Dr. Jenny Gandhi

702, 7th Floor, Solaris Kode, Near Khatu Shyam Temple, VIP Road, Vesu , Surat.
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Pain From Metastatic Lesions

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Pain From Metastatic Lesions

+91 90033 03373

Pain From Metastatic Lesions

Home

Pain From Metastatic Lesions

WHAT IS
PAIN FROM METASTATIC LESIONS?

When cancer spreads to the bone, it can cause a severe form of pain that is frequently characterized as either a dull ache or a sharp, intense pain. The tumor’s chemical and mechanical effects on nerves and bone structures, or the cancer’s weakening of the bone, which can result in fractures, are the two possible causes of this progressive pain that gets worse over time and at night.

causes

Bone Remodeling and Inflammation
Nerve Damage or Compression
Tumor Expansion
Pathological Fractures
Peripheral and Central Sensitization
Breakthrough Pain
Inflammation and Tumor Microenvironment

symptoms

Bone Pain
Pathological Fractures
Nerve Compression Symptoms
Hypercalcemia Symptoms
Swelling or Tenderness
Reduced Mobility and Functional Impairment

if untreated?

Severe, persistent pain: Pain may worsen, become incessant, and refractory to simple analgesics, severely impacting quality of life.​
Pathological fractures: Weakened bones are prone to fractures, causing sudden, severe pain and physical disability.​
Spinal cord compression: Metastases to the vertebrae can compress the spinal cord or nerve roots, leading to neurological deficits such as paralysis, loss of bladder/bowel control, numbness, and weakness.​
Hypercalcemia of malignancy: Excess bone breakdown releases calcium into the bloodstream, causing nausea, vomiting, constipation, confusion, fatigue, cardiac arrhythmias, and coma if untreated.
Anemia and marrow suppression: Bone marrow infiltration by tumor can reduce red blood cell production causing anemia, fatigue, and increased infection risk.​
Reduced mobility: Pain and skeletal complications reduce function and independence.
Psychosocial impact: Chronic pain and disability can lead to depression, anxiety, and reduced social participation.

diagnosis

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Clinical Evaluation
  • Assess patient history including known malignancy and symptoms like localized bone pain, fractures, or neurological signs from nerve compression.
X-rays
  • Initial screening tool to identify osteolytic or osteoblastic lesions and detect pathological fractures. Limited sensitivity for small lesions.
Bone Scintigraphy (Bone Scan)
  • Uses radionuclide tracer (99mTc-MDP) to detect areas of increased bone activity indicating metastases. High sensitivity but less specific.
Computed Tomography (CT)
  • Provides detailed assessment of bone cortex destruction and lesion morphology, useful for surgical planning.​
Magnetic Resonance Imaging (MRI)
  • Highly sensitive for early marrow involvement before bone destruction, critical for spinal metastases and soft tissue evaluation.​
Positron Emission Tomography (PET)
  • Combined with CT, detects metabolically active tumors using 18F-FDG or 18F-NaF tracers, helpful for staging and treatment response.​
Laboratory Tests
  • May show elevated serum calcium, alkaline phosphatase, anemia, or other tumor markers.
Biopsy
  • Definitive diagnosis by sampling bone lesion tissue via CT or MRI-guided core needle biopsy to confirm metastasis and identify primary tumor origin, especially when unknown.

Interventional Radiology
treatment

Transarterial Chemoembolization

By specifically cutting off the tumor’s blood supply, transarterial chemotherapy embolization (TACE) is a minimally invasive tumor treatment technique. Here, a catheter is used to inject tiny embolic particles coated with chemotherapy medications straight into the artery supplying the tumor. By simultaneously preventing blood flow and administering concentrated chemotherapy, tumor cells are killed more efficiently and systemic side effects are reduced. In order to ensure accurate catheter placement, the procedure is typically performed under imaging guidance, frequently through a tiny incision in the wrist or groin.
Transarterial Radioembolization (TARE)

It is a catheter-based delivery method in which Yttrium-90-containing radioactive microspheres are injected into the arteries supplying the tumor in place of chemotherapy. Localized radiation from these microspheres destroys tumor cells from the inside out while leaving healthy tissue unharmed. In addition to cutting off the tumor’s blood supply, this targeted radiation therapy gives the tumor a high dose of radiation.
Vertebroplasty / Kyphoplasty for spinal metastasis

These minimally invasive procedures inject bone cement into affected vertebrae, significantly reducing pain and stabilizing the spine in patients with metastatic spine lesions. Pain relief is achieved in a high percentage of cases (80–100%), making these effective palliative options for painful metastatic vertebral fractures.
Radiofrequency Ablation (RFA)

Another minimally invasive method for treating tumors is radiofrequency ablation (RFA), which uses high-frequency electrical currents to produce heat and destroy cancer cells. The electrical current causes localized heating through resistive heating of the ionic tissue medium after a needle-like electrode is inserted into the tumor, leading to coagulative necrosis of the tumor. In contrast to MWA, RFA depends on the electric conductivity of tissues, which can occasionally result in incomplete ablation if there is charred or desiccated tissue present during the procedure.
Cryoablation

A minimally invasive medical technique that freezes and destroys diseased or aberrant tissue using extremely low temperatures. Using imaging guidance like ultrasound, CT, or MRI, a thin probe known as a cryoprobe is inserted through the skin during the procedure to precisely target the affected area. Without the need for extensive incisions, the probe’s emissions of gases like liquid nitrogen or argon produce freezing temperatures that harm cells and destroy tumors or lesions.

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