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Chemotherapy Linked to Persistent Nerve Pain in 4 in 10 Cancer Patients

The AHA! Team — Mon, 10 Mar 2025 06:33:48 +0000

BMJ Group via News-Medical – The drugs used to treat cancer damage healthy cells and tissues, including the nervous system. Worldwide, cancer chemotherapy is linked to persistent severe peripheral nerve pain (neuropathy) for around 4 in every 10 patients treated with these drugs, suggests a pooled data analysis of the available evidence, published in the open access journal Regional Anesthesia & Pain Medicine. Notwithstanding wide regional variations, platinum based drugs, taxanes, and lung cancer seem to be associated with the highest rates of persistent painful neuropathy, lasting at least 3 months, the findings suggest, prompting the researchers to call for tailored approaches to pain relief. The drugs used to treat cancer damage healthy cells and tissues, including the nervous system. The effects can manifest in movement disturbances, such as loss of balance or coordination, and sensory disturbances, such as loss of sensation; numbness, tingling, “pins and needles”; or a burning sensation on the skin. Several factors influence the frequency and severity of chronic peripheral neuropathic pain, including type and dose of chemotherapy, pre-existing neuropathy, and the use of other drugs that can damage the nervous system, explain the researchers. The condition is thought to be caused by direct peripheral nerve cell damage which disrupts or rewires normal nerve signalling pathways, resulting in persistent pain, they add. Prompted by the growing number of cancer survivors and increasingly aggressive treatment of the disease, the researchers wanted to gauge the global prevalence of chronic painful peripheral neuropathy linked to chemotherapy. They scoured research databases for relevant studies published between 2000 and 2024, focusing on potentially influential sociodemographic, clinical, and methodological (study design, funding source, for example) factors. In all, they pooled the results of 77 eligible studies, involving 10,962 participants from 28 countries, all of whom had peripheral neuropathy that was associated with cancer drug treatment. In 4545 of these participants, this was painful and persistent, lasting for at least 3 months. The highest number of studies were carried out in the US (13) and Japan (10), and almost half were prospective observational studies. The cancers that featured most often were those of the bowel (25; 33%) and breast (17; 22%), while the largest proportion of studies focused on patients treated with either platinum based agents (13;17%), or taxanes (11; just over 14%), or both (6 ;8%), or the FOLFOX combination of folinic acid plus 5-fluorouracil plus oxalplatin (5; 6.5%). Pooled data analysis of the study results showed that the overall prevalence of persistent painful peripheral neuropathy was just over 41%. When stratified further, the analysis indicated that the highest prevalence was among patients treated with platinum based agents (40.5%) and taxanes (just over 38%). Prevalence was lowest among those treated with the FOLFOX combination (16.5%). Prevalence was also highest among those with primary lung cancer (just over 62%), possibly because of the complexities of treatment for this disease, suggest the researchers. Prevalence was lowest among those with primary ovarian cancer (31.5%) and lymphoma (36%). When stratified by continent, studies of patients in Asia reported the highest prevalence of persistent painful neuropathy (46.5%), while studies of patients in Europe reported the lowest (36%). Prevalence rates were similar in both men and women. The researchers emphasize that the design and methodology of the included studies differed substantially. And the overall certainty of evidence was considered to be low. Researchers emphasize that the design and methodology of the included studies differed substantially But they write: “Understanding the prevalence and predictors of chronic painful [chemotherapy induced peripheral neuropathy] is critical for promoting early diagnosis and developing personalized treatment strategies. “Our findings emphasize that chronic painful [chemotherapy induced peripheral neuropathy] represents a substantial global health challenge, affecting more than 40% of those diagnosed with [it].” And they conclude: “The wide variability in prevalence rates across different countries, continents, chemotherapy regimens, and primary cancer history underscores the need for tailored strategies to address this debilitating condition. “Future studies should focus on elucidating the mechanisms underlying these disparities and developing interventions that can reduce the burden of chronic painful [chemotherapy induced peripheral neuropathy] globally.” Source: BMJ Group Journal reference: D’Souza, R. S., et al. (2025). Global estimates of prevalence of chronic painful neuropathy among patients with chemotherapy-induced peripheral neuropathy: systematic review and meta-analysis of data from 28 countries, 2000–24. Regional Anesthesia & Pain Medicine. doi.org/10.1136/rapm-2024-106229 To read the original article click here.

