Minimally invasive ablation of a bone metastasis
The patient presented had a metastatic tumor in the hip bone and was already undergoing chemotherapy and immunosuppressive treatment, with a limited response. In the context of local metastasis progression and severe pain, the medical team opted for a minimally invasive procedure of image-guided tumor ablation.
The intervention was performed with the patient under light sedation, through a mini-incision. Using CT guidance, the instruments were positioned directly at the site of the bone metastasis, where the ablation was performed.
According to Dr. Ovidiu Palea, the goal of the procedure was both local control of the lesion and pain reduction, while providing the patient with additional time to continue or identify alternative systemic treatment options.
"Interventional pain therapy is gaining significant ground in oncology because we can, through guided minimally invasive procedures, stop the local progression of the disease, preventing it from invading adjacent structures."
A procedure of approximately 15 minutes
The intervention lasted approximately 15 minutes, and the results were significant for the patient's clinical progress. By treating the metastasis locally, tumor progression was halted, and the pain was reduced considerably, allowing the patient to regain functionality.
"The patient was on immunosuppressive chemotherapy, but with a very limited response, so in an attempt to buy time for other alternative systemic therapies, we performed this CT-guided intervention," explained Dr. Palea.
The metastasis had previously been stationary, but it had begun to grow rapidly and was at risk of invading the hip joint, causing severe pain and significantly affecting the patient's mobility.
Monitoring after bone metastasis ablation
"Two months after the intervention, the CT scan showed that the tumor was stationary, with no growth,” stated Dr. Ovidiu Palea.
For patients with advanced oncological disease, treatment is complex and requires a multidisciplinary approach. Interventional procedures do not replace systemic oncological treatments, but can play an important role in local lesion control and pain management, depending on the specifics of each case.
Interventional pain therapy in oncology
Advances in interventional pain therapy allow for the management of situations where cancer pain becomes difficult to control through conventional treatments. Minimally invasive procedures, performed under imaging guidance, can provide precise access to specific lesions and help reduce pain and improve functionality.
In the case of bone metastases, the choice of an interventional procedure depends on the location of the lesion, its size and progression, symptoms, and the patient's general status. The therapeutic decision must be made following an individualized and, when necessary, multidisciplinary medical assessment.
This case highlights how innovation in interventional pain therapy and image-guided minimally invasive techniques can contribute to symptom control and maintaining the quality of life for cancer patients.
Dr. Ovidiu Palea and the development of interventional pain therapy in Romania
Dr. Ovidiu Palea is a primary care physician in intensive care, a specialist in Pain Therapy, and president of ARAI – The Romanian Association for Interventional Algesiology. He is certified in Pain Therapy by the World Institute of Pain (WIP) and is a board member of the ESRA – European Society of Regional Anaesthesia & Pain Therapy.
Dr. Ovidiu Palea is the founder of the NORD Medical Group and an integrated center dedicated to pain management and professional training in this field.
ARAI – education and development of interventional pain therapy
ARAI – Romanian Association for Interventional Algesiology is an organization dedicated to the development of interventional pain therapy in Romania. ARAI supports the continuous training of physicians through courses, hands-on workshops, training programs, and educational initiatives dedicated to modern diagnostic and pain treatment techniques.
By collaborating with national and international experts, ARAI aims to develop standardized medical education and promote modern practices based on clinical experience and current developments in the field of interventional pain therapy.
