Possible Solution for Cancer Pain Through Electrical Stimulation of the Pituitary Gland

Globally, the prevalence of cancer has risen, with a projected increase in the number of annual cases from 14 million to 32 million in 2032. If detected early, cancer can be cured and total remission can be achieved.

However, survival depends on varying factors which include age, stage of cancer as when first detected, immune state of the individual, and type of cancer. People with advanced stages of cancer receive palliative care which helps to reduce symptoms and generally to improve the quality of life of patients and their caregivers.

Pain is one of the targets of cancer management and it is the most common feature cancer patients present to the emergency department with. It continues to be a challenge for people undergoing cancer treatment and even people in remission.

Various methods of cancer pain management include opioids and non-opioid medications. Over 80% of cancer patients eventually need opioids. Other methods include neurolytic block and hypophysectomy.

Hypophysectomy includes the ablation of the pituitary glands to cause relief of pain. However, this is a drastic measure and the long-term efficacy of this method is not reliable.

Electrical current causes pain reduction

Electrical stimulation of the pituitary gland is a method of relieving pain that has not been quite researched enough. This involves the delivery of electric current to the pituitary gland and surrounding nerve structures causing pain relief. A study records that an electrical stimulation of 5 to 10 minutes yields 10 hours to 10 days of pain relief.

Another intervention involves the use of a balloon device passed via the nasal cavity to cause stimulation. The balloon consists of a flexible material which can be inflated and deflated. It is attached to a tube through which air or fluid enters or leaves it enabling it to be placed against the surface of the sphenoid sinus (the sphenoid sinus surrounds the pituitary gland).

On the outer surface of the balloon are electrical simulators that deliver electric current. The balloon can be heated within a range of 42 to 44 °C or more. This improves electrical conduction and stimulates or lowers the secretion of pituitary hormones.

Scientists postulated that electrical energy leads to the release of endorphins which relieve pain. Endorphins are endogenous hormones that act like morphine, however, it has been reported that pain did not return on the administration of naloxone.

So, the consensus is that the mechanism by which electrical stimulation produces pain relief is a different one and not well-understood.

A new interventional trial currently ongoing is recruiting adult patients over the age of 18. The study involves the implantation of extradural electrodes in the pituitary fossa which can emit electrical current up to 8 times a day.

Patients with disseminated disease who have no other further systemic or radiotherapeutic treatment options and patients who have uncontrolled nociceptive pain unresponsive to opioids are being recruited.

Clinical significance

The electrical stimulation method, if adequately utilized, may bring about the end of pain, both acute and chronic, experienced by cancer patients.

Poorly controlled pain has a way of reducing the quality of life and duration of survival of patients. Using this method may significantly improve the quality of life of patients and their caregivers.

Electrical stimulation can serve as an alternative to opioids, preventing addiction.

This method may also have therapeutic applications in other disease conditions like Alzheimer’s disease, Parkinson’s disease, headaches, cerebral palsy, and epilepsy.

Conclusion

Cancer pain places a burden on the health system, and current interventional methods provide hope for patients. So far, there’s little evidence of its efficacy, however, the research efforts look promising. More clinical trials need to be carried out to determine the long-term efficacy of stimulating the pituitary gland.

References

Research with human participants. (2024, February 14). Pituitary Gland Stimulation for pain relief. In Overview of medical research in the Netherlands. Retrieved March 13, 2024, from https://onderzoekmetmensen.nl/en/trial/52130

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