Effects from radiation on spine?

[Jeff_Piano_Man]

This is a question that I am sure has been answered here. I'm not there yet - just getting SBRT for the first time nowhere near the spine or nerves.

I'm curious - SBRT is typically very successful at knocking down / eliminating the met. But I'm curious about the damage to the nerve or spinal cord when directly radiated? Or does the radiation target the met that is in the bone rather than the nerve? My gut says that you would get damage to the nerve / cord if radiated.

Experiences / knowledge?

Thanks, Jeff

[Tall_Allen]

Nerves are fairly impervious to radiation.

[Jeff_Piano_Man in reply to Tall_Allen]

AI shared with me a slightly more verbose answer:

Most cells in the body can divide, but nerve cells (neurons) cannot. Once a neuron differentiates into its mature state, it loses the ability to divide. This is one of the reasons why the brain and spinal cord are not able to regenerate fully after injury.

Nerve cells fall into the category of mature cells. This means that they divide very slowly or not at all. This is why they are more resistant to the DNA damage that radiation can cause. When the body needs new nerve cells, it must rely on stem cells or progenitor cells to differentiate into new neurons. This process is very slow and does not always happen successfully.

One of the reasons why nerve cells cannot divide is because they have a very specialized function. They are responsible for transmitting electrical signals throughout the body, and this requires a very specific structure. If nerve cells were able to divide, it is possible that their structure would be disrupted, and this could lead to problems with nerve function.

Thanks, Jeff

[j-o-h-n in reply to Jeff_Piano_Man]

to Jeff_Piano_Man,

My male AI mGuru is seldom verbose but sometimes can be quite humorous. E.g. the other day I asked him "what should I do for my dead cock?" AI mGuru responded "oh master it's too late to put it in a hole, so it's best to have him cremated together with the dead chickens". Sonofabitch I think he's toying with me......

Reminder: Black keys with right hand.......... white keys with left.........

Good Luck, Good Health and Good Humor.

j-o-h-n Wednesday 11/15/2023 10:42 PM EST

[V-Man]

Hello Jeff.. I've had 2 experiences with external radiation for palliative care, to address a meet in C-5 (2 years ago), then to my lower lumbar to L pelvic area to treat mets that were causing pain in my lower spine. Both treatments (5 consecutive days each, total of 20gy) were successful, as they both eliminated any bone pains I had neen experiencing. I didn't have many SE issues, except with the lower lumbar area to pelvis - because the beam had to irradiate a section of bowel. I had a severe boot of diarrhea (2 days, constant), and then was told to use Imodium and that immediately controlled the loose stools. If I was told to do it again, I would definitely do radiation. 8 mos later, none of the pain has returned and I golf regularly. V

[Schwah]

I had SBRT radiation to L-5 met 2 years ago and they got the entire met with zero side affects. The key is the right guy and best equipment. Where would you go? Top institution I hope.

Schwah

[Benkaymel]

I had IMRT to about 3/4 of my spine a few months ago. I had severe pain flare for a couple of days but no lasting problems after that.

[Hidden]

I had SBRT to my L-5 four and a half years ago. Haven't noticed any problems related to the treatment. It seems to be SOC for many.

Marshall.

[j-o-h-n in reply to Hidden]

Geezamacripe............. And I thought you were just a deputy...

Good Luck, Good Health and Good Humor.

j-o-h-n Wednesday 11/15/2023 10:45 PM EST

[Brightman]

I had SBRT radiation (3 years ago)on my T10 because of a tumour there. Earlier in the year a compression fraction showed up on my T10 and am now on Fentanyl patches from the pain ( dosage has just been doubled by my oncologist because of the pain). I also had SBRT radiation on my 6 th rib (at the end of August) where there was also a tumour. I had a whole body scan and CT scan last week which did not show much of a change with either. But it seems that there are risks of fractures after SBRT.

[AmitGattani]

I have had multiple rounds of VMAT/SBRT in past 18months across cervical, thoracic and lumbar spine as mets were pressing nerves/spinal cord causing all sorts of pain. Fortunately all the treatments worked to take care of the problem and I would not hesitate in recommending or doing it again. One key is to take sufficient dose of Dexa/steroid as recommended by your radiation doc during the treatment as the inflammation from radiation, which is temporary, may press nerves causing damage.

Other longer term issue is that radiation will suppress bone marrow. So precision of radiation planning, skill of doc doing it is critical, and of course how close os the met/area being radiated to the marrow.

Good luck!