symptom management of multiple, concurrent symptoms and to further develop the biobehavioral framework.
  
  
  CONCLUSIONS
  Interventions that are effective at minimizing more than one target symptom are especially needed to provide optimal symptom management for women with breast cancer.
authors.affiliation: School of Nursing, Virginia Commonwealth University, Richmond, USA. delyon@vcu.edu
authors.forename: Debra E
authors.initials: DE
authors.lastname: Lyon
authors.forename: Christine
authors.initials: C
authors.lastname: Schubert
authors.forename: Ann Gill
authors.initials: AG
authors.lastname: Taylor
mesh_terms: D000328:Adult; D018943:Anthracyclines / Q000009:adverse effects*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects*; D001007:Anxiety / Q000451:nursing / Q000628:therapy; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000451:nursing*; D003863:Depression / Q000451:nursing / Q000628:therapy; D005221:Fatigue / Q000451:nursing / Q000628:therapy; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008875:Middle Aged; D010146:Pain / Q000451:nursing; D059408:Pain Management; D017060:Patient Satisfaction; D010865:Pilot Projects; D011446:Prospective Studies; D012893:Sleep Wake Disorders / Q000451:nursing / Q000628:therapy; D011795:Surveys and Questionnaires; D050781:Transcranial Magnetic Stimulation / Q000451:nursing*
chemical_list: D018943:Anthracyclines