More information

More and more people are diagnosed with cancer each year. Treatments are also improving, and so people are living for longer with cancer. Whilst this is welcome, it brings other challenges. Bone tumours in the spine are common in people with advanced cancer. We expect 55,000 people diagnosed with cancer this year will go on to develop spinal tumours. 

Spinal tumours frequently cause pain. Over time, they can progress, causing nerve injury and making it more likely for the persons’ bones to break. They may also suffer from incontinence and weakening of their arms and legs. In extreme cases, it can lead to paralysis. 

This is all extremely distressing for the individual and those who care for them.

Where we cannot cure the cancer, we aim to reduce symptoms as much as possible. When painkillers don’t work, radiotherapy is used to reduce pain caused by spinal tumours. Unfortunately, this doesn’t work for everyone. Most people don’t experience complete pain relief; for others, pain relief is short-lived and more treatment is needed. We urgently need better treatments for these symptoms.

When giving radiotherapy it is important to avoid damaging critical parts of the body such as nerves in the spine. Stereotactic radiotherapy is a special type of radiotherapy that helps focus high doses of radiation on the cancer without causing damage to surrounding tissue. 

The technique is more complex but might work better than standard radiotherapy for relieving the pain of spinal tumours. It may also be better at controlling the cancer itself by damaging cancer cells in the treated area. However, we need to do more research to be sure.

We plan to test the use of stereotactic radiotherapy in people with secondary bone tumours in the spine. In this clinical trial, patients will receive either standard radiotherapy or stereotactic radiotherapy. This will be determined by chance. We will ask participants about the pain they experience before and after treatment, and the impact it has on their lives. Use of pain medication and NHS services will also be recorded. We will compare the groups to see if there are benefits of using stereotactic radiotherapy for patients. 

If pain control is better and lasts longer, with fewer long-term complications and less need for further treatment, this can offer value for money even if initial treatment costs are higher. So this could also be important information for people managing NHS budgets.

The research team will include experts in: 

•            radiotherapy 

•            secondary bone tumours 

•            managing cancer pain 

•            clinical trials and health economics