title: The use of transcutaneous electrical nerve stimulation (TENS) in a major cancer center for the treatment of severe cancer-related pain and associated disability.
abstract: BACKGROUND
  Cancer pain is difficult to treat, often requiring a multimodal approach. While medication management remains the mainstay for the treatment of cancer pain, medications are often associated with undesired side effects. Transcutaneous electrical nerve stimulation (TENS) provides a potential adjunctive method for treating cancer pain with minimal side effects.
  
  
  OBJECTIVE
  Few studies have been performed evaluating the efficacy of TENS on cancer pain. We sought to examine the usefulness of TENS on all cancer patients and to specifically look at the use of TENS as a goal-directed therapy to improve functionality.
  
  
  METHODS
  Retrospective cohort study.
  
  
  METHODS
  Since 2008, patients with chronic cancer pain and on multimodal pain regimens were trialed with TENS. Those patients who showed an improvement in pain symptoms or severity were educated about and provided with a TENS unit for use at home. Pain symptoms and scores were monitored with the visual analog scale (VAS), the numerical rating pain (NRP) scale, and Short-Form McGill Questionnaire at the start of TENS treatment and at 2 months follow-up.
  
  
  RESULTS
  TENS proved beneficial in 69.7% of patients over the course of 2 months. In TENS responsive patients, VAS scores decreased by 9.8 on a 0-100 mm scale (P < 0.001), and NRP scores decreased by 0.8 on a 1-10 scale (P < 0.001).
  
  
  CONCLUSIONS
  Lack of placebo and lack of blinding of physician and patient.
  
  
  CONCLUSIONS
  TENS provides a beneficial adjunct for the treatment of cancer pain, especially when utilized as a goal-directed therapy.
authors: Department of Anesthesiology, University of California Los Angeles, Los Angeles, California, USA.
authors: Jeffrey
authors: J
authors: Loh
authors: Department of Anesthesiology and Critical Care, Board Certified in Anesthesiology and Pain management, Memorial Sloan Kettering Cancer Center, New York, New York, USA.
authors: Amitabh
authors: A
authors: Gulati
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D015331:Cohort Studies; D006233:Persons with Disabilities; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*; D010146:Pain / Q000175:diagnosis / Q000453:epidemiology; D059408:Pain Management / Q000379:methods*; D010147:Pain Measurement / Q000379:methods; D012189:Retrospective Studies; D012720:Severity of Illness Index; D004561:Transcutaneous Electric Nerve Stimulation / Q000706:statistics & numerical data*; D016896:Treatment Outcome; D055815:Young Adult
keywords: Cancer Pain; Goal-Directed Therapy; Outcomes; Pain Management; Retrospective Review; Transcutaneous Electrical Nerve Stimulation