Bone Cancer

Bone Cancer

Interventional Radiology Treatment for Metastatic Cancer in Bones

Bones are the third most common location where cancer cells spread and metastasize. Each year, about 100,000 cases of bone metastasis are reported in the United States. Bone metastases occur when cancer cells gain access to the blood stream, reach the bone marrow, begin to multiply and then grow new blood vessels to obtain oxygen and food – which in turn causes the cancer cells to grow more and spread.

Some bone metastases become painful because the tumor eats away at the bone, creating holes that make the bone thin and weak. As the bones are replaced with tumor, nerve endings in and around the bone send pain signals to the brain. If left untreated, bone metastases can eventually cause the bone to fracture – seriously affecting a patient’s quality of life. This is particularly true for long bones of the extremities where a fracture may render a limb nonfunctional. These patients may require surgical intervention to restore the function of their limbs. More commonly, metastases involve the ribs, pelvis, and spine.

For the most part, the goal of treating bone tumors is not curative, but rather palliative by reducing pain, preventing additional bone destruction, and improving function.

In treating cancer patients with painful bone metastases, interventional radiologists may use one of the two different thermal ablation techniques – radiofrequency ablation and cryoablation. This form of therapy is aimed at desensitizing the bone by killing the nerve endings in the vicinity of the metastasis. They can also treat painful vertebral metastases or fractures with kyphoplasty.

Prevalence

  • Bone is the third most common site of metastatic cancer.
  • About 100,000 cases of bone metastasis are reported each year in the United States. Of those reported, 75 percent are caused by tumors in the breast, prostate, lung and kidney.

Symptoms

  • Bone pain affects 70 percent of patients with bone metastases
  • Bone fracture
  • Spinal cord compression

Macon Bone Cancer Treatments

Radiofrequency Ablation (RFA)
RFA works to kill cancer cells by heating them. RFA is a minimally invasive technique performed by an interventional radiologist inserting a small needle/probe into the tumor using CT or ultrasound to guide the needle. Electrical energy (similar to microwaves) is delivered through the needle which heats the tumor tissue and kills it. The destroyed cancer tissue turns into a scar. The FDA has approved RFA for treatment of certain tumors. While RFA of tumor can be curative, it is usually palliative, extending patient’s life expectancy and improving quality of life while living with the cancer. The procedure is performed as an outpatient in a hospital using intravenous sedation or general anesthesia. The procedure generally takes less than an hour to perform. The tumor is usually treated in one session but may occasionally require an additional treatment. Complications are unusual and occur in about 2% of patients. These include bleeding, infection or damage to adjacent tissue or organs. RFA is considered for patients in whom surgery is not a good option or when other medical conditions increase the risk of surgery.

RFA can be used to treat a variety of tumors, both malignant and benign. Tumors involving the liver, kidney, lung, and bone can be treated. RFA is particularly effective for treatment of smaller (less than 5 cm, about 2 inches) primary cancers of the liver – called hepatocellular carcinomas or HCC. Other types of liver tumors can be treated as well. Primary cancers of the kidney, renal cell tumors, can be treated with RFA as determined by the urologist. Certain types of lung cancers can be treated by this method. Painful bone tumors, malignant and benign (osteoid osteoma) can be effectively treated with either RFA or kyphoplasty.