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A Wearable Device That Soothes and Heals at Home

AHA Publisher — Fri, 22 Oct 2021 07:00:26 +0000

Abigail Klein Leichman via Israel21c – A mild pins-and-needles sensation encircled my forearm as the Healables sleeve was activated from Moshe Lebowitz’s smartphone. The intensity can be dialed up or down with the flick of a finger. I was in the Jerusalem office of Healables, a startup developing home-based “electroceutical” treatment of pain and inflammation. The device delivers microcurrent electrotherapy to legs or arms, through a port snapped onto an e-textile sleeve with built-in electrodes. The flexible, machine-washable sleeve is made in an Israeli factory that manufactures big-brand American sports apparel. “We tried to make our solution as easy as taking a pill but without any side effects or potential for addiction,” says Lebowitz, the company’s CEO. “By docking with textiles, the treatment is simply like getting dressed.” Wellness and Medical Models Healables is building two products on its technology platform: ElectroGear, a sports-and-wellness model for athletes, to be sold directly and through physical therapists and sports teams; and a medical model to be available by prescription, pending regulatory approval. A clinical trial of the medical model soon will begin on patients with knee osteoarthritis, led by Dr. Hadar Oz, chief of sports medicine at Wolfson Medical Center in Holon. “For these patients we have many kinds of treatments and one of them may be the Healables device,” Oz tells ISRAEL21c. “There is a similar treatment available, but it needs a very large machine. What they did is make it very small and incorporate it into a flexible knee brace. We hope this device will work to lessen the pain and thus allow them better active daily living.” Another trial will start at Hadassah-Hebrew University Medical Center in Jerusalem on patients with diabetic peripheral neuropathy, a common and painful leg, foot or hand complication of diabetes. As for the sports-and-wellness model, Stade Français Paris Rugby Club selected ElectroGear for a pilot through the HYPE Global Sports Accelerator. Healables is recruiting professional sports teams for additional pilots in the US, EU and UK. Healables also participated in the Hadassah-IBM Alpha Zone Accelerator, MedTech Ra’anana and BizLabs MedTech Accelerator for ultra-Orthodox (haredi) entrepreneurs like Lebowitz. Entrepreneur and Rabbi The bearded 47-year-old CEO wears traditional garb: white shirt, black pants, black frock coat and black hat. He has rabbinic ordination from a yeshiva in Israel, where he’s lived since 1997. But he was raised in Baltimore and has a BA in mass communications and user interface/user experience from Towson University. Long interested in technology, in 2002 Lebowitz launched a website builder like Wix. But the technology wasn’t mature enough yet. “I learned that timing is really important in startups,” he says. Soon after ending that venture in 2007, Lebowitz suffered a traumatic brain injury. During his long recovery, he tried a range of complementary treatments, including Chinese medicine, that helped him heal. Locating practitioners and traveling to and from sessions was tiring and time-consuming. He pondered how to bring effective treatment modalities into the home through user-friendly connected wearable devices. The wearables he saw on the market were mostly tracking health parameters rather than treating conditions. Lebowitz wanted a wearable that could treat the body with electrotherapy and–using data collected from those sessions — treat the mind with personalized behavioral health coaching. “As a rabbi, I know there’s a body and a soul, and to treat the whole person you have to look at both,” says Lebowitz. “Even on a biological level, the effect of mental health on immunology is something people have really noticed recently with corona.” In late 2017, Lebowitz founded Healables to realize his vision. He received his first investment in early 2019, a grant from the Israel Innovation Authority. Healables has raised a total of $2.5 million from the IIA and BioJerusalemand is seeking funding from sports-tech and biotech investors. “We will be collaborating with Leonhardt Ventures as well,” he says. Lebowitz finds his yeshiva background advantageous. “Talmud study is about connecting with God, but as a side effect it improves your mental capacity and ability to think creatively. People really respect that.” After all, he notes, “Startups become unicorns by solving problems differently.” Unique in Electrotherapy Physical therapists already are familiar with electrotherapy machines to ease pain and accelerate healing. Some examples are millicurrent devices like TENS (transcutaneous electrical nerve stimulation), microcurrent devices like MENS (microcurrent electrical nerve stimulation) and electro-acupuncture devices. While