Last week’s edition offered a brief mic drop. Published by ASTRO at the annual meeting and in March at ACRO, low dose radiation protocols were presented as a non-invasive alternative to medications and joint surgery. It is safe (very low dose, delivered over ten treatments to the joint- not impacting organs) and now, with longer followup and placebo trials, found to be effective. European countries have used this for some time and the presentation came form Korea, but I have treated these patients sporadically and find it very well tolerated, although I do not have the long term results regarding their pain improvement yet.

After 4 months, 70% of patient receiving a total of 3 gy ( the dose often used for just one treatment in cancers) met criteria. Meaningful improvements were detected in pain, stiffness and physical function.* 32.5 million US adults suffer when the cartilage breaks down and bones wear over time. If the joint is destroyed and cartilage gone, radiation will not repair. But I love the idea of trying a non -invasive approach if possible.

I have personally seen this used for shoulder, hands, wrists, hips and knees, I have not for spine. More will come as clinics add this management of benign disease to their plans of care. When Taylor completed her breast radiation, she returned a few weeks later for her knee. Walt had dupuytren’s contraction treated in the hand. Mark plays keyboard and guitar and enjoys his gigs post retirement, but the arthritis is crippling his ability to perform. If this could at least halt progression for a time, he would be delighted.

So I have decided to explore clinics close to home and may consider if the Radiation Oncologist offers this opportunity, before accepting a knee replacement. If you or your loved one has a question, contact your local cancer center dept. of Radiation Oncology and ask if they are treating patients with arthritis and request a consult. Bring your film disc and reports to see if you qualify. I will keep you posted on my own effort- our senior appendages need some TLC and even better if we can avoid a big surgery to keep up our own momentum.

*ASTRO news and publications, September 28, San Francisco