Cancer Pain

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Focused Ultrasound Therapy

Focused ultrasound is a noninvasive, therapeutic technology with the potential to improve the quality of life and decrease the cost of care for patients with pain from many types of cancer. This novel technology focuses beams of ultrasound energy precisely and accurately on targets deep in the body without damaging surrounding normal tissue.

How it Works
Where the beams converge, focused ultrasound produces precise ablation (thermal destruction of tissue) of the nerves that serve the cancerous region. This enables significant and sustained pain reduction without surgery.

Focused ultrasound technology is approved to relieve several types of pain. One device is approved by the FDA for treatment of pain due to bone metastases. Devices to treat arthritis pain and back pain (originating from facet arthritis) are approved in Europe, but not yet in the United States. Focused ultrasound lessens the pain through targeted and precise ablation of nerves that serve the affected area.

Advantages
The primary options for treatment of cancer pain include medications and sometimes invasive procedures.

For certain patients, focused ultrasound could provide a noninvasive and perhaps more effective alternative to existing pain management dosing strategies, with less risk of complications – such as surgical wound healing or infection – at a lower cost. Focused ultrasound pain relief does not have the added risks of nausea, respiratory depression, addiction, or other side effects associated with narcotic pain medicines. It can also be repeated, if necessary. 

Clinical Trials

clinical trial at the University of Virginia is treating patients with severe opioid resistant pain from head or neck cancer with focused ultrasound.

See a full list of clinical trials on cancer pain. 

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Regulatory Approval and Reimbursement

Focused ultrasound treatment for pain associated with cancer is not yet approved by regulatory bodies or covered by medical insurance companies.

Notable Papers

di Biase L, Falato E, Caminiti ML, Pecoraro PM, Narducci F, Di Lazzaro V. Focused Ultrasound (FUS) for Chronic Pain Management: Approved and Potential Applications. Neurol Res Int. 2021 Jun 29;2021:8438498. doi: 10.1155/2021/8438498. eCollection 2021.

Simões Corrêa Galendi J, Yeo SY, Simic D, Grüll H, Stock S, Müller D. A time-driven activity-based costing approach of magnetic resonance-guided high-intensity focused ultrasound for cancer-induced bone pain. Int J Hyperthermia. 2022;39(1):173-180. doi: 10.1080/02656736.2021.2023768.

Patel AA, Zhukosvky M, Sidharthan S, Jotwani R, Rakesh N, Gulati A. Preliminary effects of low-intensity focused ultrasound treatment program for cancer-related neuropathic pain. Pain Manag. 2021 Jun 9. doi: 10.2217/pmt-2020-0099.

Filippiadis DK, Tselikas L, Bazzocchi A, Efthymiou E, Kelekis A, Yevich S. Percutaneous Management of Cancer Pain. Curr Oncol Rep. 2020 Apr 16;22(5):43. doi: 10.1007/s11912-020-00906-x. Review.

Marinova M, Huxold HC, Henseler J, Mücke M, Conrad R, Rolke R, Ahmadzadehfar H, Rauch M, Fimmers R, Luechters G, Cuhls H, Radbruch L, Schild HH, Strunk H. Clinical Effectiveness and Potential Survival Benefit of US-Guided High-Intensity Focused Ultrasound Therapy in Patients with Advanced-Stage Pancreatic Cancer. Ultraschall Med. 2018 Apr 17. doi: 10.1055/a-0591-3386.

Dababou S, Marrocchio C, Scipione R, Erasmus HP, Ghanouni P, Anzidei M, Catalano C, Napoli A. High-Intensity Focused Ultrasound for Pain Management in Patients with Cancer. Radiographics. 2018 Mar-Apr;38(2):603-623. doi: 10.1148/rg.2018170129. Epub 2018 Jan 30.

Dababou S, Marrocchio C, Rosenberg J, Bitton R, Pauly KB, Napoli A, Hwang JH, Ghanouni P. A meta-analysis of palliative treatment of pancreatic cancer with high intensity focused ultrasound. J Ther Ultrasound. 2017 Apr 1;5:9. doi: 10.1186/s40349-017-0080-4. eCollection 2017.

Shi Y, Ying X, Hu X, Shen H. Pain management of pancreatic cancer patients with high-intensity focused ultrasound therapy. Pak J Pharm Sci. 2017 Jan;30(1 Suppl):303-307.

Click here for additional references from PubMed.

Clinical Trials