• Debra E Lyon, Christine Schubert, and Ann Gill Taylor.
• School of Nursing, Virginia Commonwealth University, Richmond, USA. delyon@vcu.edu
• Oncol Nurs Forum. 2010 Jul 1;37(4):476-83.

Purpose/ObjectivesTo examine the feasibility, relationships among variables, and preliminary outcomes of a self-directed complementary modality, cranial electrical stimulation (CES), for symptom management in women receiving chemotherapy for breast cancer.DesignBiobehavioral pilot feasibility study.SettingTwo university-based cancer centers.Sample36 women with stage I-IIIA breast cancer scheduled to receive chemotherapy.MethodsData were collected via interview, questionnaires, and interactive voice technology (IVR). Biomarkers were measured from a blood sample taken prior to the initial chemotherapy.Main Research VariablesSymptoms of depression, anxiety, fatigue, pain, and sleep disturbances; biomarkers (proinflammatory cytokines interleukin-6, tumor necrosis factor alpha [TNF-alpha], interleukin-1 beta) and C-reactive protein [CRP]); and CES.FindingsCES appears to be a safe and acceptable modality during chemotherapy. Recruitment and retention were adequate. IVR was associated with missing data. Symptoms of depression, anxiety, fatigue, and sleep disturbances were highly correlated with each other, and most symptoms were correlated with CRP at baseline. Depression and TNF-alpha had a positive, significant relationship. Levels of depression increased over time and trended toward less increase in the CES group; however, the differences among groups were not statistically significant.ConclusionsThe data support the feasibility of CES. Further testing in larger samples is needed to examine the efficacy of CES for symptom management of multiple, concurrent symptoms and to further develop the biobehavioral framework.Implications For NursingInterventions that are effective at minimizing more than one target symptom are especially needed to provide optimal symptom management for women with breast cancer.

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