Until recently, a widespread treatment called “hemi-body” irradiation was commonly used to ease pain in prostate cancer patients with metastases to bone in several places. Hemi-body irradiation involved what radiologists call “wide fields” of radiation—large expanses of the body, and comparatively high doses of radiation. The problem was that this often wiped out key blood-forming cells in the bone marrow and compromised the body’s immune system, resulting in such complications as infections and the need for transfusions.

Now, for pain that is concentrated in one area—a portion of the spine, for instance—more specific pain treatment is a far better approach. Two good options are “spot” radiation and radioactive strontium-89.

“Spot” Radiation

This is localized external-beam radiation treatment, targeted at one or several painful bone metastases. It won’t prevent new metastases from cropping up in bone, but it generally helps ease pain in the sites it does treat. Spot radiation often results in several months of dramatic relief from pain, and it helps prevent spinal cord compression (see below). In recent studies, 55 percent of patients received complete relief from pain, 33 percent had partial relief, and only 12 percent had little or no response.

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