Scrambler therapy for the treatment of chronic post-mastectomy pain (cPMP) in breast cancer survivors.

Authors

null

Thomas J. Smith

Johns Hopkins Medical Institutions, Baltimore, MD

Thomas J. Smith, Charles L. Loprinzi, Andrea L. Cheville

Organizations

Johns Hopkins Medical Institutions, Baltimore, MD, Mayo Clinic, Rochester, MN

Research Funding

Other

Background: cPMP is chronic pain in the front thorax, axilla, and/or upper half of the arm beginning after mastectomy or lumpectomy persisting > 3 months after treatment and presents with pain, allodynia and disability. cPMP occurs in half of all patients with breast cancer and is severe in 13% (Gartner R JAMA 2009). Epidural bupivacaine, memantine, gabapentin or venlafaxine may help prevent cPMP, but there are no established proven treatments. (Shen J, Up to Date 2016) Scrambler therapy (ST) is an FDA-cleared treatment for neuropathic pain supported by multiple trials in over 800 patients with cancer pain, chemotherapy induced neuropathic pain, back pain, and post herpetic neuropathy (PHN). (Majithia N JSSC 2016) Methods: We treated 2 women with cPMP with standard ST, with repeated treatment if the pain returned. ST was done with ECG pads above and below the pain for 45 minutes daily, until pain resolved, and repeated if/when pain recurred. Results: Case 1: A 60 year-old woman had bilateral mastectomy 2 years prior with cPMP like “a barbed wire bra”. Before treatment, her pain was 8, which decreased to 0-2 after 5 treatments. Her pain returned 4 months later and was successfully retreated. She resumed a more normal life and was able to taper and eventually stop her opioids. Case 2: A 56 year-old woman had deep aching cPMP for a year following chemo, Mastectomy, and RT. Her pain was 10, decreased to 0-1/10. Her pain returned 1 month later; 3 treatments reduced her pain from 4/10 to 0/10 and improved her quality of life, which lasted for several months until cancer recurrence. Conclusions: Scrambler therapy successfully treated cPMP in 2 patients with improved pain and quality of life, and enabled one patient to stop her opioids in line with new CDC guidelines. Scrambler therapy appears to hold promise, as it does in chemotherapy-induced neuropathy, failed back syndrome, PHN, low back pain and other conditions; prospective trials are indicated to further evaluate this treatment modality.

Case 1 Pain Scores (ST = Scrambler Therapy given that day)
Day1 ST2 ST3 ST4 ST5 ST30,90100 ST101 ST130
6-852101400
Case 2 Pain Scores
Day1 ST2 ST3 ST71421 ST224249
1032224011

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Abstract Details

Meeting

2016 Palliative and Supportive Care in Oncology Symposium

Session Type

Poster Session

Session Title

Poster Session B

Track

Biologic Basis of Symptoms and Treatment Toxicities,Psycho-oncology,End-of-Life Care,Survivorship,Management/Prevention of Symptoms and Treatment Toxicities,Psychosocial and Spiritual Care,Communication in Advanced Cancer

Sub Track

Long-term toxicities/symptoms

Citation

J Clin Oncol 34, 2016 (suppl 26S; abstr 253)

DOI

10.1200/jco.2016.34.26_suppl.253

Abstract #

253

Poster Bd #

K13

Abstract Disclosures

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