Non-invasive Treatment for Pain Related to Bone Metastases

I recently gave a radio interview about my work with a relatively new, FDA-approved treatment for pain related to bone metastases using Magnetic Resonance-guided Focused Ultrasound (MRgFUS). You can listen to the interview:


Coincidentally, our team was also featured in a recent InSightec newsletter, which gives a great overview of the research we’re doing with this technology.

The procedure, which I’d like to discuss more in this blog post, provides relief from tumor-related bone pain. It’s a non-invasive procedure, which heats up bone tissue, at the same time a MRI thermal imaging system continuously measures temperature changes at the bone, thus pinpointing and guiding the treatment. The treatment is also called HIFU, which stands for High Intensity Focused Ultrasound.

Pain Related to Bone Metastases
After the lungs and the liver, bone is the third most common organ affected by metastatic disease. Pain related to bone metastases can substantially lower patients’ quality of life. Patients with prostate and breast cancer in particular can suffer for years from pain and disability caused by bone metastases. Radiation therapy is currently considered the standard treatment for pain from bone metastases. Previous studies, however, have shown that approximately 20 to 30 percent of patients treated with radiation therapy do not experience pain relief. Depending on the radiation therapy protocol, options for retreatment may be limited. Alternatively, patients can be treated with narcotic medications, but those medications may lead to malaise, mental status changes, nausea, and constipation.

Relieving Pain in Bone Metastases Using MRgFUS
MRgFUS is performed on an outpatient basis so that patients can return to normal activities within a few days. The procedure is performed with the patient lying on the stomach or on the back in an MRI scanner for three to five hours under conscious sedation. An ultrasound probe is located under or over the site of the bone metastasis, and a water bath or gel is used to maximize acoustic contact between the skin and the ultrasound transducer. The ultrasound probe generates high intensity waves that focus on the bone metastasis and cause the temperature in the bone and metastasis to rise.

Benefits and Expected Results
Most patients report a decrease in their pain within one or two days after MRgFUS. It has been shown that in addition to pain relief, patients also frequently experience an improved quality of life. MRgFUS offers the following additional benefits:

  • It can be used when radiation therapy fails.
  • No overnight hospital stay is required, and usually only one treatment is required for one bone metastasis.
  • MR-guided focused ultrasound is a completely non-invasive procedure, meaning there is no surgery, no incision, and no blood loss.
  • The patient can return to normal activities within a few days.

For more information on relieving pain in bone metastases using MRgFUS, please click here.