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Chronic Cancer Pain: New Hope for Chemotherapy-Induced Peripheral Neuropathy (CIPN)

Chronic Cancer Pain: New Hope for Chemotherapy-Induced Peripheral Neuropathy (CIPN)

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Pain is “An unpleasant sensory and emotional experience, associated with actual or potential tissue damage, or described in terms of such damage.”  IASP (International Association for the Study of Pain).  

Pain has an emotional component called suffering. The sensation of pain is unique to each individual and is difficult to measure. Pain is the most common reason patients seek medical attention. Approximately 30% of the U.S. population suffers from chronic pain.

Chronic pain affects numerous aspects of quality of life, and people with long-lasting pain experience a multitude of negative physical, psychological, social, and spiritual feelings. A European telephone survey showed that chronic moderate to severe pain occurred in 19% of the adults contacted, seriously affecting daily activities and social and working life. The majority had not received specialist pain treatment, and 40% felt that their pain had been poorly managed. As far as cancer pain is concerned, a recent survey highlighted that 56% of the 5,084 adult patients contacted reported suffering moderate to severe pain on a monthly basis or more often.

CIPN:

Chemotherapy-induced peripheral neuropathy (CIPN) describes the damage to the Peripheral Nervous System (especially the hands and feet) incurred by a patient who has received a chemo-therapeutic drug that is known to be “neuro-toxic” (damaging to the nerves). A common clinical course begins with tingling and burning located in the toes and fingers. These symptoms then spread upwards to affect both legs and arms in a characteristic ’stocking and glove‘ pattern. Patients with pre-existing peripheral neuropathy from another cause, like diabetes, may develop a more severe and persistent CIPN.

With the use of many chemotherapy agents, in addition to numbness, tingling, burning/stabbing pain in hands and feet, which can become severe with increased doses, weakness of distal muscles, decreased deep tendon reflexes, and foot drop have been noted with high doses. Blood disorders are also common side effects.

Chemotherapy-induced peripheral neuropathy is also a major’dose-limiting side effect’ of many commonly used chemotherapy drugs, in other words, the more one takes of the drug(s), the worse the pain gets. And the incidence of CIPN often ranges from 30 to 40% of patients receiving chemotherapy!

A number of factors influence the incidence of CIPN in patients receiving neuro-toxic chemotherapy, including the patient’s age, intensity of the dose one gets, how much one gets (cumulative dose), therapy duration, simultaneous administration of other neuro-toxic chemotherapy drugs, and pre-existing conditions such as diabetes and alcohol abuse.

CIPN can be extremely painful and/or disabling, causing significant loss of functional abilities and decreasing quality of life. Neuro-toxic chemotherapeutic agents may cause structural

damage to peripheral nerve cells, resulting in dysfunctional changes in a patient’s sense of touch, heat, cold, balance, vibration, etc. While symptoms may resolve completely, in many instances CIPN is only partly reversible on its own, and in other cases, it has not appeared to be reversible at all. In fact, until recently, there has not been a consistently-effective prevention or therapy, and countless thousands of patients have had to endure permanent, intractable pain as a by-product of their cancer treatment.

New Hope Through a Paradigm Shift:

What if a therapy could “re-program” the nervous system instead of merely trying to block pain messages at the synapse? The problem in chronic pain is over-excitation in the nerves. What if we could calm them down, and keep them calm, by directly affecting the brain? Safely. With no side effects. Injured nerves can become over-excited or ’wound-up‘- like your immune system during allergy season. The pain-sensory system is not just simply a system for the conduction of pain impulses from the periphery to the brain. We now know that ’neuro-plastic‘ changes (changes in connections between nerves and the way the brain functions) can take place in the peripheral nervous system, the spinal cord, and also in higher brain centers following injury, inflammation and other toxic events. These changes may increase the magnitude of the perceived pain and may contribute to the development of chronic pain syndromes and increased pain sensitivity. In this case, pain becomes a disorder in and of itself, rather than a symptom of a disease process.

Because of the brilliant research efforts of Dr. Giuseppe Marineo, in Rome, Italy, a revolutionary new pain therapy device was recently cleared for use in the U.S. to treat chronic pain, including CIPN. The Calmare MC-5A Pain Therapy Device helps effect positive neuro-plastic changes to counteract (undo) changes that have occurred in the chronic CIPN pain patient. It re-programs the brain.

