External Beam Radiation Therapy Effective in Providing Bone Metastases Pain Relief

A single treatment of external beam radiation therapy is very effective in providing relief for painful bone metastases from breast and prostate cancers, according to a new study presented October 20, 2003, at the American Society for Therapeutic Radiology and Oncology’s Annual Meeting in Salt Lake City.

This randomized prospective phase III study of palliative external beam radiotherapy was conducted for patients with breast or prostate cancer and painful bone metastases. More than 160 hospitals and universities in the United States and Canada participated in the study. Eligible patients, 897 of the 949 enrolled, had moderate to severe pain, radiographic evidence of bone metastases at a painful site, a life expectancy of more than 3 months, no prior surgery or palliative external beam radiation therapy to that site and no change in systemic therapy for 30 days. The group was evenly divided between women with breast cancer and men with prostate cancer and patient pre-treatment characteristics were equally balanced between the two treatment arms.

“This is good news for patients with pain from cancer. Radiation therapy was effective in significantly reducing pain in two-thirds of these patients. Treatment with a single larger dose was just as effective as the longer treatment course of 10 treatments in 2 weeks. There were very few side effects from the treatments as well,” said William F. Hartsell, M.D., a radiation oncologist at Advocate Lutheran General Hospital in Park Ridge, Ill., and lead author in the study. “We also found that 33 percent of the patients no longer needed narcotic medications.”

The American Society for Therapeutic Radiology and Oncology is the largest radiation oncology society in the world, with more than 7,000 members who specialize in treating patients with radiation therapies. As a leading organization in radiation oncology, biology and physics, the Society’s mission is to advance the practice of radiation oncology by promoting excellence in patient care, providing opportunities for educational and professional development, promoting research and disseminating research results and representing radiation oncology in a rapidly evolving socioeconomic healthcare environment.

Source: ASTRO press office. Edited by J. Strax. Page updated Oct 21, 2003.

Special types of cancer pain

Neuropathic pain in patients with cancer. Manfredi PL, and team. Department of Neuro-Oncology, Section of Pain and Symptom Management, MD Anderson Cancer Center, Houston, Texas. J Palliat Care. 2003 Summer;19(2):115-8.

"The most frequent sites of neurological injury were nerve roots, spinal cord and cauda equina, brachial and lumbosacral plexus, and peripheral nerves." Patients with neuropathic pain may require special medications.

Caregivers' distress when their loved ones are in pain:

My love is hurting: the meaning spouses attribute to their loved ones' pain during palliative care. Mehta A, Ezer H. Sir Mortimer B. Davis-Jewish General Hospital, School of Nursing, McGill University, Montreal, Quebec, Canada. J Palliat Care. 2003 Summer;19(2):87-94

"Two different states emerged, the 'in-pain state' and the 'out of pain state.' The spouses described feelings of helplessness, fear, and unfairness when witnessing their loved one in pain. Once the pain had been controlled, spouses described feelings of peace and relaxation, and felt this meant that the couple could return to their old routines because their spouse was still alive. It was discovered that the meanings placed on the cancer pain differed for the spouse and the patient, with the spouse focusing on future consequences. Implications and suggestions for nursing practice and future research are proposed."