Radiation therapy can be used to treat spots of cancer within the bones that are causing pain. If given soon enough, radiation therapy also can prevent the risk of fracture. Different types of radiation therapy can be given for bone metastasis:
- External beam radiation therapy: For many women, a single dose or several doses of external radiation therapy — delivered to the affected areas(s) of the bone — is enough to provide pain relief. It’s fairly common to have a pain flare 2 or 3 days later, but it usually only lasts for about 24 hours or so. Your doctor may give you the steroid medication dexamethasone to prevent a pain flare.
- Stereotactic body radiation therapy (SBRT): SBRT targets high doses of radiation to the areas of cancer while minimizing any exposure to nearby healthy tissue. SBRT can treat small- to moderate-size tumors, either as part of a single treatment or a few treatments over time. With SBRT, the areas of cancer are mapped first using imaging scans so that the beams can be targeted with great precision. You’re more likely to hear SBRT described with brand names such as CyberKnife or GammaKnife. This technology is not available everywhere, so check with your doctor.
- Radiopharmaceuticals: If you have many painful bone metastases in different areas, your doctor may recommend an internal form of radiation that travels throughout the entire body. Medications called radiopharmaceuticals are injected into a vein. Then, they move through the body and concentrate in areas of the bone where there is a lot of cell activity — old cells dying and new cells growing — as is the case when cancer is present. The radiation that’s given off destroys the cancer cells. Doctors may use a radiopharmaceutical such as strontium-89 (brand name: Mestastron), or samarium-153 (Quadramet). This treatment tends to work best if the bone metastases are osteoblastic, meaning that they have led to enlarged, rigid growths on the bone.