Prof Tim Watson said:
Ron. This is a 'popular' topic in my e mail inbox! Yes, we use TENS in cancer pain - in palliative care and at other stages - with good evidence of benefit. There is actually noting out there in the evidence that says TENS increases the rate of development of tumour, masses or mets. Most therapists steer clear on the basis that they would rather not take the risk of making things worse. In the Contraindications chapter for the new textbook, we have TENS listed as a local contraindication - i.e. advised not to employ in the immediate area except when the patient is receiving palliative care. It does not sound, from your message, that the patient is in that stage as yet (though I can't be sure). Personally, I would consider it to be a valid treatment option so long as the patient is aware that there is the POSSIBILITY (nothing stronger than that) that the TENS COULD change the rate of development of any metastases if they are present, even though there is no direct evidence that this is the case. Sorry if that is not the definitive answer that you were hoping for. Maybe others will come up with a more definite response? Tim
Anyway, Professor, the problem is that we must follow the indications written in the manual of usage of the device: specially in Italy, if something is written to be not done, and something happen to the Pt after we dit the forbidden thing (despite literature, evidence...), front of a Judge, it could be our guilty.
How is in the UK? USA?
