New surgical procedure greatly reduces bone cancer fracture pain

Jun. 12—A new pain relief treatment with a futuristic-sounding name, OsteoCool, is helping bone tumor cancer patients avoid using, and potentially abusing, medically prescribed opioids.

Janice Grainger, a resident of Stockton, was diagnosed in 2015 with multiple myeloma, when cancerous cells accumulated inside the marrow of her bones. Surgery and a transplant followed in 2016, though she said there were setbacks in the months and years that followed.

For cancer patients such as Grainger, metastasized bone tumors can produce pain, decreased mobility and even painful bone fractures. In her case, bone tumors had caused three compression fractures to the T9, T10 and T11 vertebrae at the base of the spine. That was causing her massive amounts of discomfort and forcing her to take opioids to blunt a portion of the pain. Worse, the daily back agony was forcing her to delay efforts to treat her cancer.

"I was taking more hydrocodone for pain than I wanted to," the 70-year-old said recently, "but nothing worked. I would have spasms in my back that hurt so much I couldn't breathe. I couldn't lay down ... without pain, and eventually, I couldn't cook for myself. I couldn't do anything — even going to bed was extremely painful, and I couldn't sleep."

While meeting with Freeman Health System oncologist Dr. Atman Shah, she learned details concerning two procedures used in tandem to ease the type of pain Grainger was suffering: the new OsteoCool ablation procedure — recently made available to Joplin area residents — as well as the vertebral-stabilizing procedure called Kyphon Balloon Kyphoplasty.

Upon hearing Shah's endorsement for the surgery, "I said, 'Great — let's do it,'" Grainger said. "I still have the cancer — I'll always have it — but ... Dr. Shah had to put a hold on (the cancer treatment) until I could get my back fixed."

She underwent the same-day surgery back in February, in which both of the above procedures were performed by Freeman's Dr. Joshua Sweaney. With OsteoCool, he made two small incisions near the location of the fractures. Sizing tools created a pathway into the bones. Using radiofrequency ablation to generate heat, a probe intentionally dried up and killed the cancerous cells there. Then, using the same incision sites, he inserted a balloon to raise the bone's collapsed portions to create newly formed cavities; he then filled up the spaces with surgical cement to prevent further bone collapse and new spasms of pain.

"As far as the benefits go, we are seeing very quick responses — in less than 72 hours the pain is completely gone," Shah said, adding that he's recommended about 10 patients to undergo OsteoCool treatment over the past three to four months. "We've had patients that were on narcotics ... and then they were off those and back in (cancer) treatment in less than three days. It's a very dramatic change in pain relief."

Even better, "OsteoCool has led to immediate pain relief for cancer patients," Shah continued. "It can be performed before or after radiation therapy, and it can be done in many cancers where metastasis has occurred."

For Grainger, she now leads a more normal life, and she couldn't be happier about that.

"I was coming out of my surgery, going into recovery, and somebody asked me how my pain was — and it was gone," she said. "I mean, literally — gone. I just can't tell you the relief I had when I had that surgery."

She's still fighting and treating her cancer, however: "I know it's always going to be a battle, but you know — it's a fight that you have to do every day. But I'm up for it. And I can do it as long as I feel good."

Thanks to her surgery and with the pain of the back bone fractures gone, she said, "Getting past that pain has made a world of difference. I would recommend this procedure for anybody that has problems because it works. It really does work."

Kevin McClintock is features editor for The Joplin Globe.