Yennurajalingam S, et al. – This preliminary study strived to ascertain the feasibility and preliminary efficacy of a 4–week Cranial Electrotherapy Stimulation (CES) intervention on depression, anxiety, sleep disturbance, and pain scores, also concurrent salivary biomarker studies were performed. The clinicians found that in advanced cancer (ACP), the use of CES was safe and feasible. The use of CES was correlated with significant improvement in depression, anxiety, pain, and sleep scores and these findings supported further studies of CES in ACP for symptom control.

• ACP’s with 1 or more of 4 moderate intensity (≥3/10) ESAS symptoms (depression, anxiety, sleep disturbance, and pain) were eligible in this one group open label pre- and post-intervention study with a 4-week CES intervention.
• The clinicians evaluated adherence (0-100%), satisfaction rates (0-10), and safety.
• They assessed ESAS, HADS, PSQI, BPI, and salivary levels (cortisol, alpha amylase, CRP, and IL-1 beta and IL-6) from baseline to week 4.

• 33 out of 36 (92%) completed the CES.
• In this study, median (IQR) adherence CES use and satisfaction scores were 93% (89-100) and 10(9-10) respectively and the adherence criteria was met in the study.
• As per the outcomes, CES use was safe (no grade 3 or higher adverse events).
• After 4 week CES treatment, HADS anxiety (p < 0.001), HADS depression (p=0.024), ESAS anxiety (p= 0.001), depression (p=0.025), BPI pain (p=0.013), PSQI daytime dysfunction (p=0.002), and Medication use (p=0.006) scores improved.