S08 E07 Your Guide to Bone Mets: Traditional & Innovative Approaches Using Radiation

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In this second of three episodes on managing bone metastases in MBC, we bring you a broad review of the major interventions to treat and manage bone mets. We explain the differences among the specialties of Radiology (think x-rays and PET/CT scans) vs. Radiation Oncology (external beam, Stereotactic Radiation Surgery (SRS) or Stereotactic Body Radiation Therapy (SBRT) and Interventional Radiology (Biopsies, Cryoablation, Radiofrequency Ablation among others). The majority of patients with MBC have bone metastases and may have been treated with some form of radiation.  For patients with "oligometastatic" disease, where the number of distant sites of metastatic spread is generally considered to be 5 or less, radiation treatment may be “curative”. It gets a little less clear in those of us with heavier tumor burden and more widespread disease. In that case, radiation is often offered for pain and neurologic considerations, such as preventing a tumor from pressing on the spinal cord, possibly resulting in serious spinal cord compression. But, can different radiation strategies be helpful in disease management, beyond pain management? We ask these questions of both experts here – the first Dr. Shalom Kalnicki, Professor of Radiation Oncology and Associate Director of the Montefiore Einstein Comprehensive Cancer Center in New York City. Our second expert clinician is Dr. Rory Goodwin, who leads the Duke Center for Brain and Spine Metastasis in Durham, North Carolina. He’ll talk about this innovative Center’s approach to managing bone mets, including offering some lesser-known treatment approaches like Cryoablation (freezing the tumor), and Radiofrequency Ablation (heating the tumor). We also address an emerging therapy called “Theranostics” which is when a radioactive tracer (like the ones used in PET/CT scans) is bound to a radiation treatment that can deliver a lethal dose directly to the bound cancer cell. So listen here and learn with us, and check out the more detailed show notes on our website for the links to what’s covered in the episode.