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Review

Interventional treatments for metastatic bone cancer pain

    Vivek Sindhi

    Department of Physical Medicine & Rehabilitation, East Carolina University Brody School of Medicine, Greenville, NC 27858, USA

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    &
    Michael Erdek

    *Author for correspondence:

    E-mail Address: merdek@jhmi.edu

    Berman Institute of Bioethics, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA

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    Published Online:29 May 2019https://doi.org/10.2217/pmt-2018-0073

    Abstract

    Metastatic bone cancer pain may cause significant morbidity among the cancer patient population. Painful bone lesions are challenging to manage due to the aggressive pathophysiology of the pain generator involved. The WHO’s approach to cancer pain treatment involves the use of a three-step ladder which provides a guideline for clinicians to treat patients who struggle from cancer pain syndromes. It is possible that this ladder is no longer helpful for patients who continue to fail oral or transdermal medication options. A fourth step in the cancer pain ladder has been proposed to include interventional approaches to cancer pain management. This review will discuss opioid therapy, radium-223, denosumab and bisphosphonate therapy, but will primarily review the available interventional treatment options for metastatic bone cancer pain.

    Papers of special note have been highlighted as: • of interest

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