A New Treatment for Painful Bone Mets from Prostate Cancer
Prostate cancer bone metastasis
In the U.S., prostate cancer (PCa) is the third leading cause of cancer death among men. It is estimated that about 1 out of 8 men will be diagnosed with PCa, and nearly one in 40 will die from it. If left untreated, prostate cancer tumors will grow, become more aggressive, and begin to metastasize (spread) to other areas of the body.
When a man is diagnosed with PCa, the doctor determines the extent of the cancer:
- Localized – the cancer is confined to the prostate gland and capsule (estimated at about 82% of newly diagnosed cases)
- Regional – the cancer has spread beyond the capsule to nearby tissues, e.g. seminal vesicles, prostate bed, pelvic lymph nodes (estimated at about 10% of newly diagnosed cases)
- Distant – the cancer has spread to distant lymph nodes, bones or other organs, and systemic treatments are used to control but not cure the disease (estimated at 3% or more of newly diagnosed cases)1
PCa cells have certain molecular factors that give them a “preference” for spreading to bone. This is called prostate cancer bone metastasis, or bone mets. At this stage, treatment has two goals:
- Systemic treatments such as chemotherapy, immunotherapy, targeted therapies, etc. are used to control and slow the cancer by reducing the amount of it in the body.
- Local treatments are used for symptom management, and to further reduce or “debulk” the amount of cancer by destroying local tumors as they develop.
Treating bone mets
Pain in the lower back, hips, or other location is commonly the first symptom of prostate cancer bone mets. Other symptoms include bone fractures, spinal compression, and elevated blood levels of calcium due to the cancerous tumors breaking down the structure of the bones. While systemic treatment will continue to prevent or slow further cancer spread, medication will be given to strengthen bones. In addition, pain management generally begins with drugs, and fractures are repaired if they occur.
Destroying bone mets with MRgFUS
If pain medication becomes ineffective, the patient’s medical team may recommend an intervention aimed at the bone lesion itself. Traditionally, surgery or radiation therapy were the only available methods to remove or try to destroy the lesion. However, surgery is invasive, and radiation therapy takes several weeks to take effect – if at all – while exposing patients to the effects of ionizing radiation.
Now there is a remarkable new approach to destroying prostate cancer bone mets and relieving the pain they cause. It is called MR-guided Focused Ultrasound (MRgFUS).
MRgFUS is a noninvasive treatment that ablates (destroys) bone lesions by applying intense heat. Following accurate MRI identification of the location and extent of a bone lesion, the high-resolution images are used to plan a precise ablation of the bone mets. MRI imaging guidance allows the targeted delivery of ultrasound (sound waves) to the lesion. The ultrasound “beams” are aimed at the tumor from numerous directions, and each one passes harmlessly through skin and other tissues. Then, when the beams converge, they generate a short blast of lethal heat at the point where they meet. This heat destroys (ablates) the bone mets at that site, and deadens the nerves that send pain messages to the brain. Not only does the MRI scan map out the treatment, it also uses a special technology called thermography to monitor the temperature and boundaries of the focused ultrasound. In this way, the doctor is confident that the lesion is destroyed while sparing adjacent healthy bone.
Within 3-7 days, most patients have significant pain reduction – in many cases, almost none.
Advantages of MRgFUS
Prostate cancer bone mets patients who are candidates for bone surgery or radiation are also candidates for MRgFUS. MRgFUS offers unique advantages:
- Noninvasive procedure done inside the MRI equipment
- No surgery, no risk of infection
- No exposure to radiation
- Outpatient procedure
- Return to normal activity in a few days
- Pain control results in a week or less
- Competitive, if not better, results when compared with surgery and radiation
- Significant pain relief that is as durable, if not more so, than radiation
If you or a loved one has been diagnosed with prostate cancer bone mets, the Sperling Medical Group offers state-of-the-art MRI to scan for detection and diagnosis. If there are bone mets causing pain, our Center offers the Exablate MRgFUS to relieve pain that does not respond to medication. For more information, contact our Center, or visit our website.
- Bone mets