New pain treatment methods for bone tumors

Bone cancer, a skeletal cancer usually occurring as a spreading tumor from cancer elsewhere in the
body; seldom as the first tumor in an area of rapid growth. Cancer cells gain access to the blood
stream, reach the bone marrow, and grow new blood vessels to obtain oxygen and food - bone
metastases. Bone metastases become painful when the tumor starts to destroy bone. Fracture may
occur. Most bone cancers are spreading tumors; commonly occur in the ribs, spine and pelvis.
Osteosarcomas, chrondrosarcomas and fibrosarcomas are the most common bone cancers.
Treatments include surgical removal of the slow-growing tumors or the whole limb, radiation and
chemotherapy [1,2].

NEW PAIN TREATMENTS

More than 60% of patients with advanced cancer have bone metastases and, pain treatment could
benefit as many as 100,000 people in the United States each year. Three new nonsurgical techniques
have been presented in the 30th Annual Scientific Meeting of the Society of Interventional Radiology
and they are osteoplasty, radiofrequency ablation and cryoablation. Because of the localized nature of
these techniques, they may not have any systemic side effects.

CRYOABLATION Cryoablation kills the cancer tissue locally by freezing it with extreme cold argon
gas in a sealed probe, while sparing the healthy tissue. In this procedure, the interventional radiologist
uses CT and ultrasound imaging to guide 8 probes through the skin into the tumor, under anesthesia.
The "ice ball" that is created around the probe, visible with CT imaging, grows in size and destroys the
frozen tumor cells.

RADIO FREQUENCY ABLATION Radiofrequency ablation kills the cancer tissue locally by
transmitting radiofrequency to the tip of the needle, where it produces heat in the tissue. The tumor
tissue dies, shrinks and forms a scar. This technique uses CT and ultrasound imaging for guidance.
This successful rate is about 93% percent of cases in a study. The FDA has approved radio frequency
ablation for the treatment of tumors in soft tissues including the lung [3,4].

OSTEOPLASTY Osteoplasty kills the cancer tissue by injecting medical grade bone cement into the
tumor.  In this procedure, radiologist uses fluoroscopy (continuous X-ray imaging) to guide the probe to
the tumor. The cement becomes hot when it is mixed. This heat kills the tumor and hardens the
weakened bone to prevent fracture. Tumors often eat away healthy bone. This is an established
technique used to treat painful vertebral metastases or fractures in the spine from osteoporosis.

REFERENCES

[1] Mosby's Medical Encyclopeida, 2000 TLC, Inc.
[2] 30th Annual Scientific Meeting of the Society of Interventional Radiology, Three Nonsurgical Pain Treatments for Bone Tumors
Very Effective, 03 Apr 2005
[3] E.J. Mundell New Hope Against Inoperable Liver, Lung Cancers HealthDay News April 4 2005
[4] Prospective, Multicenter Lung Cancer Trial Shows Heat Directly Kills Tumors In 93 Percent of Cases, PRNewswire, April 2,
2005
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