Radiation therapy for painful bone metastases

Portal Forums Radiation Oncology Radiation for Distant Metastases Radiation therapy for painful bone metastases

This topic contains 5 replies, has 4 voices, and was last updated by catdander forum moderator catdander forum moderator 5 years, 10 months ago.

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August 2, 2012 at 11:20 am  #1246280    


Radiation therapy is standard of care for symptomatic bone mets. My question is when do you treat painful bone mets with radiation – do you wait until patien has severe pain or prophylactically treat the bone mets even if the patient has mild/mod pain?

August 2, 2012 at 11:45 am  #1246282    
catdander forum moderator
catdander forum moderator

Radiation oncologists will radiate painful bones mets when they become painful, period. They don’t want to wait until it is severe. Prophylactically would mean before it is painful. There is no reason for a person with advanced lung cancer to have pain if it can be relieved whether mild, moderate, or severe.

I hope you get relief sooner than later,
forum moderator

August 2, 2012 at 11:51 am  #1246283    
catdander forum moderator
catdander forum moderator

I need to add that bone mets can cause bone fractures (causing severe pain) if not treated. Radiation can keep this from happening.

August 2, 2012 at 12:29 pm  #1246286    
JimC Forum Moderator
JimC Forum Moderator

In addition to the excellent information Janine provided, you might want to read Dr. West’s introduction to bone mets, which discusses radiation to palliate symptoms they cause: http://cancergrace.org/lung/2007/02/17/bone-metastases-in-lung-cancer-an-introduction/

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Jul 2008 Wife Liz (51/never smoker) Dx Stage IV NSCLC EGFR exon 19
4 cycles Carbo/alimta, 65% shrinkage
Tarceva maintenance
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Sep 2010 multiple brain mets, WBR
Oct 2010 large pericardial effusion, tamponade
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August 2, 2012 at 8:49 pm  #1246296    
Dr West
Dr West

The only other thing I’d add is that we will generally be more inclined to recommend radiation if the pain is limited to one or a few locations, rather than many. We tend to favor systemic rather than local therapies if there are very diffuse lesions. And then, as Jim and Janine noted, either pain or fracture risk or both will lead us to favor radiation to a bone lesion.

-Dr. West

August 3, 2012 at 5:37 am  #1246303    
catdander forum moderator
catdander forum moderator

Thanks for that clarification Dr. West. It’s hugely important and I made assumptions after reading the initial thread.
That’s just the kind of example that points to why a doctor who trains and treats and speaks and plans everyday about lung cancer is necessary to a forum that wants to educate seekers on the subject. Grace rocks.

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