Low-Dose Radiation Treatments for Osteoarthritis
Osteoarthritis is a disease that impacts many patients every year. The World Health Organization has cited osteoarthritis as the second leading cause of disability in the United States. Osteoarthritis is associated with wear and tear of the joints and loss of cartilage (cushion) between the joints, leading to bone-on-bone contact. A variety of joints may be affected, including the knee, hip, hand, wrist, ankle, spine, and shoulder. Although common among adults 45 and older, osteoarthritis is not considered a regular symptom of aging.
Maxwell Tran, MD, Cancer Care and Radiation Oncology at Holzer Health System, says, “People with osteoarthritis usually experience inflammation, pain, stiffness, swelling, and mobility issues in their respective joints. It tends to get worse with activity and be more prevalent with age. This is different than rheumatoid arthritis, which is more of an autoimmune disorder.”
Dr. Tran talks about the ways in which people manage osteoarthritis, saying “There are non-pharmacological approaches, such as weight loss, support braces, and physical therapy. People can then progress to topical pain relievers, then systemic pain medications such as ibuprofen, then steroids or other injections in the joint. Surgeries and joint replacements are the final steps. However, if patients have tried systemic pain medications/steroid injections and are not yet ready for surgery, low-dose radiation is a great option that has been proven to help.” Medicare often covers this treatment for patients age 65 or older. Patients 50 years or older are also eligible medically, pending insurance pre-authorization.
Low-dose radiation for osteoarthritis works via an anti-inflammatory mechanism, relieving pain, improving mobility, and reducing further joint damage. Though some patients may have concerns about radiation side effects including radiation burns, because the radiation dose is very low (only 3 Gray compared to 70 Gray for a typical prostate cancer treatment), side effects are minimal and burns from the radiation are not expected to occur. One study reports only 1 out of 1,000 patients experienced mild skin redness. In addition, most of the joints treated are not near critical organs, so treatment is very low risk.
Dr. Tran states, “There have not been any reported cases of secondary cancers caused from low-dose radiation. In addition, they have not found any interference with future treatments that may be needed. Thus, if you ultimately needed a future joint replacement surgery or a future steroid injection, low-dose radiation treatments will not impact these options.”
Low-dose radiation for osteoarthritis typically entails 3 Gray of radiation given over 6 total treatments, with 2 treatments each week. This contrasts with cancer treatments, which typically involve daily treatments Monday through Friday for several weeks. Low-dose radiation treatments are completely non-invasive, so there are no injections or incisions. Overall, this treatment is a great option for patients who are not ready or suitable for surgery.
Overall, when it comes to low-dose radiation treatments for osteoarthritis, there is a 70 percent response rate to pain. Dr. Tran says, “Low-dose radiation carries a high chance of benefit with almost zero risk in terms of side effects. There has been good feedback from patients across the board. The majority of patients say their pain levels and mobility are improved.”
What parts of the body can be treated when it comes to low-dose radiation for osteoarthritis? While the knee is the most common part of the body that is treated, there are other areas that can be treated as well. This includes hips, hands, wrists, ankles, and other joints. “If you have multiple joints that need low dose radiation, we will treat one joint at a time. If you have success in one area, we can try other joints afterwards,” states Dr. Tran.
Low-dose radiation treatments for osteoarthritis can be repeated, if needed, after at least 3 months. Compared to steroid injections, low-dose radiation has the potential to give longer-lasting pain relief, with some studies showing up to 1-2 years. “Ultimately, we work in collaboration with our orthopedic surgery and primary care teams to select the most suitable treatments for each patient, whether that be lifestyle changes, medications, injections, radiation, or surgery,” says Dr. Tran.
Dr. Tran encourages patients to visit his office if they are interested in radiation as a treatment option for either osteoarthritis or a variety of cancers. He is located at the Holzer Center for Cancer Care at 170 Jackson Pike, Gallipolis, OH. For more information, or to make an appointment, call 1-855-4HOLZER (1-855-446-5937).
