Relieving cancer pain caused by bone metastases
Pain is the most common symptom of bone metastases. Over 70% of patients with bone mets suffer from significant pain.
Current treatments include systemic therapies such as analgesics, chemotherapy, hormonal therapy, bisphosphonates and local control such as radiation therapy and surgical stabilization of the affected area.
External beam radiation therapy is the current standard of care for clinically active bone metastases. However 20 to 30% of patients do not experience any pain relief from radiation treatments and another 27% experience only partial relief or pain recurrence and they may be no longer eligible for radiation treatments due to dose accumulation from previous treatments.
ExAblate is a one-time bone pain treatment that uses focused ultrasound to destroy the nerves in the bones that surround the bone tumor providing speedy and lasting pain relief without radiation. Most patients feel bone pain relief within a few days and some even reduce their intake of pain killers.
The ExAblate® system uses MR guided focused ultrasound technology which combines high intensity focused ultrasound that heats and destroys targeted tissue non-invasively and Magnetic Resonance Imaging (MRI) which visualizes patient anatomy, and continuously controls the treatment and monitors the effect on the tissue.
Ultrasound is a form of energy that passes through skin, muscle, fat and other soft tissue. High intensity focused ultrasound energy, focused on a small target volume, provides a therapeutic effect by raising the tissue temperature of the target high enough to destroy it. This is similar to how the sun's rays ignite a flame when focused under a magnifying glass.
How does MRgFUS treat bone pain?
The focused ultrasound destroys the outer membrane of the bone that contains the pain sensing nerves. The patient lies in the MRI system, and the bone tumor and surrounding tissue can be precisely visualized. Treatment is continuously controlled and monitored by the operator of the ExAblate system.
The focused ultrasound waves are focused down onto a small area of the painful bone. This causes the bone surface to heat up and destroys the adjacent neural tissue. The focused ultrasound is then targeted to another area nearby. The process is repeated several times until the nerves in the bone surface of the painful bone tumor are destroyed.
Why choose ExAblate for pain palliation of bone metastases?
ExAblate is a treatment for pain caused by bone metastases using MR guided focused ultrasound.
Another option when radiation fails
– When no additional dose can be provided
– When primary tumor is less susceptive to EBRT
– Faster impact than radiation
Potentially no collateral damage
– No bone weakening
– No risk for vasculitis
– Minimal risk for skin injuries
– No additional treatment prevention (radiation and surgery)
What are bone metastases (bone mets)?
Cancer that has spread from the part of the body where it started (called “primary site”) to other parts of the body is called metastatic cancer. The cancer cells travel to other places in the body through the bloodstream or through the lymph system. Even when it has spread from one part of the body to another it is still named after the part of the body where it started. So if prostate cancer spreads to the bones it is still called prostate cancer, not bone cancer. If breast cancer spreads to the lungs it is still breast cancer, not lung cancer.
Bones are a common place for spreading cancer cells to settle in and start growing. The bone metastases (often called “bone mets”) can happen anywhere in the body but are mostly found in bones near the center of the body such as spine, pelvis (hips), ribs, and skull.
* References
Catane R, Beck A, Inbar Y, Rabin T, Shabshin N, Hengst S, Pfeffer RM, Hanannel A, Dogadkin O, Liberman B, Kopelman D. MR-guided Focused Ultrasound Surgery (MRgFUS) for the Palliation of Pain in Patients with Bone Metastases – Preliminary Clinical Experience, Annals of Oncology, 2006.
Liberman B, Gianfelice D, Inbar Y, Beck A, Rabin T, Shabshin N, Chander G, Hengst S, Pfeffer R, Chechick A, Hanannel A, Dogadkin O, Catane R. Pain Palliation in Patients with Bone Metastases Using MR guided Focused Ultrasound Surgery: A Multicenter Study, Annals of Surgical Oncology, 2008.
Gianfelice D, Gupta C, Kucharczyk W, Bret P, Havill D, Clemons M. Palliative Treatment of Painful Bone Metastases with MR Imaging-Guided Focused Ultrasound,Radiology, 2008
Chow E. Palliative Radiotherapy Trails for Bone Metastases: A Systematic Review. Journal of Clinical Oncology, Vol 25, No 11, April 10, 2007
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