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Revolutionary MRgFUS for Lung Cancer Bone Metastasis

Lung cancer is the second most common cancer in men and women, behind prostate and breast cancer. However, lung cancer is more feared because it is more deadly. As lung cancer tumors develop, tumor cells can spread beyond the lungs. If these cells establish a new tumor in bone, it is called metastatic lung cancer to the bone, or simply lung cancer bone mets. This distinguishes it from primary bone cancer (cancer that begins in the bone).

Bone mets statistics

There are two basic types of lung cancer:

  1. Non-small cell lung cancer (NSCLC) represents 80-85% of lung cancer cases.
  2. Small cell lung cancer (SCLC), about 10-15% of lung cancers.

Statistics suggest that anywhere from 30-60% of NSCLC patients will have lung cancer bone mets.1 Bone mets have symptoms of their own, including bone pain, unstable bones, fractures, and spinal compression. Roughly 50% of patients with any type of metastatic cancer to the bone will have poorly controlled pain.2

Conventional treatments to ease bone pain

When a specific bone lesion develops pain severe enough to interfere with quality of life, the traditional standard of care has been to target that site with either a course of radiation or surgery. However, many patients do not get adequate pain control from either strategy. In addition, radiation is slower-acting so its effectiveness is not really known for up to several weeks, and surgery itself is often painful.

A revolutionary focal treatment to control bone pain

Since the traditional treatment approaches tend to be less than satisfactory, a new type of treatment to control painful lung cancer bone mets is finally available. It is called MRI-guided Focused Ultrasound (MRgFUS). MRgFUS is creating a revolution in treating painful bone mets. Unlike surgery, it is noninvasive and does not create additional short-term pain. Unlike radiation, its effectiveness begins within days.

As the name suggests, MRgFUS is done under real-time MRI guidance (inside the tunnel of the MRI machine). Thanks to high resolution 3D imaging, the precise source of the bone pain is identified, and the imaging is used to plan and deliver the treatment. The “active ingredient” is ultrasound, or sound waves. These waves are focused from different angles on the metastatic bone lesion, passing harmlessly through other tissues on their way to the target. Then, when the sound waves meet, or intersect, they accurately create targeted heat to destroy the bone lesion and deaden the nerves that send pain messages to the brain. This is accomplished without breaking skin, and there is no radiation involved.

A study published in September, 2017 compared the therapeutic effects of radiation therapy (RT) vs. MRgFUS. According to the authors, “MRgFUS was more efficient than RT in terms of the time course of pain palliation as it yielded a significantly higher response rate at 1 week after treatment.”3 Specifically, 71% of MRgFUS patients had pain relief at one week, compared with only 26% of RT patients.

For patients with lung cancer bone mets who are experiencing severe pain, the Sperling Medical Group is proud to offer the ExAblate® MRgFUS system. For more information, contact our Center.

1Huang SM, Yang JJ, Chen HJ, Wu SP et al. Epidermal growth factor receptor is associated with the onset of skeletal related events in non-small cell lung cancer. Oncotarget. 2017 Jun 28;8(46):81369-81376.
2 Rim CH, Choi C, Choi J, Seong J. Establishment of a Disease-Specific Graded Prognostic Assessment for Hepatocellular Carcinoma Patients with Spinal Metastasis. Gut and Liver. 2017;11(4):535-542. doi:10.5009/gnl16486.
3 Lee HL, Kuo CC, Tsai JT, Chen CY et al. Magnetic resonance-guided focused ultrasound versus conventional radiation therapy for painful bone metastasis: a matched-pair study. J Bone Joint Surg Am. 2017 Sep 20;99(18):1572-1578.

Bone mets