Focusing sound on metastatic bone cancer pain, tumor cells

May 9, 2013 | by Darrin Joy

Breast, prostate, colon and other cancers that spread to other parts of the body often take root in bone. These metastatic tumors can be very difficult to eradicate and often create terrible pain for the patient. A new technique helps alleviate that pain — and it might one day eliminate the cancer, too.

 

X-Ray image of bone metastases in hip. Cancer that spreads to bone can cause significant pain. Magnetic resonance guided focused ultrasound, or MRgFUS, can alleviate bone cancer pain. City of Hope researchers hope it also will destroy tumors.

 

When treating metastatic bone cancer pain, surgery is seldom used. Radiation is the preferred choice, but not all patients can receive it, and others choose not to have it.

So some clinicians are now turning to magnetic resonance-guided focused ultrasound, or MRgFUS (as it is inelegantly abbreviated), specifically to provide care that reduces patients’ cancer-related bone pain.

"MRgFUS is for those select patients who cannot have radiation therapy because they have previously been irradiated or they do not want it," said Jeffrey Wong, M.D., chair of City of Hope’s Department of Radiation Oncology.

MRgFUS, which first emerged as a noninvasive way to treat uterine fibroids, uses pinpointed high-energy sound waves to heat and destroy pain-causing nerves in the membrane surrounding bone. This lowers or eliminates pain, improving the patient’s quality of life for months, according to the Food and Drug Administration, which approved MRgFUS for metastatic bone cancer in October 2012.

Wong recently treated the first patient in Southern California to receive MRgFUS for metastatic bone cancer outside of a clinical trial.

Now, he and his colleagues are working to turn MRgFUS to an even higher purpose — eradicating cancer cells altogether.

"We’ve got a clinical study for prostate cancer ready to go," Wong said. The trial will evaluate the feasibility of using MRgFUS to destroy prostate tumors.

Wong also is working with John Shively, Ph.D., chair of the Department of Immunology, to develop a method using MRgFUS and nanoparticles to improve drug delivery to tumors. Training the ultrasound on tumors would make the arteries and capillaries feeding those tumors more porous, so the nanoparticles, which carry chemotherapy agents, could more easily deliver the drugs deep into the tumor. But those studies are in early stages and years from use in humans, Wong said.

For now, the goal is easing pain — and opening the door to a potential cancer treatment.

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