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Focused Ultrasound May Relieve Bone Cancer Pain

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Focused ultrasound, guided by MRI, can noninvasively relieve pain for metastatic bone cancer patients, according to results of a clinical trial published online last month in the Journal of the National Cancer Institute.

The ultrasound destroys the cancer by heating it to a temperature of 65 to 85 degrees Celsius (150 to 185 degrees Fahrenheit). Real-time MRI monitors the temperature and precisely targets the ultrasound to avoid damage to adjoining healthy tissues.

Mark D. Hurwitz, MD, of Thomas Jefferson University in Philadelphia, lead author of the article, said the approach could be a boon to patients with bone-cancer pain:

It’s clear that for many of these patients, pain has a major impact on their everyday lives. This approach offers a new way to help alleviate that pain via an outpatient noninvasive procedure.

Dr. Hurwitz is vice chair of quality, safety, and performance excellence and director of thermal oncology in the university’s radiation oncology department. He was quoted in a university news release distributed by Newswise.

Most patients with pain related to bone cancer receive radiation therapy. If that doesn’t fully relieve their pain, they may have few other options, especially if they have reached radiation dosage limits.

The study involved 147 patients spread among 17 locations in the United States, Canada, Israel, Italy, and Russia. They were randomized to undergo either magnetic resonance–guided focused ultrasound or a sham treatment (with the ultrasound device not turned on). Patients who did not respond to the placebo treatment within two weeks were offered the chance to switch to the real thing.

After three months, 64 percent of the treated patients said they experienced either no pain or significantly less pain. Most reported improvement within a few days of treatment.

“This work provides cancer patients with more options for treatment of cancer pain and the opportunity for patients to reduce opioid use, which has significant side effects,” said Adam P. Dicker, MD, PhD, chair of the university’s radiation oncology department. Dr. Dicker was not involved in the study.

Related CME seminar (up to 31.75 AMA PRA Category 1 credits™): UCSF Radiology Review: Clinical Highlights (all-new release)

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