Thank you all for this wonderful information! I shared this with our oncology
group yesterday. We definitely have a lot to consider. I appreciate your help!
Kristen
Sent from Yahoo Mail for iPhone
On Thursday, April 28, 2022, 8:45 AM, Kozempel, Jean A
<Jeannie.Kozempel@xxxxxxxx> wrote:
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Hello,
We do have the scrambler here. It was donated to us. Unfortunately it is very
expensive for patients bc it is not covered by insurance. The protocol for its
use also requires the patient to come in daily for treatments. For many that is
not possible. We have also not seen great results with it and many times the
patients are then referred to us. We essentially provide the care that you
have outlined in your email and we get better results than what is reported by
the patients who tried the scrambler.
Jeannie
From: aptaoncology-bounce@xxxxxxxxxxxxx <aptaoncology-bounce@xxxxxxxxxxxxx>On
Behalf Of Steve Wechsler
Sent: Tuesday, April 26, 2022 9:38 PM
To: aptaoncology@xxxxxxxxxxxxx
Subject: [aptaoncology] Re: Treatments for CIPN, fibrosis, covid related issues
EXTERNAL sender! Do you TRUST this email? If you are unsure, send the email to
InfoSec for review by using the Report Phish button.
Hi Kristen,
Wanted to share our scoping review of high quality RCTs assessing
pharmacological and nonpharmacological management of CIPN that was published in
February: https://pubmed.ncbi.nlm.nih.gov/35128938/
The one study that assessed a topical cream (ketamine + amitriptyline) found
that it was not effective. Interestingly, the two RCTs that examined the
effectiveness of scrambler therapy found no significant benefit… I know RCTs
aren’t necessarily the be all end all, but thought this may give some
direction.
Hope this helps. Happy to discuss if you want to reach out.
Steve
On Apr 26, 2022, at 8:59 PM, Kristen <dmarc-noreply@xxxxxxxxxxxxx> wrote:
Thank you for the recommendation for Scrambler Therapy. I'll look into it!
On Tuesday, April 26, 2022, 08:49:41 PM EDT, chitra Srinivasan
<chithrats@xxxxxxxxxxx> wrote:
Recently Scrambler Therapy is FDA approved for CIPN and studies show promising
results. Only some clinics have it as insurances don't cover this treatment,
yet.
How do you bill for dry needling?
C. Srinivasan
On Apr 26, 2022, at 7:42 PM, Kristen <dmarc-noreply@xxxxxxxxxxxxx> wrote:
Hello! We are getting a lot more referrals for CIPN, often after chemo is
already complete and the patient has severe neuropathy. We currently address
balance, strength, sensory normalization techniques (contrast baths, various
textures of fabric), STM, TENS, and in some cases dry needling. Any
recommendations for other modalities or treatments that you have found
successful? Also wondering if there are any topical creams (over the counter or
Rx) that you have found really help.
Unrelated, but I recently had a patient with h/o breast cancer and radiation
fibrosis. Her biggest complaint was breast itchiness ever since her surgery and
only got worse with radiation; the itchiness was mostly under her incisions but
she says the feeling is "deep" and she can never get the itch to go away. She
said she has tried every over the counter ointment and lotion with nothing
helping. We have just started treatment for her including using non-thermal low
level laser for the fibrosis, but wondering if there is anything else we can do
to help specifically with the itchiness?
Last topic...has anyone noticed any correlation with persistent breast tissue
pain after a patient has had COVID? We have seen a couple patients with
persistent breast tissue pain despite all our best interventions. The
physicians are at a loss what to do next and are referring to pain management.
We have even asked about rheumatology consults. The most relief we have been
able to provide these patients is completing MLD and taping for edema. Just
curious what others have observed.
Our oncology rehab group is new-ish (has really grown this past year), so we
are all still learning and would be interested in other specialists' insight
into these topics!
Thank you,
Kristen Knox
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