Atlanta Man Finds Relief From Metastatic Spine Tumors Thanks to Two Innovative Therapies Working Together to Relieve Pain

Having cancer is challenging enough, and if it metastasizes or moves into surrounding bone, it can be extremely painful — making every day even more challenging.

That’s what happened to Peter, 57. Peter was diagnosed with kidney cancer in 2012. Years later, the cancer recurred, and Peter sought care at Cancer Treatment Centers of America outside Atlanta.

Peter underwent chemotherapy, radiation treatments to lesions on his sacrum, and surgery to remove a football-size tumor from his kidney.

Then he began to suffer severe back pain.

“I told my oncologist I’m having this severe back pain, and it’s gotten progressively worse,” Peter says. “I can’t get up in the morning out of bed without bending over, I said – it’s that bad.”

A scan found Peter had tumors on his lumbar spine. “It looked like a snake in my back,” he said.

Cancer spreads to the bone in 60-80% of patients with metastatic disease¹ , most frequently among patients with primary malignancies of the breast, prostate,  and lung. ²

Peter was referred to Dr. Nathan Neufeld, a pain management and rehabilitation specialist who is fellowship-trained in anesthesia. Neufeld recommended Peter undergo two minimally invasive procedures called OsteoCool™ RF Ablation Therapy and Balloon Kyphoplasty (BKP).

Radiofrequency (RF) ablation uses alternating, low-power energy to generate heat during the procedure. The heat is delivered by a probe to the tumor to intentionally dry out and kill cancerous cells. BKP is a minimally invasive procedure for the treatment of spinal fractures due to osteoporosis, cancer, or non-cancerous tumors.

“It’s not a thing that you do on its own to treat cancer, but it works with radiation and chemo and everything else to be able to ablate these tumor cells and cause them to die,” Neufeld says. “And when they die, it creates a void or cave inside the vertebral body. Then that cave is at risk of being able to crack further because you’ve taken the tumor out, and so ultimately I put in some bone cement, and that actually seals up the cracks.”

Peter said the outpatient procedures, which took about an hour, helped relieve his pain and restore his quality of life.

“The very next day, the sciatic pain was gone,” Peter says. “Everything else I had prior to that didn’t work. Now I feel like I can enjoy my retirement and do everything I want to do. ”

Risks of the OsteoCool™ system include damage to surrounding tissue through iatrogenic injury as a consequence of electrosurgery; pulmonary embolism; nerve injury including thermal injury, puncture of the spinal cord or nerve roots potentially resulting in radiculopathy, paresis, and paralysis. If a patient has a tumor in the cervical spine (neck), this procedure should not be used.

Although the complication rate for Balloon Kyphoplasty is low, as with most surgical procedures, serious adverse events, some of which can be fatal, can occur, including heart attack, cardiac arrest (heart stops beating), stroke, and embolism (blood, fat, or cement that migrates to the lungs or heart). Other risks include infection; leakage of bone cement into the muscle and tissue surrounding the spinal cord and nerve injury that can, in rare instances, cause paralysis; leakage of bone cement into the blood vessels resulting in damage to the blood vessels, lungs, and/or heart.

 

*The following testimonial contains the opinions of and personal surgical techniques practiced by Dr. Nathan Neufeld.  The opinions and techniques presented herein are for information purposed only and the decision of which technique to use in a particular surgical application should be made by the surgeon based on the individual facts and circumstances of the patient and previous surgical experience.

REFERENCES

1. Schulman, et al. Economic Burden of Metastatic Bone Disease. American Cancer Society,
2. Kurup AN, Callstrom MR. Ablation of Skeletal Metastases: Current Status. J Vasc Interv Radiol. 2010;21(8 Suppl): S242-S250.
3. Goetz, et al. Percutaneous Image-Guided Radiofrequency Ablation of Painful Metastases Involving Bone: A Multicenter Study. J Clin Oncol. 2004;22(2):300–306.
4. Spiegel D, et al. Pain and depression in patients with cancer. Cancer. 1994;74:2570-2578.
5. Gangi et al. Image-Guided Ablation Therapy of Bone Tumors. Elsevier Inc, 2009.

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