DALLAS -- January 25, 1999 -- Borrowing from the ancient practice of Chinese acupuncture, a newly developed electrical nerve-stimulation technique may help alleviate pain associated with cancer that has spread to bones, said researchers at UT Southwestern Medical Center at Dallas.
In the December issue of The Clinical Journal of Pain, UT Southwestern scientists detail findings that Percutaneous Electrical Nerve Stimulation (PENS), a technique that involves the insertion of acupuncture -- like needles into the soft tissue surrounding bones, produced significant acute pain relief in patients. During the procedure, a small electrical current is passed through the needles, apparently disrupting normal pain signals by stimulating local nerves.
Some cancers that spread to bone (bony metastases) can trigger severe chronic pain that is often unresponsive to analgesic drugs, including morphine. Researchers have found that PENS may reduce the need for narcotics and other more invasive procedures, such as spinal-cord stimulation, by becoming part of an interdisciplinary approach to treating pain associated with certain types of cancers and, eventually, other chronic conditions.
"Our goal is to complement, not eliminate, other pain-management techniques by introducing PENS as an integral part of a comprehensive patient-care program," said Dr. Paul White, professor of anesthesiology and pain management at UT Southwestern. "By helping patients avoid the side effects and expense of more invasive procedures, we feel PENS can improve the quality of life of patients suffering from some cancer-related pain. Our research is still very preliminary, but we're very excited about what it suggests and anticipate further success in future clinical trials."
In this anecdotal report, which details the cases of three patients treated with PENS, two of the patients -- one with prostate cancer and spinal metastases, and the other with rectal cancer with bone involvement -- reported a significant reduction in pain after only 30 minutes of stimulation. But the treatment failed to provide any marked relief for a third patient with metastatic gallbladder cancer who had no evidence of bone involvement.
"Although PENS does not appear to be as effective in treating patients whose cancer has not spread to the bones, we've seen very encouraging results in those with bony metastases," said White. "Pain is such a frustrating element to deal with, for both doctors and patients, which makes these preliminary findings all the more exciting. Any stride we can make in aiding the comfort of our patients, particularly those with terminal diseases, is an important one."
Other Eugene McDermott Center for Pain Management investigators involved in the project include UT Southwestern researchers Dr. Philip Huber, professor of GI/endocrine surgery; Dr. Hesham Ahmed, clinical pain research fellow; and Dr. William Craig, clinical assistant professor of anesthesiology and pain management.
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