Clinical Myth Busters: Addressing Common Patient Questions About TTFields Therapy in Metastatic NSCLC

Beth Sandy and Dr Eshan Patel address common patient questions about Tumor Treating Fields (TTFields) therapy in metastatic non-small cell lung cancer (NSCLC), including concerns about daily activities, travel, and physical interaction. They review how TTFields therapy is delivered, what patients can expect, and how clinicians can support patient confidence through clear, proactive education.

Dr Eshan Patel: Hi, I'm Eshan Patel. I'm a medical oncologist. I work at Robert Wood Johnson University Hospital, Somerset and New Brunswick. I work for Rutgers Cancer Institute of New Jersey. 

Beth Sandy: I'm Beth Sandy. I'm a nurse practitioner in thoracic medical oncology at the Abramson Cancer Center at the University of Pennsylvania in Philadelphia. 

So today, Dr Patel and I will walk through some most frequent questions or myths we hear and clarify the facts. In clinic, patients and their families often have questions about Tumor Treating Fields and the therapy. So, to start us off, Dr Patel, can you tell us what Tumor Treating Fields therapy is? 

Dr Eshan Patel: TTFields or Tumor Treating Fields are low-intensity, alternating electric fields delivered through adhesive arrays placed on the skin. They're designed to disrupt cancer cell division. In metastatic non-small cell lung cancer patients, they are FDA approved for use in patients who have progressed on or after a platinum-based regimen, alongside either immunotherapy or docetaxel. 

Beth Sandy: So let's start off with the first myth. Patients will ask, “Can I be around other people while using Tumor Treating Fields therapy?” They'll say things like, “Is it safe to be around my family and friends while I'm wearing this?” 

Dr Eshan Patel: The answer is yes. Tumor Treating Fields do not emit radiation, and there is no known exposure concern for people nearby. So no isolation is needed. Normal social contact is completely fine. 

Beth Sandy: So Myth #2: “Can I hug my children or grandchildren while using Tumor Treating Fields therapy?” Patients sometimes will say, like, “Can I hug someone? Can I physically interact?” Especially with children, I think that's where people get worried. 

Dr Eshan Patel: And I think that's a very valid concern. But yes, they can do and they can hug their grandchild. Because Tumor Treating Fields deliver localized electric fields that don't emit radiation or affect people nearby. There is no restriction on physical closeness, including hugging or being around children. However, I do recommend being mindful of the cables and making sure the device is secure. 

Beth Sandy: Sure, you make a great point. You don't want to go in for that really aggressive bear hug or something that might mess up the cables. But, I think we don't want to confuse this with things like implanted radiation devices. This is not any kind of therapy that's emitting radiation to other people. 

Myth #3: Can I travel or go through airport security with Tumor Treating Fields therapy?”

Dr Eshan Patel: So, you know what? Personally, I had a patient who went through this, so I can speak for it. Yes, patient can fly with the device. The support team includes device support specialists who can help prepare for travel, including providing airline guidance and documentation letter. The batteries are portable and patient can pause device use as needed during the trip, including the TSA clearance, and everything was very smooth for my patient. 

Beth Sandy: Myth #4: Will these electrical fields burn me? There's often confusion about whether the therapy actually generates heat or causes burns. 

Dr Eshan Patel: The therapy doesn't generate heat. But people do get mild to moderate skin irritation, which can occur under the arrays. And it's usually more related to the adhesive or the moisture, but it's usually manageable with topical care and repositioning. 

Beth Sandy: The next myth: Does Tumor Treating Fields therapy hurt? Like, will I feel it working? I think sometimes patients feel like they're wearing the device and are we going to feel tingling or pain?  

Dr Eshan Patel: Tumor Treating Fields are non-invasive. Most patients do not feel the therapy itself. It's typically not associated with pain or tingling or any kind of sensation. It's very quiet also, so a lot of the time, patients are doing their daily activities, and it does not even make noise or anything. So you wouldn't even notice that they're on something. So, no, it does not cause any discomfort of any kind. 

Beth Sandy: The next myth is: Will people know that I'm wearing the Tumor Treating Fields? Like, can you see them under the clothes? Will we sometimes hear patients say, like, “Will others be able to see this? Will they know I'm wearing something underneath of my shirt?”

Dr Eshan Patel: The device is designed to be wearable under clothing. Some patients are self-conscious at first, but many find it easy to conceal and get used to it very quickly. 

Beth Sandy: Yeah, if you've seen the device, it's very thin; it's just a very thin, almost sticker-like thing. So, unless you're like wearing something super tight or something like that, you really wouldn't have any idea that it's underneath of there. 

Dr Eshan Patel: Right. And patient finds a way, then once they get used to it, they find certain clothing that is better at hiding those cables. So, it's very, as I said, it does not make noise. It's very, underneath the clothes, very thin, so barely anybody can notice it. 

Beth Sandy: All right. Well, thank you for walking us through these questions and myths and addressing these common misconceptions that come up in clinic and can ease the uncertainty for patients when we're talking about this device. They can feel more prepared to start and stay on their treatment. 

Dr Eshan Patel: This type of questions come up often than you think. And when we proactively address them, we can better support the patients in their day-to-day experience. I always remind patients that they can speak with their care team or Device Support Specialist about daily routines, travel, and skincare. It is important that they follow the instruction for use and the guidance provided by their clinicians. If they have any skin reactions or concern about the device, they should contact their care team or Device Support Specialist promptly. I think early detection and management is really helpful to mitigate those side effects that we see. 

Beth Sandy: Or just any worries or concerns that they have that may not even be an issue. 

Dr Eshan Patel: Correct. In my personal experience, I think between the Device Support Specialist and their care team and my nurses, patients feel very comfortable and they always bring their attention whatever is happening with the device right away, and we can always troubleshoot in a very timely manner. 

Beth Sandy: Well, thank you for joining me, Dr Patel. This was a very interesting discussion. And hopefully we've educated people about these different myths that are out there about the Tumor Treating Fields. 

Dr Eshan Patel: Great. Thank you so much for having me.