Cancer that has spread to bone or soft tissues can cause severe pain and be difficult to treat. Doctors at Brown University now report success in reducing pain in such cases by freezing the cancerous mass.

In four patients with advanced disease who had not been helped by surgery, chemotherapy or external beam radiation therapy, so-called cryoablation provided significant pain relief and reduced their need for narcotics, Dr. Damian E. Dupuy told AMN Health.

Normally, patients like these would require ever-increasing doses of narcotics, making it difficult for them to leave the house, drive or even read, Dupuy noted. “Their narcotic usage decreased after the treatment,” he said. “Any decrease in that can certainly improve a patient’s quality of life - they’re not so sleepy all the time.”

The patients included a 57-year-old man with rectal cancer that had formed a large mass in the region around the lower spine; a 20-year-old woman with an ill-defined 6-inch tumor in the right pelvis; a 55-year-old woman with breast cancer and a smaller mass around the upper spinal cord; and a 49-year-old man with Colon cancer and a soft-tissue mass in the mid-back.

Cryoablation involves insertion of a special probe with up to eight ultra-cold applicators that are applied to the tumor to freeze it. Two patients requested general anesthesia during the procedure, while the other two underwent conscious sedation. The procedure produces relatively little pain, Dupuy noted, because the freezing numbs tissue.

The first patient reported an improvement in pain immediately after the procedure and continues to be pain-free after 12 months, Dupuy and his colleagues in Providence, Rhode Island, report in the American Journal of Roentgenology.

The second patient, who had refused all but surgical treatment, also reported an improvement in her pain, but died a month later.

The third patient remained pain-free 13 months after treatment. While cryoablation resulted in loss of sensation and movement in her left arm, the researchers note, the patient had been warned of this risk and said she was satisfied with the results.

The fourth patient reported some improvement in pain as well.

The therapy could have been more effective if patients had been referred for treatment earlier, Dupuy said, but the current practice is for patients to exhaust all drug-based treatments before they are referred for newer procedures.

“There has to be a team of professionals involved from the start and there needs to be better integration into routine cancer care,” he added.

Dupuy’s group is currently conducting a larger study of cryoablation for cancer pain relief. The researcher said he believes the technique could eventually be used for curative purposes.

SOURCE: American Journal of Roentgenology, March 2005.