Radiation Therapy For Bone Mets?

[Olivia007]

Hello my Dads doctor suggested radiation for his bone mets. Before I make an appointment and go for a consultation I wondered has anyone on here been through it and has it HELPED with PAIN Relief? How long were the treatments and how many times a week did you go and for how long. At the end we will make our choice I want to hear from others. Thank you

[ctarleton]

I have not had such treatment, but this document may provide much information and food for thought as you learn and consider more Options with your doctors.

"Palliative radiation therapy for bone metastases: Update of an ASTRO Evidence-Based Guideline"

practicalradonc.org/article...

Charles

[Dan59]

I have had a very nagging pain in rt hip , which they call Cancer, After 3 sessions of IMRT to that and other bulky masses, the hip pain has gone and after 5 no longer walking with a limp. I go 5 days a week for 20 minutes over 4 weeks.

[YostConner]

I had palliative radiation to a rib in 2014. Pain beforehand was excrutiating. I had five sessions on successive days. It was very successful. Good luck to your dad!

[Olivia007 in reply to YostConner]

Thanks for responding. Did it work that quickly for you? And you only had to go for 5 days ?Did you have any pain reoccurrence?

[YostConner in reply to Olivia007]

Relief was nearly immediate. That spot does stil hurt from time to time, but not like then.

[Olivia007 in reply to YostConner]

Thank you, for responding.

[qkhanhxvi in reply to YostConner]

Im here asking for my husband who is also in the battle with bone mets. He’s about to have his first round of radiotherapy, may I ask about the side effects ? Does it as tired as chemo ? Did you feel nausea or fatigue during radiation ? And lastly, does it really effective for the bone mets ? Love to here your answer !

[pjoshea13]

Olivia,

How many mets would be treated?

& this would be purely for pain relief?

I had a solitary spinal met (at L5) radiated at in 2015. I wasn't in pain, but I found a radio-oncologist who felt it reasonable to treat a small numer of mets.

-Patrick

[Olivia007]

Its his thigh bone, and he is in pain I'm wondering how soon would he get pain releif?

[hysir]

I had 3 Mets on my spine 2-3 years ago. No pain. I had 3 sessions of cyberknife. I now have 2 spots. One is on a rib and another on right pelvic area. This will be treated with Cyberknife also.

[qkhanhxvi in reply to hysir]

can i ask what is cyberknife ? thanks

[hysir in reply to qkhanhxvi]

SBRT is a radiation therapy that sens high dose and very precise radiation to cancer cells. I have had it on two occasions. The first time was for bone mets on vertebra on my spine. The second was for a few bone mets on a few spots on rib cage and pelvic area. It is using computerized image guidance to treat the spots. I have had great success with this treatment as evidenced by treated spots havent returned. I hope this helps.

[NancyWorld]

My 90-year-old Dad had one session of palliative radiation to his sacrum and retroperitoneal lymph nodes before starting hospice care. The lymph nodes are partially obstructing a ureter. His sacral pain had become excruciating to the point that he couldn’t lie prone on the table for radiation mapping in spite of receiving the maximum dose of opiates, so he had to be admitted for anesthesia to be able to undergo the process. It was a very risky anesthesia due to his heart problems, but the alternative was intractable pain.

On hospice care, he was given a fentanyl patch and PRN oxycodone, and sat up to sleep as usual. After about a week, he needed less oxycodone. A few days later, my Mom forgot to replace the fentanyl patch and they went 4 days without realizing it. He just got the PRN oxycodone 3 or 4 times a day.

That is a huge, huge improvement. He can now lie down and is less drowsy from opiates. I highly recommend Dr. Borghero and his radiation oncology team at Banner MD Anderson Cancer Center in Mesa, AZ. Dr. Borghero did his residency at MD Anderson in Houston.

[wifeofvet]

yes, it helped my husband a lot the three times they spot radiated the mets.

[Ian2017]

I had radiation in July this year - once a day over 5 days to "break up" the tumor up and down my spine (my metastasis is widespread). I was exhausted during and for a few weeks after the radiation. There was no follow up by the radiation oncologist once the 5-day process had ended and I was let go. One Saturday, three weeks later, I ended up in ICU with a haemoglobin count of only 3 and platelets count at 8. Frankly, and unbeknown to me, close to death. My feeling is that my system had been shut down by the heavy radiation and had not 'rebooted' (stopped producing red blood cells, etc). I cannot get an adequate explanation out of any of the 3 or 4 doctors I've seen subsequently (they tend to close ranks on these issues) but my sense is that I should have been closely monitored post radiation and what subsequently happened ranks as negligence on the part of the radiation oncologist! It took me about 6 weeks to recover. Haemoglobin climbed back steadily (I had 3 transfusions in ICU) and is now at 12.6. Platelets count around 350. The radiation cleared the pain very effectively but beware of potential side effects.

