Battling Prostate Cancer Pain

Bisphosphonate ibandronate as effective as radiotherapy

/ Author:  / Reviewed by: Joseph V. Madia, MD

(RxWiki News) When prostate cancer spreads to the bones, it can be very, very painful.  New research shows more effective ways to ease this extreme pain, which can extend the lives of advanced prostate cancer patients and provide researchers insight into how pain relief works.

A recent clinical trial showed one dose of a bone-strengthening drug, bisphosphonate ibandronate (IB) was just as effective as one dose of radiotherapy in reducing advanced prostate cancer pain. The study also found that patients who received both pain medication and radiation lived longer.

"Ask  your oncologist about the best way to treat prostate cancer pain."

Radiation is the standard way of treating pain in prostate cancer, but the reason why it works is uncertain, according to Professor Peter Hoskin, consultant clinical oncologist at the Mount Vernon Cancer Centre, Northwood, UK, and professor of clinical oncology at University College, London. IB works to prevent bone loss by sticking to calcium and inhibiting osteoclats, which break down bone.

The trial examined 470 prostate cancer patients in extreme pain due to malignant bone tumors, called bone metastases. One group  received a single dose of radiotherapy and the other group received one dose of intravenous bisphosphonate ibandronate (IB). Patients tracked their pain and were followed for one year.

Pain level was measured by the World Health Organization's pain ladder, which measures pain by what is needed to control it - from simple painkillers to strong opioids, and the Mercadante method which converts painkiller use to its equivalent methadone dose.

While the IB group needed more re-treatments at four weeks, by the sixth month and at end of the first year, there was no significant difference in pain relief between the IB group and the radiotherapy group. Side effects were similar.

Survival rates were similar for both groups receiving single pain therapies. Patients receiving radiotherapy lived an average of 11.8 months compared to 11.4 months for those who were given IB.

More interestingly, patients who received combined treatments lived longer. Those who had  radiotherapy then IB lived 12.6 months, while patients who received IB followed by radiotherapy had the best survival rate - 16.8 months.

Hoskin is optimistic about this study, not just for new methods in pain relief, but for future research that can help identify how and why the body responds to specific types of therapy. Furthermore, he believes these results can be applied to research involving advanced breast cancer patients with bone metastases.

This study was presented at the 2011 European Multidisciplinary Cancer Congress.

Research is considered preliminary until published in a peer-reviewed journal. 

Reviewed by: 
Review Date: 
October 8, 2011
Last Updated:
October 10, 2011