Focus of the Report: Use of Scrambler therapy (ST), also referred to as Calmare Pain Therapy and transcutaneous electrical modulation pain reprocessing (Calmare Therapeutics Inc.), for the management of chronic pain related to cancer or cancer treatment.
Technology Description: ST is a noninvasive transdermal treatment for the symptomatic relief of chronic pain. Treatment is performed by applying electrodes corresponding to the dermatome on the skin just above and below the area of pain. The system is a multiprocessor with artificial neurons that generate synthetic action potentials. The device provides electrical signals to nerves via electrodes presenting nonpain information to the painful area using continuously changing, variable, nonlinear waveforms, aiming to substitute the “pain” sensation for “nonpain.”
Controversy: ST provides a clinical alternative for management of chronic pain; including pain related to cancer or chemotherapy-induced peripheral neuropathy (CIPN). Currently, Duloxetine is the only agent with proven efficacy for the treatment of CIPN; however, it only provides modest relief. There are potential barriers to access for clinical implementation of ST. The therapy is administered in a clinical setting and patients are required to make daily visits for at least 2 weeks to receive treatment; this may not be tenable for patients with fragile health status or transportation limitations. Furthermore, ST relies on practitioner training, skill, and familiarity with the technique; and the benefits may be operator dependent.
Is ST effective for managing chronic pain related to cancer or cancer treatment?
How does ST compare with clinical alternatives?
Is ST safe?
Have definitive patient selection criteria been identified for ST?
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