A New Treatment for Painful Bone Mets from Melanoma

What is melanoma?

Melanoma is a skin cancer, though it also rarely arises in other locations such as the eyes. Of the three types of skin cancer (basal cell, squamous cell, melanoma), melanoma is the most aggressive and deadly even though it accounts for only 3-5% of skin cancers.

It is possible to lower the chances of developing melanoma. Up to 90% of melanomas are caused by exposure to ultraviolet (UV) radiation, with sunlight being the most common source. For this reason, people are encouraged to use a broad-spectrum sunscreen that protects against both UVA and UVB radiation, and products should be marked with a “sun protection factor” (SPF) of at least 15.

Melanoma has a high likelihood of metastasizing (spreading). Tumor cells initially spread into tissues adjacent to the primary tumor, then into the bloodstream and nearby lymph nodes. From there, they travel to more distant internal organs. The most common remote sites are the liver, lungs, bone and brain.

Melanoma metastasis in the bone

When melanoma has spread beyond lymph nodes to distant organs, it is called Stage IV disease. According to the American Cancer Society, 5-year survival rates are 15-20%, and 10-year survival is 15-20%. It is estimated that melanoma has 23-49% probability of metastasizing to skeletal locations. This is called melanoma bone metastasis or bone mets.

The first symptom of bone mets is often bone pain. Other symptoms include bone fractures, and elevated blood levels of calcium as the cancerous tumors in the bone break the bone down which releases calcium into the bloodstream. Any bone pain symptom should be immediately evaluated by a doctor.

Treating painful melanoma bone mets

If melanoma bone mets become too painful to be controlled by medication, there is a revolutionary, noninvasive treatment to ease pain and put the brakes on bone mets at that location. It is called MR-guided Focused Ultrasound (MRgFUS).

MRgFUS starts with magnetic resonance imaging to identify the exact source of bone pain. This same imaging allows the physician to plan noninvasive targeted delivery of ultrasound (sound waves) to the bone mets lesion. When the soundwaves are aimed from several different directions to the lesion, they generate 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.

Within 3-7 days after treatment, most patients have significant pain reduction – in some cases, almost zero pain.

Advantages of MRgFUS

Melanoma bone mets patients who are candidates for bone surgery or radiation are also candidates for MRgFUS. If given a choice, most patients choose MRgFUS because of its benefits:

• 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 melanoma, the Sperling Medical Group offers state-of-the-art MRI to scan for bone mets. 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.