# Transcutaneous vagus nerve stimulation in breast cancer: a neuroimmune model to improve quality of life

## TL;DR

This paper explores using transcutaneous vagus nerve stimulation to improve quality of life for breast cancer survivors by restoring autonomic balance and reducing symptoms like fatigue and anxiety.

## Contribution

The paper proposes tVNS as a novel bioelectronic strategy to address autonomic and immune dysregulation in breast cancer survivorship.

## Key findings

- tVNS modulates brain-body signaling and reduces inflammatory load.
- tVNS improves sleep, reduces anxiety, and enhances cognitive function in survivors.
- tVNS activates cholinergic anti-inflammatory pathways, offering a precision-guided intervention.

## Abstract

Breast cancer care has shifted beyond remission toward optimizing long-term physiological, emotional, and functional recovery. Many survivors continue, however, to experience persistent symptom clusters, such as insomnia, fatigue, anxiety, pain, depression, and cognitive impairment. These poor quality of life outcomes reflect underlying dysregulation of autonomic, neuroendocrine, and immune systems. Autonomic imbalance characterized by vagal withdrawal and sympathetic hyperactivation is linked to increased inflammatory load, impaired stress regulation, disrupted sleep, and poorer survival outcomes. Given the role of the vagus nerve in coordinating brain–body signaling and immune modulation, transcutaneous vagus nerve stimulation (tVNS) has emerged as a promising intervention to restore autonomic balance and attenuate psychophysiological burdens. Evidence suggests that tVNS modulates locus coeruleus–norepinephrine activity, regulates arousal and sleep, reduces fatigue and anxiety, enhances cognitive function, and activates the cholinergic anti-inflammatory pathways. Supported by mechanistic and clinical evidence, we propose tVNS as a precision-guided bioelectronic strategy for improving survivorship outcomes in breast cancer.