Cancer that spreads to the bones often causes pain. Also, cancer in the bones can make them weak and more likely to break. This type of break is called a pathological fracture.
Doctors can treat bones affected by cancer by using special cement to strengthen them. This is called cementoplasty. There are two techniques:
- percutaneous cementoplasty
- vertebroplasty and kyphoplasty
Cementoplasty means using a special cement to strengthen and support bone. Percutaneous means under the skin, and describes how the cement is put into the bone.
Doctors use the cement to fill parts of bone destroyed by cancer that are causing pain. It can help to relieve pain and make the bone more stable. It has also improved walking for some people.
You have this minor operation either under a general anaesthetic. Or, when you are drowsy, after taking a sedative. Using x-rays to guide the way, the doctor puts a needle into the skin and injects the cement into the bone.
You are most likely to have percutaneous cementoplasty to help control symptoms of secondary bone cancer. You are less likely to have this treatment for a cancer that started in the bone (primary bone cancer).
The National Institute for Health and Care Excellence (NICE) guidance says that doctors can use percutaneous cementoplasty as part of NHS treatment, but only if other ways of treating your pain have not worked.
Vertebroplasty and kyphoplasty
These are different forms of cementoplasty for the spine.
In vertebroplasty, bone cement is injected into damaged bones in the spine (vertebrae). The treatment eases pain and helps to support the spine.
Some studies have shown that vertebroplasty can relieve pain in up to 9 out of 10 people (up to 90 %) with myeloma or other types of cancer that have spread (metastatic cancers).
Balloon kyphoplasty is similar to vertebroplasty. It treats fractures of the spine. For kyphoplasty, little balloons are put into the spine. They are slowly inflated so that the spine goes back to as near its normal height as possible. Then special cement is injected into the space created by the balloon to strengthen the bone.
Trials have shown that this technique can help to relieve pain and restore some height.
Access to treatment
NICE has issued guidance on vertebroplasty for treating fractures in people with painful conditions of the spine, including tumours. They say that doctors should consider it only if other ways of treating your pain have not worked.
NICE has approved balloon kyphoplasty for use in the NHS as a treatment for collapsed bones in the spine.