Electrophysical agents (EPAs) for symptom control in cancer care - what is the evidence?

Background: Physiotherapists generally accept that electrophysical agents (EPAs) should not be applied directly over, or in the vicinity of cancerous tumours or other malignancies. The idea that EPAs are contraindicated is based upon the theoretical, but rarely proven risk of stimulating malignant cell proliferation and thus tumour growth and/or dissemination. However, a growing body of literature suggests that some electromagnetic and physical energies may be beneficial for use in the treatment of cancerrelated or cancer treatment-related sequelae, and tumours. Objectives: The aim of this narrative review was to collate information on the state of knowledge regarding the application of EPAs in some typical clinical presentations in physiotherapy cancer care; understand whether there is evidence for using EPAs in physiotherapy cancer care; and, how planning might progress to further the evidence in this field. Major findings: Few EPAs have been specifically tested for the capacity to increase tumour growth or dissemination. Evidence exists for the use of some EPAs for symptom control and palliative management of cancer-related or cancer treatment-related symptoms and side effects. Conclusions: Physiotherapists should reconsider the potential use of EPAs in cancer care. Further research will elucidate how best to utilize EPAs in this field of practice. Using some EPAs for tumour treatment could be considered.