Fox Chase Cancer Center Investigates the Use of Ultrasound to Alleviate Severe Pain Caused by Cancer's Spread to the Bones
MRI-guided focused ultrasound to be tested when other options fail.
PHILADELPHIA (July 29, 2008) - Cancer that has spread to the bone is one of the most frequent causes of severe pain in people with the disease. While medications, radiation therapy and surgery are sometimes effective in reducing the pain, a common technology being studied at Fox Chase Cancer Center may offer a new approach to alleviating the discomfort. It's called MRI- guided focused ultrasound or MRgFUS.
According to the American Cancer Society, bone metastasis occurs with many cancers, but more often in breast, prostate, kidney, lung, and thyroid cancers. The society says most people who die of cancer (about 565,650 per year) will have bone metastasis at some point in their illness. Current treatment options for pain control include analgesics, chemotherapy, hormonal therapy, bisphosphonates, radiation therapy, surgery and radio frequency ablation.
Fox Chase physicians are participating in an international study to see if MRgFUS can safely and effectively reduce the pain associated with bone metastases when other accepted treatments for pain such as radiation therapy doesn't help. Fox Chase is the only hospital in the tri-state area studying the technology for this use.
"The ultrasound technique we're studying is much more powerful and intense than the ultrasound most people are familiar with such as that used to see structures in the abdomen,"explains Andre Konski, M.D., a radiation oncologist at Fox Chase one of the lead investigators of the phase III study. "The ultimate goal for this study is to make sure MRgFUS is safe and can offer relief from the pain."
MRgFUS works by focusing ultrasound to heat a small spot much like a magnifying glass can be used to focus light on a spot. Unlike light, ultrasound passes through the skin into the body to a spot your doctor wants to destroy, such as a spot in a tumor.
MRgFUS was found safe and effective for treating uterine fibroids and was approved by the Food and Drug Administration (FDA) for this use in 2004. The ultrasound technology device is called ExAblate manufactured by InSightec Ltd. The company's efficacy and safety results in feasibility studies led the FDA to give its permission to investigate ExAblate to treat pain caused by bone metastasis.
For this study, physicians will use MRI to guide them to the area in the bone where the cancer has spread. The ultrasound is then delivered to the area causing extreme heating--destroying the nerves that supply sensation to the bone to alleviate the pain. The MRI allows the physician to monitor and continuously adjust the treatment in real time. Patients receive conscious sedation to alleviate pain and minimize motion.
"We're optimistic about this approach to treating the pain caused by bone metastasis, but only after the completion of the clinical trial will we know if the technology is useful,"Konski adds. "At Fox Chase, we also hope to study MRgFUS to treat tumors in the abdomen, breast and prostate in the future."
Since it is not known if MRgFUS can relieve pain caused by cancer, volunteers in this clinical trial will be randomly assigned to one of two groups: a group that will receive treatment and a group that won't receive treatment for the first three weeks they are in the study. After three weeks, the second set of patients will receive active treatment. Patients in either group will not know if they are receiving treatment so that MRgFUS effectiveness can be accurately measured.
Fox Chase Cancer Center, part of Temple University Health System, is one of the leading cancer research and treatment centers in the United States. Founded in 1904 in Philadelphia as one of the nation’s first cancer hospitals, Fox Chase also was among the first institutions to receive the National Cancer Institute’s prestigious comprehensive cancer center designation in 1974. Fox Chase researchers have won the highest awards in their fields, including two Nobel Prizes. Fox Chase physicians are routinely recognized in national rankings, and the Center’s nursing program has achieved Magnet status for excellence three consecutive times. Fox Chase conducts a broad array of nationally competitive basic, translational, and clinical research and oversees programs in cancer prevention, detection, survivorship, and community outreach. For more information, call 1-888-FOX-CHASE (1-888-369-2427).