Bone pain considerable advances in techniques to target treatment exclusively at the tumour in order to reduce the side effects and complications caused by chemotherapy, radiotherapy, and analgesia.It is well known that some of the worst forms of pain arise from tumour metastases and bone pain. Options for treating these have traditionally been limited. Over the past few years there have been considerable advances in techniques to target treatment exclusively at the tumour in order to reduce the side effects and complications caused by chemotherapy, radiotherapy, and analgesia.
Bone metastases are rarely treated surgically because surgery is rarely curative; it can also be difficult to gain surgical access to the tumour without destroying too much healthy tissue. In addition adequate surgical excision often excessively weakens the affected bone thus increasing the risk of fracture.
While open surgery is playing a smaller role in the management of metastatic deposits there have been rapid advances in percutaneous techniques guided by new imaging technologies. In his article for totalhealth London-based Anaesthetist, Dr Nigel Kellow explains some of the most up to date options for both tumour destruction and spine stablisation.
Radiofrequency ablation (RFA) involving a fine probe inserted into the centre off the tumour has become the treatment of choice for many patients with liver, lung, or bone metastases and offers an alternative to surgery for some patients with primary lung tumours.
- Cryoablation where freezing is used to destroy the tumour rather than heat.
- Vertebroplasty where bone cement is injected into the spine to treat pain from metastatic spinal cancer.
- Balloon kyphoplasty. A balloon is inserted into the diseased vertebral body then inflated to restore the vertebral body towards its pre-fracture height and shape.
Dr Kellow also answers the question most patients will have: “Am I a suitable candidate for these treatments?"
