title: Pilot evaluation of scrambler therapy for pain induced by bone and visceral metastases and refractory to standard therapies.
abstract: OBJECTIVE
  Scrambler therapy is a non-invasive neurocutaneous electrical pain intervention, effective for the treatment of neuropathic pain. Currently, few data about the efficacy of this treatment in cancer pain induced by skeletal and visceral metastases are available. The aim of this single-center case series is to evaluate the efficacy of scrambler therapy in reducing this kind of cancer pain after failure of standard treatments, including pharmacological therapies and radiation therapy.
  
  
  METHODS
  Twenty-five consecutive patients underwent scrambler therapy individually delivered by MC5-A Calmare for 10 daily sessions each of 30-40 min. Pain was measured by a numeric rating scale at baseline, as well as before and after each treatment session.
  
  
  RESULTS
  One hundred percent of patients reached a pain relief ≥50 %. Pain score was reduced from 8.4 at baseline to 2.9 after treatment, with a mean pain relief of 89 %. The sleeping hours improved from 4.4 ± 1.2 to 7.5 ± 1.1. The duration of pain control by scrambler therapy was 7.7 ± 5.3 weeks. No adverse events were observed.
  
  
  CONCLUSIONS
  Scrambler therapy does not present toxicity and allows opioids dosage reduction, and it is also a repeatable treatment. Present novel data support that scrambler therapy seems to be effective for the treatment of cancer pain. Further evaluation in randomized and controlled clinical trials should be performed to confirm our findings.
authors.affiliation: Pain Medicine, Dipartimento di Anestesiologia- Ospedale Niguarda Ca' Granda, Milano, Italy. paolo.notaro@ospedaleniguarda.it.|Dipartimento di Terapia del dolore, Ospedale Niguarda Ca' Granda, Piazza Ospedale Maggiore, 3-20162, Milano, Italy. paolo.notaro@ospedaleniguarda.it.
authors.forename: Paolo
authors.initials: P
authors.lastname: Notaro
authors.affiliation: Pain Medicine, Dipartimento di Anestesiologia- Ospedale Niguarda Ca' Granda, Milano, Italy.
authors.forename: Carlo Alberto
authors.initials: CA
authors.lastname: Dell'Agnola
authors.affiliation: Pain Medicine, Dipartimento di Anestesiologia- Ospedale Niguarda Ca' Granda, Milano, Italy.
authors.forename: Alessandro J
authors.initials: AJ
authors.lastname: Dell'Agnola
authors.affiliation: Dipartimento di Ematologia e Oncologia, Niguarda Cancer Center, Ospedale Niguarda Ca' Granda, Milano, Italy.
authors.forename: Alessio
authors.initials: A
authors.lastname: Amatu
authors.affiliation: Dipartimento di Ematologia e Oncologia, Niguarda Cancer Center, Ospedale Niguarda Ca' Granda, Milano, Italy.
authors.forename: Katia Bruna
authors.initials: KB
authors.lastname: Bencardino
authors.affiliation: Dipartimento di Ematologia e Oncologia, Niguarda Cancer Center, Ospedale Niguarda Ca' Granda, Milano, Italy.
authors.forename: Salvatore
authors.initials: S
authors.lastname: Siena
mesh_terms: D000328:Adult; D000368:Aged; D001859:Bone Neoplasms / Q000150:complications / Q000556:secondary; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009369:Neoplasms / Q000150:complications* / Q000628:therapy*; D059408:Pain Management / Q000379:methods*; D010147:Pain Measurement / Q000379:methods; D010865:Pilot Projects; D012189:Retrospective Studies
keywords: Calmare®; Electroanalgesia; Metastatic bone and visceral pain; Scrambler therapy; Untreatable cancer pain