TENS effectively prevents pain signals from reaching the brain, it doesn’t address the source of pain. Microcurrent, 1,000 times less than millicurrent, actually aids healing. Studies show microcurrent increases the body’s production of ATP, a compound that fuels many cell processes. It stimulates metabolic activity, improves cellular function, and recruits immune-system cells, growth factors and other proteins that foster wound healing. Microcurrent also decreases systemic inflammation, the underlying cause of many chronic conditions. However, three drawbacks have hampered the wide adoption of this electrotherapy, says Lebowitz. “One, it’s too complicated for many home users and even professionals to feel comfortable with selecting the right settings and it often takes multiple appointments to figure out the appropriate treatment for each patient. “Two, it’s too restrictive because the patient usually needs to be confined to a treatment table for an hour with sticky electrodes and wires that pop off if you move the wrong way. “And three, it’s too time consuming because the patient needs to travel to a clinic multiple times a week.” Healables was designed to overcome all three drawbacks, integrating smart textiles, electronics and software to reduce inflammation, accelerate healing and relieve pain, while eliminating travel time. The same device with different settings can treat different conditions. “Some conditions require half an hour a day, some two hours a day, but you can be doing other things during the treatment. You just press a button on your smartphone and it goes. For an athlete, you can be treating your leg while working out your arms in the gym.” The Healables system is HIPAA-compliant and includes artificial intelligence for personalizing and improving treatment based on response data. Later, this will also be used to power the behavioral health coaching component. A Family Affair The company’s chief scientific officer, retired US Army Col. George Lowell, was director of laboratories at Walter Reed Army Institute of Research, former CSO of BioDefense at GlaxoSmithKline Biologicals, and present board member of BiondVax Pharmaceuticals. Lowell is also Lebowitz’s father. He had Anglicized the family name, and Moshe changed it back to the original after relocating to Israel. Most of the startup’s crew of 14 are Orthodox or ultra-Orthodox, including Chief Medical Officer Andrew David Shiller, a physician specializing in treating acute and chronic illness and pain. Before moving to Israel in 2015, Shiller saw “some astonishing results” when he started using microcurrent technology in his practice. He tells ISRAEL21c that before earning his MD at Duke University and doing residencies at Harvard-affiliated hospitals, he studied mechanical engineering at MIT. “I was always interested in putting engineering together with what I learned about complementary healing, but I never got around to it until I joined this company,” he says. Inflammation is the fundamental process that drives most chronic illness such as diabetes, autoimmune disease, cardiovascular disease and degenerative brain disease, Shiller explains. “It’s not about red-hot swelling but about low-grade protein shifts in the blood that don’t always show up in clinical tests. People treated with microcurrent are getting better with their pain but also decreasing pro-inflammatory proteins like the cytokines IL-6 and IL-1. This is a stunning potential gamechanger.” Clinical Results Shiller told me about results of user testing the sports wearable on several people. One was a 50-year-old woman with disfiguring osteoarthritis. One ankle was giving her excruciating pain even after surgery and physical therapy. “We tried the device once and she stopped using crutches. After three sessions she has almost no ankle pain,” Shiller says. Another tester was a soldier from a special forces unit, sidelined because of knee pain. “He has bone marrow edema associated with chronic trauma, and he was using oxycodone and Celebrex just to sleep at night,” says Shiller. After one session, he was able to stop taking drugs. “He’d find the pain creep back after a week, so we gave him a device and sleeve to test at home, programmed for him. He’s using it several times a week. I hope at some point he’ll have no pain,” says Shiller. “Whether they are completely better or not, there is significant improvement and it’s very gratifying to see that with our device.” Shiller adds that the Healables protocols will be refined with the help of collected data and outcomes of clinical trials. “Our initial studies are studying two conditions but there’s a whole potential world of treating chronic inflammatory problems with wearable microcurrent electrotherapy, which is kind of thrilling,” he says. For more information, click here To read the original article click here.

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