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Managing Cancer Pain from Bone Metastasis

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For the Best Pain Relief, Keep a Diary

If you have bone metastasis, you can help manage the pain by keeping track of it. "A really clear understanding of the pain is going to help the most," says Julie R. Gralow, MD, professor of medical oncology at the University of Washington School of Medicine and director of breast medical oncology at the Seattle Cancer Care Alliance.

She advises keeping a pain diary so that you can answer questions your oncologist may ask, like:

  • When is your pain the best and worst -- for example, with movement or when lying down?
  • How severe is the pain on a scale of 1 to 10?
  • What is the pain like? Is it burning? Sharp? Dull?
  • Where is the pain located? In one place? In several places?

Providing this kind of information to your doctor can help ensure effective treatment, says Gralow. "Very good communication is going to get you the best pain relief."

Bone Metastasis: What Treatment Is Best for You?

Your doctor will consider many factors when determining your treatment options. One is the location of the pain. For example, metastasis in a weight-bearing bone is more painful than in other bones, Fasano says. This may affect the approach to treatment.

Pain management may also depend on how widespread the pain is. "If pain is focal -- meaning just in one place -- we would manage that somewhat differently than if it is in multiple places," Gralow tells WebMD.

If you have pain only in one or two spots, it is possible to target the cancer with radiation therapy. This uses high-energy X-rays to kill cancer cells and help relieve bone pain. Often, though, the pain is in several spots, Gralow says. It is not possible to focus a directed therapy such as radiation on many spots. "So we have to use a more total body treatment for the pain, such as drug therapy."

Treatments to Relieve Bone Metastasis Pain

From simple pain medications to orthopaedic procedures to radiation therapy, a wide range of options can help control pain. And, of course, it is always important to get the disease under control with whole-body therapies, Gralow says. This might include chemotherapy, hormone therapy, or other cancer treatments.

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