Treatments for Bone Tumor Pain

Studies have shown that three nonsurgical treatments reduced the severe pain caused by bone tumors by 74-89% in patients for whom conventional treatments were not effective.

The three techniques are osteoplasty, radiofrequency ablation, and cryoablation. These heat or freeze the tumor, killing the nerve endings that cause the pain. Cancer often metastasizes to bone, and can cause terrible pain that is unrelieved by narcotics and other standard pain treatments. While radiation reduces pain in about 70% of patients, the pain often returns or increases over time, and further radiation is often not possible because it would damage healthy tissue. In addition, radiation can take five to 20 weeks to work.

"Pain affects greater than 60% of patients with advanced cancer and for many, the pain isn't due to bone metastases,” remarked Matthew Callstrom, M.D., Ph.D., an interventional radiologist at Mayo Clinic (Rochester, MN, USA; www.mayoclinic.com). "This research shows these new interventional techniques are effective to help these patients without surgery, and offer a short recovery time.”

Osteoplasty treats bone pain by injecting medical-grade bone cement into the tumor. The cement gives off heat and then hardens to reinforce weakened bone that otherwise would be susceptible to fracture. This is an established technique used to treat painful vertebral metastases or fractures in the spine from osteoporosis. Most frequently, this is an outpatient procedure performed using conscious sedation. A study showed osteoplasty was effective in all eight patients enrolled, who experienced prompt and lasting pain relief with no significant complications.

Cryoablation probes have become smaller and are now insulated, so they can be inserted through a small nick in the skin, without the need for an operation or stitches. Of 10 patients in a recent study, 80% had an average 74% reduction in their worst pain.

Radiofrequencing ablation (RFA) delivers heat directly into the tumor via a probe that is inserted through the skin, using computed tomography (CT) and ultrasound imaging for guidance. From the tip of the needle, radiofrequency energy is transmitted into the targeted tissue, where it produces heat and kills the tumor. Pain relief was achieved within a week for all of the 11 patients who underwent RFA.




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