Electrotherapy as an alternative treatment of cancer (meta analysis)

Therapy: Electrotherapy
1. Definition of the application

Electrotherapy is a therapeutic approach that consists of applying direct current electric pulses accross the tumor area. The treatment is also being reffered to as "direct current treatment" or "electrochemical treatment".
2. Physical principle

Following mechanisms have been proposed for tumor regression or remission as a result of electrotherapy treatment:
1) Autolysis processes, at the positively biased tumor site, produce a significant decrease in pH, which helps to promote tumor necrosis. [1]
2) An increase in acidity at the tumor site appears to damage red blood cells, inhibiting delivery of oxygen to the tumor. [6]
3) The low pH at the tumor site is indicative of a positive charge at that location (relative to surrounding normal tissue). Cancer-fighting white blood cells, with a negative charge on their membrane surface, will be attracted to the tumor site.
4) The electric field at the tumor site draws water away from the tumor (electroösmosis). Water starvation stresses the poorly formed tumor vascular system, interfering with the tumor's blood supply, causing the tumor to shrink.
5) Cathodic and anodic gas formation (hydrogen, chlorine and oxygen) elevates the pressure in the cancerous tissue, producing further stress on the tumor structure and tumor blood supply.
3. Description of the treatment

The electrotherapeutic treatment consists of applying direct current electric pulses to the area to be treated. Pulses that are being used are monopolar direct current pulses in the range between 0,1 mA and 100 mA, and of the length in the range between less than one and up to 30 hours. Electrode configuration and placement for electrotherapy varies with respect to location, type of cancer and size of the tumor.

4. Efficacy, clinical relevance

Several in vitro and in vivo experiments have shown either tumor growth delay, remission or even tumor necrosis [1][2][3][8][9]. The efficacy varies due to different currents used, duration of electrotherapy and by different tumor models, electrode materials [1] and geometry employed. Some researchers report better antitumor effect when using cathodic electrodes inserted into the tumor as opposed to using anodic electrodes inserted into the tumor. Electrotherapy is being clinically used predominantly in China.

5. Safety, Side effects, Risk-Benefit ratio

The principle that differentiates electrotherapy from standard chemotherapy is its abbility to target cancerous areas of the body without harming healthy tissue, which eliminates chemotherapy side-effects and improves risk-benefit ratio of the treatment in general. No perceivable side effects or safety issues regarding electrotherapy were reported so far, but those cannot be excluded for certein due to the insufficient knowledge of the mechanisms involved in the trreatment. Electrotherapy in combination with low-dose conventional chemotherapies appears to provide a far superior combination of results from the standpoints of: 1) clinical effectiveness, 2) cost, 3) quality of life for the patient, 4) reduced stress on the health care practitioners who are administering treatment, 5) ability to administer repeat treatments (no noticeable resistance for multiple EChT treatments), 6) less side effects and 7) compatibility with other cancer therapies and 8) a very high benefit/cost ratio for the patient, the patient's insurance carrier and the treatment facility.

6. Remarks

Electrotherapy was demonstrated to be an effective and relatively inexpensive local treatment of murine solid subcutaneous tumors. The insufficient knowledge of the mechanisms involved still hinders its more extensive use in clinical oncology. FDA Approval was granted in July 1996. This protocol was approved by the IRE3 in September 1996. The first patient approved by the treatment took place on October 3, 1996 [7].

7. References

1. Miklavcic D, Sersa G, Kryzanovski M, Novakovic S, Bobanovic F, Golouh R, Vodovnik L. Tumor treatment by direct electric current – tumor temperature and pH. Bioelectrochem. Bioenerg. 30: 209-220, 1993.

2. Miklavcic D, Fajgelj A, Sersa G. Tumour treatment by direct electric current – electrode material deposition. Bioelectrochem. Bioenerg. 35: 93-97, 1994

3. Sersa G, Miklavcic D. The feasibility of low level direct current electrotherapy for regional cancer treatment. Reg. Cancer Treatment 1: 31-35, 1993

4. Batista U, Miklavcic D, Sersa G. Low level direct current – cell culture fibroblast model. Bioelectrochem. Bioenerg. 35: 99-101, 1994y.

5. Journal of the IABC In Medicine and Biology (January - December of 2002), Dr. George O'Clock, Dr. Björn E.W. Nordenström

6. Electrotherapeutic Devices: Principles, Design and Applications, Artech House, Boston, MA (2007)

7. Electrochemical Treatment of Localized Tumors with Direct Current, C. K Chou et al

8. Potential uses of low-level direct current electrotherapy for the treatment of cancer, George D. O'clock, Mark Lyte

9. Electrochemical therapy to treat cancer (In Vivo Treatment), M. Tello et al.
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