Cryoablation and its Effects on Cancer Pain
An underappreciated use of cryoablation is increasing — pain management in cancer patients. A 2021 study released by the Radiological Society of North America (RSNA) confirms that cryoablation is a safe, effective treatment of pain caused by metastatic bone tumors. An article by J. David Prologo, an interventional radiologist at Emory Healthcare in Atlanta, published by CancerNetwork.com, confirms his experience using cryoablation to provide effective pain relief with minimal downtime or side effects.
Pain in Cancer Patients
Cancer pain happens when cancerous tumors press on bones, nerves, or organs in the patient’s body. Even small tumors can cause extreme pain when they are located adjacent to a nerve or near the spinal cord.
Pain is incredibly draining and demoralizing — especially given that they face regular treatments at their cancer centers which may be located a significant distance from their home. Adding to the stress of their cancer diagnosis, their pain level may cause crucial mental health issues, including anxiety and depression.
Patients with metastatic disease are particularly impacted. While strong opioids may provide temporary relief, opioids are associated with a substantial risk of adverse events (AEs), affecting patients’ quality of life. Patients complain that the side effects are almost as harmful as the pain — sedation, dizziness, nausea, vomiting, constipation, and confusion. And opioids don’t always work for cancer pain.
The result of cancer pain is that patients lose hope when they cannot live an even “close-to-normal” life or participate in their favorite activities.
Study Details and Results
The Multicenter Study of Cryoablation for Palliation of Painful Bone Metastases (MOTION) was an international, multi-location, single-arm study looking at the efficacy and safety of just one cryoablation treatment for palliation of painful bone metastases. Each institution approved the protocol. The study period ran from February 2016 to March 2018 and included 11 sites in the United States and France. Patient selection included confirmed diagnosis by imaging or biopsy and that current analgesic therapies had failed. Patients had to have pain rated at least 4 out of a scale from 0-10. Patients diagnosed with bone cancer were excluded.
Study results are remarkable. “Mean pain scores improved by 2 points at week 1 and reached clinically meaningful levels (more than a 2-point decrease) after week 8; scores continued to improve throughout follow-up. Quality of life improved, opioid doses were stabilized, and functional status was maintained over 6 months.”
Insights from Emory Healthcare
- David Prologo, MD, shares the story of one patient. Esther, a woman in her late 30’s diagnosed with metastatic breast cancer, had been a runner before her diagnosis. She was depressed and disappointed that pain from a large tumor prevented her from running. She reported that she felt “like a zombie” while taking oxycodone. Esther sought help from interventional radiology. Within 24 hours, her pain had practically disappeared. The following week, she participated in the Dopey Challenge race at Disney World — a 5k, 10k, half-marathon, and full marathon in just 4 days — fulfilling one of her life goals.
Prologo points out that Esther’s experience is not unique. Reviews of 22 papers reveal that cryoablation reduced mean pain levels by 62.5% after 24 hours, 70.0% at 90 days, and 80.9% at six months. Cryoablation does not interfere with chemotherapy or other treatment protocols.
Prologo is quick to note that thousands of cancer patients still experiencing pain or serious AEs are candidates for cryoablation. Education and cooperation between oncologists and interventional radiologists can help relieve pain experienced by cancer patients.