Best treatment for bone pain with multiple osteoblastic metastases
Is there a way to successfully treat a patient with bone pain associated with multiple osteoblastic metastases?
Patients with bone pain from osteoblastic metastases can be treated primarily with four modalities: cancer-specific chemotherapy, radiation therapy, narcotic pain management, or radiopharmaceutical agents that target bone. The last option is often the best when multiple sites are involved that cannot be easily targeted by radiation therapy or would result in excessive radiation to uninvolved tissues or the whole body. Radiopharmaceutical agents, such as strontium-89 ( 89 Sr) chloride (Metastron) or samarium-153 ( 153 Sm) ethylenediaminetetramethylene phosphonic acid (EDTMP) (Quadramet), which are beta-emitters, can be injected intravenously in patients with osteoblastic metastases for relief of pain. Studies suggest that 80% of patients experience some pain relief, and almost 50% have complete relief. Pain relief lasts a mean of 6-8 months, and patients can be retreated with similar pain relief. Although these treatments are not considered curative, they can substantially improve a patient’s quality of life and decrease reliance on narcotic medications.