Radiotracer pain palliative therapy: a revisit

Metastatic bone disease can be extremely painful, the pain usually increases with time. Its management with drugs needs constant increase in dosage, change of drugs, and change in the mode of administration. A time is reached when pain can no longer be controlled by these means. Drug treatment is often associated with unacceptable side effects. Hormonal therapy is an option available in a few malignancies like those of prostate and breast, although it can offer good pain relief in some cases, the effect is not sustained. Focal external beam radiotherapy is an effective method of treatment when pain is limited to one area. Multiple painful areas present a management challenge to the doctor. Such patients can be managed by systemic administration of radiotracer pain palliative agents. Radiotracer pain palliative agents in use are Phosphorus-32(p/sup 32), Strontium-89(Sr/sup 89/), Samarium-153 (Sm /sup 153/), Rhenium-186(Re/sup 186/), and Sn/sup 117m/. All of these agents are locally available, and can be used effectively for pain palliation in skeletal metastatic disease. (author)