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A Precision Treatment for Bone Mets from Thyroid Cancer

Metastatic Thyroid Cancer

In 2005, thyroid cancer was estimated to have the highest annual statistical increase of any type of cancer.1 It is three times more common in women than men, and the age at onset generally ranges from 30-50 years old. Thyroid cancer is considered to have a high cure rate, with studies reporting that 80-90% of cases have 10-year survival rates. However, if thyroid cancer cells escape into the blood stream or lymph nodes, they can spread to distant sites (distant metastasis). According to EndocrineWeb, distant metastasis is infrequent, but if it occurs, the lungs and bone are the most common sites.

Thyroid cancer mets in the bone

Anywhere from 2-13% of thyroid cancer patients will be found to have metastatic thyroid cancer in the bone (bone mets). The most prevalent form of thyroid cancer is papillary thyroid cancer, which accounts for about 85% of all cases. Another type, follicular thyroid cancer, occurs in less than 15% of cases, but it is more likely to spread to bone than papillary thyroid cancer. According to one source, “Although follicular thyroid cancer accounts for less than 15% of all differentiated thyroid cancers, it has an incidence of bone metastases of 7–20%.” This compares to only 1-7% of papillary thyroid cancer cases.2

Treating thyroid cancer bone mets

The thyroid gland needs iodine to function properly, and healthy thyroid cells take up iodine in order to produce thyroid hormone. Likewise, thyroid cancer cells also take up iodine. Therefore, if thyroid cancer has spread to other body parts, including bone, studies will be done to determine if the cancer cells are still taking up high levels of iodine. If so, the standard treatment is called radioactive iodine treatment (RAI or RI treatment). The dose of radioactive iodine is given by mouth (a pill). RAI usually kills each thyroid cancer cell that absorbs it. However, past a certain tumor stage or size, or in the case of multiple sites of bone mets, RAI will be less effective.

Additional treatments that may be recommended after or instead of RAI treatment are

  • surgical removal of bone mets tumors

    • beam radiation to the local bone tumor

  • shrinking the tumor by blocking up its blood supply (arterial embolization)
  • chemotherapy

Painful bone mets

Bone pain is a common symptom of thyroid cancer bone mets. The effort to relieve bone pain is called palliation, meaning to ease. Palliative measures include drugs, as well as the treatments listed above. When these measures no longer succeed in reducing bone pain, or for patients who cannot have more radiation, there is a new noninvasive outpatient treatment called MR-guided Focused Ultrasound (MRgFUS). The therapeutic effect comes from precisely directing ultrasound beams {soundwaves) from several different directions to the location of the bone mets. The soundwaves pass harmlessly through other tissue on the way to the target. Then, when they converge (meet) at the target, they generate lethal heat. This heat destroys (ablates) the metastatic bone tumor, and deadens the nerves that send pain messages to the brain. There is no need for surgery or radiation.

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

Advantages of MRgFUS

Patients who are candidates for any surgical or radiation bone mets therapy are also candidates for MRgFUS. In fact, when given a choice, most patients choose MRgFUS because it offers the following 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 thyroid cancer bone mets, the Sperling Medical Group offers the Exablate MRgFUS to relieve bone pain. For more information, contact our Center, or visit our website.

1Edwards BK, Brown ML, Wingo PA, Howe HL et al. Annual report to the nation on the status of cancer, 1975–2002, featuring population-based trends in cancer treatment. J Natl Cancer Inst. 2005 Oct 5;97(19):1407-27.
2Wexler JA. Approach to the thyroid cancer patient with bone metastases. J Clin Endocrinology & Metabolism. 2011 Aug; 96(8):2296-2307.

CATEGORY:
Bone mets