Why Is Bone Cancer So Painful? Bone cancer disrupts normal bone cell activity that is intended to help keep bones strong without becoming too bulky. This disruption in bone cell function can cause a bone to become either too brittle or too thick and overdeveloped. Either of these situations may then lead to intense pain by irritating nerves inside the bone or by stretching the membrane that covers the bone. Bone Cancer: Pain Medications Most pain medications for bone cancer are taken by mouth, in pill or liquid form. If swallowing is difficult, pain medication can also be delivered through a patch placed on the skin, an injection, or a rectal suppository. The type of medication your doctor prescribes will depend on the type and severity of the pain you experience. Bone Cancer: Mild to Moderate Pain If your bone pain is generally mild, your doctor may suggest over-the-counter pain medications, like acetaminophen (Tylenol), or nonsteroidal anti-inflammatory drugs (NSAIDs), like ibuprofen (Motrin, Advil). Side effects of NSAIDs include stomach irritation and bleeding, easy bruising, and kidney damage. Acetaminophen taken in heavy doses can cause severe liver damage. Bone Cancer: Moderate to Severe Pain If you have moderate to intense pain, your doctor will likely prescribe an opioid. Opioids include:
CodeineVicodin or Anexsia (hydrocodone)Oxycontin or Roxicodone (oxycodone)Palladone or Dilaudid (hydromorphone)Duragesic (fentanyl)Dolophine or Methadose (methadone)
Side effects of opioids include:
constipationsleepinessnausea and vomiting
Additional medications can be used to help minimize these adverse effects. Bone Cancer: Medications for Tingling and Burning Pain For pain that leads to tingling, numbness, or a burning sensation, medications that treat neuropathic, or nerve-related, pain are recommended. These include anti-seizure drugs and antidepressants. Anti-seizure drugs used to treat bone cancer pain include:
Neurontin (gabapentin)Depakote (divalproex acid)
Side effects of antidepressants include:
dry mouthsleepinessconstipationdizziness
Antidepressants used to treat bone cancer pain include:
Elavil (amitriptyline)Tofranil (imipramine)Adapin or Sinequan (doxepin)Desyrel (trazodone)
You’ll need a prescription for these medicines. Keep in mind that these drugs have been shown to treat nerve-related pain effectively; taking them does not necessarily mean you are depressed or about to suffer from seizures. Side effects of anti-seizure drugs include:
liver damagelight-headednessfatigue
Bone Cancer: Pain From Swelling Doctors often prescribe steroids like Meticorten or Orasone (prednisone) and Decadron (dexamethasone) to help offset the pain of bone and joint inflammation. Steroids are usually very good at relieving this type of pain, but frequent side effects may limit it use. These adverse effects include:
fluid retentionstomach discomfort and irritationbleeding of the stomach liningincreased blood sugarmuscle weaknessincreased risk of infection
Bone Cancer: Bisphosphonate Drugs Bisphosphonate medications are often used to treat osteoporosis, or brittle bones. Additionally, they can be used to treat pain due to cancer by helping to fortify weakened bone tissue. The U.S. Food and Drug Administration approved two drugs for this purpose, Zometa (zoledronic acid) and Aredia (pamidronate). Side effects of bisphosphonates include:
feverfatiguecold- and flu-like symptomsesophageal and stomach irritation
Bone Cancer: Radiation Therapy Radiation therapy is also used to relieve bone cancer pain. Doctors can direct an external source of high intensity X-rays at bone tumors, causing them to shrink. Another type of radiation therapy involves injecting a radioactive substance into a patient’s vein. Because cancer cells tend to grow more rapidly than normal cells, the radioactive substance is more apt to travel to these cells and then destroy them. Though potentially effective, radiation therapy has to be used carefully for pain relief, as it can damage the bone marrow and lead to reduced blood cell counts, or even leukemia. Bone Cancer: Freezing the Pain Currently, doctors are investigating a new method of pain relief for bone cancer that involves freezing the cancer cells on contact. In this method, known as cryoablation, doctors direct a slender probe through the skin to a bone cancer tumor. The probe is then used to place ice on the cancer cells, freezing them in place. Researchers have found that cryoablation can significantly alleviate pain associated with bone cancer. If you’re experiencing pain due to bone cancer, tell your doctor. Numerous medications and therapies already exist and additional treatments are still being developed. There is no need to suffer in silence.
