Treating Bone Metastasis with Interventional Radiology
Bone metastasis: what does the treatment involve?
Bone metastasis and interventional radiology: Symptoms and treatments
Bone metastases are secondary malignant tumors located on the bones. They occur when a primary tumor in an organ spreads to the body’s bone tissue.
One of the primary symptoms is bone pain, which is often unbearable. To address the pain, the bone tumor needs to be eliminated. To do this, several possible methods include radiation therapy, chemotherapy and immunotherapy; but these treatments are not always possible for every patient.
Interventional radiology offers new, minimally invasive approaches to reduce the pain related to bone metastases. These include embolization, ablation and cementoplasty. These advanced techniques are aimed at increasing how quickly patients feel relief and maximizing the duration of that relief.
What are the benefits of using interventional radiology to treat bone metastasis?
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Embolization
Embolization involves destroying the tumor by blocking the blood vessels that feed them. This cuts off the oxygen and nutrients to the tumor, causing it to die. To do this, we use an embolic agent (Gelfoam TM, microparticles, liquid glue, etc.).
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Ablation
Ablation offers the following techniques to eliminate bone metastasis and cause a lasting improvement in symptoms:
- Alcoholization: injecting alcohol to dehydrate the tumor tissue;
- Thermal: using cold by cryoablation or heat by radiofrequency or microwave ablation.
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Cementoplasty
Cementoplasty involves stabilizing the weakened bone by injecting medical cement into the bone. This makes it possible to keep bone fragments in place and accelerate healing, while reducing pain. It can be performed alone or in conjunction with other treatments.
Interventional radiology offers many advantages for treatment of bone metastases. Since the operations are minimally invasive, hospitalization is shorter and recovery is quicker. Patients also report less post-operative pain and complications.
How is interventional radiology treatment of bone metastases carried out at the American Hospital of Paris?
Depending on the situation, bone metastases can be treated in various ways: by embolization, ablation or cementoplasty. Whatever the option chosen, the Interventional Radiology team at the American Hospital of Paris has the skills and equipment necessary to perform these procedures.
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PRE-OPERATIVE CONSULTATION
Before any operation, you will meet the interventional radiologist for a consultation to determine the appropriate treatment.
You will also see the anesthesiologist who will take care of you, from consultation to the operation, until post-op.
Standard laboratory tests and imaging tests will also be performed.
In addition, a multidisciplinary team will validate all cases before any operation.
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PROCEDURE
The day of the procedure, you will be taken to the radiology room to meet the physicians. The procedure is performed under local or general anesthetic, in the interventional radiology room.
The interventional radiologist performs the procedure using imagery to guide the small instruments. That makes it easy to spot the organs and choose the best point of entry for the needle, while monitoring its path throughout the procedure.
After inserting the needle into the lesion, the bone metastasis may be treated with the following various methods:
- Radiofrequency ablation: via alternating current. This subjects the tumor to high temperature (60 to 100°C), leading to its destruction
- Microwave ablation: via electromagnetic microwaves. This subjects the tumor to high temperature (60 to 100°C), leading to its destruction
- Cryoablation: via cycles of extreme cooling with argon, followed by heating with helium. This subjects the lesion to a temperature of -100°C, destroying the tumor with extreme cold
- Cementoplasty: via medical cement, gradually released into the bone. This stabilizes the bone
Whatever procedure is chosen, the duration of the operation is fairly short; count on a maximum of one hour. The procedure may be performed on an outpatient basis, with return home possible the same day.
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POST-OPERATIVE MONITORING
After the procedure, the nursing staff will closely monitor you for several hours. The same anesthesiologist will be available at all times to manage any post-operative pain.
After making sure that everything went as planned, you can return home. We automatically schedule a follow-up visit one week after the procedure. At that appointment, you will meet with the medical team, who will ensure that the operation was successful.
In addition, we remain available by telephone 24/7 to answer any questions you may have. The on-call Medical-Surgical team is also available if necessary.
The interventional radiology techniques used are minimally invasive and not traumatic. You can therefore quickly resume your professional activity.
How do you prepare for interventional radiology treatment for bone metastases?
These interventional radiology operations do not require any specific preparation. The day of your consultation, just remember to bring the following documents:
- Laboratory test results
- Blood test results
- Imaging test results
- List of your medications
What are the outcomes for these interventional radiology treatments for bone metastases?
The American Hospital of Paris has achieved excellent outcomes treating bone metastases with interventional radiology. We have observed greater than 80% control of the tumor.
There are two reasons for our results: the skills of our team of experienced physicians, accredited by the best French hospitals, and our state of the art, latest generation equipment. The operating room has all the equipment needed to enable us to operate under the highest safety and quality conditions for our patients, including a vascular surgery table, 3D sensor, image fusion, MRI scanner, etc.
What are the complications of interventional radiology treatment for bone metastases?
At the American Hospital of Paris, we take every precaution necessary to reduce complications as much as possible. Complications related to interventional radiology treatment for bone metastases are relatively rare and include:
- Cementoplasty:
o Extraosseous cement leakage (rare and almost always asymptomatic)
o Infections during the procedure (very rare)
- Radiofrequency ablation:
o Hematoma at the puncture site (frequent)
o Skin burns when treating superficial lesions (rare)
o Burns to adjacent structures or organs (rare)
o Secondary fractures to weakened bones (rare, prevented by a stabilization procedure)
- Cryoablation:
o Hematoma at the puncture site (frequent)
o Secondary fractures to weakened bones (rare, prevented by a stabilization procedure)
Note that untreated bone metastasis may lead to a vertebral fracture with compression of the spinal cord. Treatment solely by radiation therapy may also lead to a weakened bone, with further vertebral fracture, which confirms the importance of coupling stabilization by cementoplasty with radiation therapy.
Consult with the interventional radiology team
Learn moreKey figures: Interventional radiology and bone metastases
85 %
The rate of positive results for bone pain and patient function after cementoplasty.
24 to 48 hours
The time needed after vertebroplasty to experience a lasting reduction in pain related to bone metastases.