The Calmare Device (www.calmarett.com) provides non-pain information to the excited pain nerves to ’scramble‘ the effect of pain information. What results is safe, effective, non-invasive relief for patients suffering with severe pain, including oncologic and neuropathic pain (like CIPN), resistant to morphine and other harmful narcotic painkillers.

The device consists of a computer multiprocessor able to simulate five artificial neurons by the application of surface electrodes on skin overlying the painful areas. The device induces a trans-dermal (through the skin) modulation of pain responses by transmitting low-frequency stimulation to the patient’s nerves using surface electrodes (like an EKG) at each patient’s specific pain areas.

The new signal is communicated through the skin into the nerves which then reach the spinal cord and up to the brain. The signal is similar to the original pain signal but is now read as pain free. The CNS cannot adapt to the pain free information, and the patient does not become desensitized to it over time. With subsequent treatments, the pain recurs with constantly diminishing intensity until it disappears in a high percentage of cases.

Indications:

In addition to CIPN, Calmare Therapy effectively treats the following conditions:

  • Oncologic pain resistant to drug treatment
  • Phantom Limb Pain
  • Failed Back Surgery Syndrome (FBSS)
  • Complex Regional Pain Syndrome (CRSD)
  • Post Herpetic Neuropathy
  • Post-Surgery Nerve Lesion Neuropathy
  • Pudendal and Pelvic Neuropathy
  • Brachial Plexus Neuropathy
  • Trigeminal Neuralgia (Approved in the EU)
  • Low Back and Sciatic Pain

Since 2002 more than 3500 patients have been successfully treated in eleven hospitals.

Well Researched:

Although this treatment is new to the U.S., its usage is solidly grounded in years of intensive research, clinical trials, and extensive FDA review. It has been in use in Europe for several years and is currently providing thousands of patients with safe, effective ongoing pain relief while avoiding harmful, and even potentially fatal, adverse side effects and addictive properties linked to narcotic painkillers.

Currently, research for CIPN treatment with Calmare Paqin Therapy is ongoing at Virginia Commonwealth University, Mayo Clinic, and The University of Wisconsin, Madison.

Treatment:

A treatment regimen consists of 10 to 12 45-minute treatments carried out over consecutive days (as close together as possible). Here is a chart illustrating the outcome of a 225 subject study, all with a various types of chronic pain, including CIPN, treated with Calmare Therapy:

Understanding Expectations:

• The MC-5A Therapy treats alterations in pain perceptions (chronic), and
not the organic pathology that generated it

• Pain cannot be treated in advance

• The MC-5A Therapy produces analgesia (pain relief), not anesthesia (lack of sensation)

• Most types of neuropathic pain can be treated to a favorable outcome

• “Acute” pain (e.g. from a sprained ankle) is not affected.

• Chronic pain (altered perception) is treated as an independent pathology

• Monoradicular pain (involving one nerve) tends to be more readily stabilized, with longer pain-free periods

• Pluriradicular pain (involving multiple nerves) requires follow-up treatments every 60-90 days

• Oncological pain must be treated with standard protocol and additional treatments
when needed

Contraindications:

The following exclusion criteria are recommended when considering a patient for treatments: Pacemaker or defibulator users; persons with any type of electrical implant used to control pain; patients with epilepsy. It is recommended that patients receiving neuroleptic drugs for pain control (Gabapentin, Lyrica, Neurontin, etc.) plan on decreasing their dose or completely weaning off before Calmare Therapy because those drugs can cause a reduction in the duration of pain relief from Calmare Therapy.

What It Is Not:

Calmare Pain Relief Therapy is not traction, electrical simulation, TENS, manipulation, acupuncture, hypnosis, biofeedback, drug therapy, or any other type of pain relief treatment currently in use in hospitals or private practice, except in clinics specifically incorporating Calmare Therapy.

 In Conclusion:

Calmare Pain Therapy is a revolutionary approach to treat chronic high-intensity neuropathic and oncologic pain, including CIPN. The Calmareplatform is proven to be highly effective in the treatment of pain and has long-lasting effects – an important benefit for both physicians and their patients.

Dr. C. Evers Whyte is medical director of The Center for Health Renewal in Stamford, CT. He is a “Medical Detective” and specializes in helping patients with chronic pain and with other difficult-to-treat conditions. For more information about Calmare Therapy and Dr. Whyte, please visit: www.MediCalmPainReliefTherapy.com or www.TheCenterForHealthRenewal.com