Treatment of cancer pain with noninvasive brain stimulation.

To the Editor: Although therapeutics for the treatment of pain have developed considerably in the last few years, they still may fail to alleviate pain in cancer patients or become associated with significant undesirable side effects. Pain because of pancreatic cancer may be an example of such an instance. Patients with locally advanced or advanced pancreatic cancer often require increasing doses of opioid pain medications to control their pain. Although effective in pain control, opioids are often associated with adverse side effects: constipation, nausea, confusion, and drowsiness. Other treatment optionsdsuch as radiation or celiac plexus blockdmay not provide sustained pain relief. Recent advances in the techniques of noninvasive brain stimulation may offer alternative therapeutic options for pain control. We recently reported that transcranial direct current stimulation (tDCS), based on the application to the scalp of a weak direct current that flows between two relatively large electrodesd an anode and a cathodedis a an effective method of reducing pain in patients with spinal cord injury and fibromyalgia. The present case provides proof-of-principle evidence that tDCS can exert clinically meaningful analgesic effects in patients with pain because of pancreatic cancer.