Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong Special Administrative Region, China.
Cancer Med. 2023 Sep;12(18):19081-19090. doi: 10.1002/cam4.6466. Epub 2023 Aug 17.
Cancer is globally a disease of significant public health concern owing to its prevalence, and association with morbidity and mortality. Thus, cost-effective treatments for cancer are important to help reduce its significant morbidity and mortality. However, the current therapeutic options for cancer such as chemotherapy, radiotherapy, and surgery may produce serious adverse events such as nausea, vomiting, fatigue, and peripheral neuropathy, especially in the long term. In addition, these therapeutic options may not be well tolerated by the elderly especially those who are frail. The current article is aimed at discussing an alternative therapeutic option, non-invasive vagus nerve stimulation (VNS), and the roles it plays in cancer pathology and immunotherapy. The VNS does this by reducing oxidative stress via silent information regulator 1 (SIRT1); inhibiting inflammation via both hypothalamic-pituitary-axis (HPA) and the release of corticosteroid from the adrenal gland, and cholinergic anti-inflammatory pathway (CAP), and increasing vagal activity which helps in the regulation of cell proliferation, differentiation, apoptosis, and metabolism, and increase chance of survival. Furthermore, it helps with reducing complications due to cancer or its treatments such as postoperative ileus and severity of peripheral neuropathy induced by chemotherapy, and improves cancer-related fatigue, lymphopenia, and quality of life. These suggest that the importance of non-invasive VNS in cancer pathology and immunotherapy cannot be overemphasized. Therefore, considering the safety of non-invasive VNS and its cost-effectiveness, it is a therapeutic option worth trying for these patients, especially in combination with other therapies.
癌症是一种全球性的重大公共卫生问题，其发病率高，与发病率和死亡率有关。因此，开发具有成本效益的癌症治疗方法对于降低其高发病率和死亡率非常重要。然而，癌症的当前治疗选择，如化疗、放疗和手术，可能会产生严重的不良反应，如恶心、呕吐、疲劳和周围神经病，尤其是在长期治疗中。此外，这些治疗选择可能无法被老年人特别是体弱的老年人耐受。本文旨在讨论一种替代治疗选择，即非侵入性迷走神经刺激（VNS），及其在癌症发病机制和免疫治疗中的作用。VNS 通过沉默信息调节因子 1（SIRT1）来减少氧化应激；通过下丘脑-垂体轴（HPA）和肾上腺皮质激素的释放来抑制炎症，以及通过胆碱能抗炎途径（CAP），并增加迷走神经活动，从而有助于调节细胞增殖、分化、凋亡和代谢，并增加生存机会。此外，它有助于减少癌症或其治疗引起的并发症，如术后肠梗阻和化疗引起的周围神经病的严重程度，并改善癌症相关疲劳、淋巴细胞减少和生活质量。这表明非侵入性 VNS 在癌症发病机制和免疫治疗中的重要性不容忽视。因此，考虑到非侵入性 VNS 的安全性和成本效益，对于这些患者来说，这是一种值得尝试的治疗选择，特别是与其他治疗方法联合使用时。
