Bone Cancer Pain Responds to New Treatment
When cancer spreads to the bone, the accompanying pain can be severe and debilitating and is often treated with radiation. Now a new treatment for bone cancer pain has been shown to be effective, and it requires only one dose.
How to deal with pain from cancer spread to bone
The spread of cancer (metastatic cancer) to bone can cause damage and pain in a variety of ways. In some patients the cancer cells produce agents that weaken the bones and cause them to break, while others experience pain related to tumor growth in the bone. Still others may have sclerosis, in which the cancer makes the bones harden.
Treatment of bone cancer pain depends on several factors, including where the pain is (e.g., metastasis in weight-bearing bone hurts more than do other bones) and how many painful areas a patient has. Radiation therapy is often used to treat pain that appears in one or two areas.
However, radiation therapy is not always effective or cannot be repeated for some patients, in which case other treatment options can be tried. Now researchers report on an effective option called magnetic resonance image-guided focused ultrasound (MRIgFU) ablation therapy, which is delivered via a device called ExAblate.
News of the treatment option was presented at the annual meeting of the American Society of Clinical Oncology. According to the study’s lead researcher, Mark Hurwitz, MD, director of Thermal Oncology for the Department of Radiation Oncology at Thomas Jefferson University and Hospital, 67 percent of patients who were administered the new treatment experienced pain relief compared with 21 percent who received placebo.
A total of 142 patients were enrolled in the randomized, placebo-controlled trial. All of the participants either could not undergo radiation therapy or had not responded to it.
ExAblate utilizes small ultrasound beams that target the tumor within bone with heat, which destroy the growth. Pain reduction occurs within just a few days of treatment, and only one dose is necessary.
ExAblate is a type of ablation therapy, and there are other treatment options in this category for bone pain. Typically these treatments involve placing a probe into a tumor and administering heat, cold, electric current, or a chemical to kill the cancer cells.
The advantages of the new ablation treatment for bone cancer pain is that it’s noninvasive and non-ionizing, it allows clinicians to monitor the temperature both in the tumor and in surrounding tissues to help avoid overheating other areas, and it provides accurate anatomic data so doctors can easily see what they are treating. Hurwitz also noted that “The response to ExAblate was as good as radiotherapy, which was notable because it is very unusual to see a second-line treatment with a response rate that is as high as first-line therapy.”
In addition to radiation therapy and ablation therapy, there are several other treatment options for bone metastasis. They include
- Pain medications, including nonsteroidal anti-inflammatory drugs, steroids, and narcotics
- Bisphosphonates (e.g., Aredia, Zometa), which were originally approved for treatment of osteoporosis. However, bisphosphonates can be used to prevent and treat bone metastases because they can reduce pain while also reducing bone damage and fracture risk
- Denosumab (Xgeva), which is an injectable drug used to prevent breakdown of bone and reduce pain
Results of the new study indicate that ExAblate therapy can provide significant improvement in pain associated with cancer that has spread to the bone.
American Society of Clinical Oncology
Thomas Jefferson University