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External Beam Radiation Therapy For Bone Metastasis

What you should know

  • External beam radiation can be used to treat one or more cancer tumors, or it can be used to help stop cancer cells from spreading. Radiation is a very strong x-ray that has a beam of energy. The energy beam is pointed towards areas of the body that have cancer. This therapy is used with other treatments such as medicines, chemotherapy and surgery. When cancer spreads (metastasis) from one area of your body to your bones, it is called bone metastasis. Cancer that spreads to your bones can be painful and place you at a higher risk of breaking your bones.

  • External beam radiation therapy can decrease pain caused by bone metastasis. This treatment may be done after surgery to decrease pressure on nerves caused by cancer that has spread to your spine. It may also be done after surgery to repair your bones, or make them more stable. Radiation therapy after surgery can help prevent more surgery, and may help you be more active. If you have many tumors that cannot be removed, radiation therapy may be used to destroy the tumors. Your pain may decrease or go away within two days of a radiation treatment. In some people it may take two weeks or longer for the pain to go away.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.


  • When you have bone metastasis, your bones can crack or break after your treatment, or between treatments. Bone marrow cells can be damaged, decreasing the number of blood cells that your bone marrow makes. This makes it easier for you to get infections, and make you get tired very easily. High doses of radiation can weaken your pelvis bone, making it easier to break for up to one year after your treatment. Your skin over the area getting radiation may get red and very dry. It may flake off. Your skin may also get moist and bleed, or it may peel off. If your lower body (below your waist) is treated with hemibody radiation, you may get an upset stomach, throw up and have loose, watery bowel movements. If your upper body (above your waist) is treated , you may lose your hair or get pneumonia. It may take a few days or weeks before your pain decreases or goes away. After treatment your pain may come back, and you may need to have more treatments.

  • You may be at a greater risk of getting a blood clot in your leg or arm. This can cause pain and swelling, and it can stop blood from flowing where it needs to go in your body. The blood clot can break loose and travel to your lungs. A blood clot in your lungs can cause chest pain and trouble breathing. This problem can be life-threatening.

  • If you do not have external beam radiation therapy, the tumor may damage or pinch your nerves and cause pain. You may get weak, or lose feeling in parts of your body. If the tumor is in your spine (back bones), you may have trouble moving or feeling parts of your body. Tumors in your bones may also grow. The tumors can damage and weaken your bones, causing them to break easily. Your pain may not get better with other treatments such as medicine or surgery. When you cannot do things you usually are able to do, you may get anxious or very sad. Talk to your caregiver if you have questions or concerns about your condition, treatment, or care.

Getting Ready

The week before your treatment:

  • Ask a family member or friend to drive you home after your radiation treatment. Do not drive yourself home.

  • Ask caregivers if you need to stop using aspirin or any other prescribed or over-the-counter medicine before your treatment.

  • Bring your medicine bottles or a list of your medicines when you see your caregiver. Tell your caregiver if you are allergic to any medicine. Tell your caregiver if you use any herbs, food supplements, or over-the-counter medicine.

  • Tests: You may need to have blood and urine tests, and a biopsy. X-rays, a bone scan, computerized tomography (CT) scan, or magnetic resonance imaging (MRI) may also be done. Ask your caregiver for more information about these and other tests that you may need. Write down the date, time, and location of each test.

The night before your treatment:

  • You may be given medicine to help you sleep.

  • Ask caregivers about directions for eating and drinking.

The day of your treatment:

  • Write down the correct date, time, and location of your procedure.

  • What to bring: You may want to bring items such as a toothbrush and bathrobe.

  • Your caregiver may give you medicine to help prevent nausea (feeling sick to your stomach) and vomiting (throwing up) after your treatment.

  • You or a close family member will be asked to sign a legal piece of paper (consent form). It gives your caregiver permission to do the treatment. It also explains the problems that may happen, and your choices. Be sure all your questions have been answered before you sign this form.


What will happen:

  • You will be asked to change into a hospital gown, and taken to the room where the treatment will be done. You will be placed on a special table that can be moved to different positions. Your caregiver will move your body so that he can see the area that needs to be treated. Pillows or supports are used to hold you in place. Shields to block radiation from going to other parts of your body may be put over you. The machine that delivers the radiation is placed near where you are lying. The size and power of the beam of radiation is set by your caregiver. The machine makes a buzzing sound as it is turned on.

  • The machine sends a beam of radiation to the area where the cancer is. The narrow beam of radiation may be pointed at the tumor to kill only the cancer cells. A wider beam can be used to treat a larger area with many tumors. The beam may also be pointed at areas near the tumor to prevent cancer cells from spreading. You will need to lie still and breathe normally. You should not feel any pain, heat, or tingling during the treatment. Your caregiver will stay nearby in a room where you are able to talk to each other.

After your treatment:

You will be taken to a room where caregivers will watch you closely for problems. Do not try to get out of bed until your caregiver says it is OK. When you are OK, you will be taken to your hospital room, or be allowed to go home.

Waiting area:

This is an area where your family and friends can wait until you are able to have visitors. Ask your visitors to provide a way to reach them if they leave the waiting area.

Contact a caregiver if

  • You cannot make it to your treatment on time.

  • You have a fever.

Seek Care Immediately if

  • You have trouble breathing or chest pain all of a sudden.

  • You have fallen, and your arm, leg, or another part of your body is swollen, painful, or does not look the same as it did before.

  • Your pain has grown much worse.

© 2014 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

Learn more about External Beam Radiation Therapy For Bone Metastasis (Precare)