[Break60]

I had IMRT to all pelvic lymph nodes in 2015 when PSA increased to 1.3 after RP and SRT and MRI found two suspicious iliac lymph nodes. This was 50 fractions at 75 grays. I had no pain so I viewed it as potentially curative not palliative. No recurrence there since. Then this year after stopping ADT3, PSA climbed to 2.3. So I had axumin scan which found a met on right femur. This time I had high dose SBRT in three fractions and 27 grays. Again I had no pain.

I highly recommend SBRT if the mets are in an area which can be safely treated due to the convenience of fewer fractions.

But be sure to use a highly experienced RO!

Bob

[Olivia007 in reply to Break60]

What is SBRT AND what does fractions and greys mean I new to this radiation terms

[ctarleton in reply to Olivia007]

This page from UCLA has some Frequently Asked Questions about SBRT.

radonc.ucla.edu/sbrt

Radiotherapy fractions:. The full dose of radiation is usually divided into a number of smaller doses called fractions. This allows healthy cells to recover between treatments. You have the fractions as a series of treatment sessions that make up your radiotherapy course.

nrc.gov/reading-rm/basic-re...

Charles

[Olivia007 in reply to ctarleton]

Thank you for explaining it to me

[Break60 in reply to Olivia007]

A gray is a unit of radiation absorbed by the body during radiation treatment. It replaced the term rad. One gray= 100 rads.

[Hidden]

Hi Olivia,

My suggestion would be to ask his Onc about Xgeva. It's hard to call what pain is what when it comes to this disease. But, if mets are involved this will surely help. A few years ago, I was certain I had mets in and around my neck and spine, a few vicotin changed my mind. But, later on I did have two on my spine, and one on my hip for a year or so, that never bothered me. My most recent imaging shows the mets are no longer recognized. I assume the Xgeva did it's job. I feel like I will beat this thing.

J

[Olivia007 in reply to Hidden]

Hello thanks for the reply he is on xgeva and has been as well as Lupron and he had the Provange too i Called the doctor and he had his office manager call back and tell me to take my dad to get radiation and I was offered 2 doctor names I called him to talk to him about my dads bone pain yes he has bone Mets but the way he describes it sounds like sciatic nerve so I really don’t know what to do?

[ctarleton in reply to Olivia007]

When I was first diagnosed 4 years ago with Stage IV prostate cancer metastatic to many bones, I was in severe pain in my lower back that felt very much like the pain from other lower back problems. It turned out to be related to "mets" in the L4-L5 region of my spine (among other locations), and my pain faded away after about 3-4 weeks on primary ADT treatment, with pain killers to bridge the gap.

(Someday, when the various treatments stop working and bone mets pain may return, I too will be considering the pros and cons of palliative radiation and/or a treatment like Xofigo (Rad-223).)

Imaging should be able to distinguish between things like bulging or herniated spinal discs that may be pressing nerves, and locations being affected by metastatic disease.

Charles

[Olivia007 in reply to ctarleton]

Is Xofigo used to treat pain or only to keep the Psa down? The doctor said it was for both then his office manager told me it was only for the Psa I have no clue

[Hidden in reply to Olivia007]

It's chemo. It will go everywhere, and kill all it can. This is why your dad's on Xgeva, it's used when there are mets with no pain. Xofigo (Radium-223) comes on board when you have pain.

[Olivia007 in reply to Hidden]

Thank u

[ctarleton in reply to Olivia007]

Here is more info on Xofigo.

accessdata.fda.gov/drugsatf...

[NancyWorld in reply to Olivia007]

Hi... I don’t know whether you read my post above? My family and the radiation oncology staff basically moved heaven and earth to get my 90-year-old Dad one session of palliative radiation treatment. They had to re-admit him to the hospital for anesthesia when he’d been discharged less than a week before. Hospitals don’t like to do that because Medicare doesn’t want to pay for patients who bounce back. He was in too much pain from cancer in his sacrum to lie still for radiation, so he had to be anesthetized. That was after two shots of dilaudid and a shot of fentanyl, on top of his regular narcotics, didn’t quell the pain.

Less than two weeks after treatment, he can now, for the first time in months, stay awake and carry on a conversation. Before, he was on too much pain med to stay awake.

It’s like a miracle, especially since the anesthesiologist told us there was a 50/50 chance of him surviving anesthesia due to his congestive heart failure. It was a terrible decision to have to make and the whole family made it together based on his then-current quality of life. We weren’t sure the radiation would work, but it did.

My Dad is a retired medical doctor. He kept telling the radiation oncologist that his left seat bone hurt, but fortunately the rad onc reviewed the bone scans I got to them and knew the cancer was in the sacrum. The pain can be referred to other places.

I only wish we had had the opportunity for radiation therapy sooner, before he became so devastatingly frail. We’d been going to an extremely well-known clinic (won’t write the name here) and were never offered radiation. Hormone therapy failed my Dad after a year and he’s not a candidate for further chemical treatment.

[Olivia007 in reply to NancyWorld]

Thank you for your response it feels good getting ideas. And people’s feedback.

[karlsiller]

I had 5 treatments 5 days in a row. They concentrated on some tumors in my pelvis and hip area. Side effects for me was minimal and helped with the pain considerably. Have no regrets. Take care.