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Cancer and Health

Strontium-89, Metastron, Morphine, Heroin

This Christmas Cancer pain can be relieved by a single injection

By Dr. W. Gifford Jones

This Christmas is it possible to eliminate the agony of metastatic bone pain without using morphine or heroin? Simply by giving patients a single injection that cures the pain for up to six months? It sounds like science fiction. But a new drug, Strontium-89 (Metastron) is now being used to treat patients in several countries who suffer from the terrible pain of cancerous bone lesions resulting from prostate and breast malignancy. How does Strontium-89 work and why isn't it being used in this country?

Radioactive P-32 phosphorus has been used for over 20 years as a way to attack bone cancer. It worked well on metastatic lesions, but it was highly toxic to patient's bone marrow. Later researchers in London and Edmonton switched to Strontium-89. So far over 500 patients have been treated with this drug.

75 per cent of patients received some alleviation of pain and 20 per cent total relief from metastatic pain. Patients who responded favourably started to have remission of pain in 10 to 20 days. They continued to be pain free anywhere from 4 to 12 months without the use of painkillers. Others who were only partially relieved of pain nevertheless noted a "levelling out" of their pain.

How does Strontium-89 work? Dr. A Porter, Head of Radiation Oncology at the London Regional Cancer Centre, says that bone is a living tissue and that calcium is constantly being built up and broken down in the bony matrix. Luckily Strontium imitates calcium and gravitates to metastatic lesions where their is rapid activity in the bone.

I asked Dr. Porter the obvious question," Does radioactive Strontium pose a health hazard to either cancer patients, medical personnel or the patient's family?" Fortunately Strontium-89 is a beta-emitter so unlike protons which go on forever, beta electrons come to a halt very rapidly. Patients can therefore be given an injection as an outpatient and return home.

Minimal precautions are required initially. Patients must double flush the toilet for a few days and spilled urine should be wiped up with a tissue which is then flushed away. Soiled clothing should be washed separately without delay. These precautions have to be followed for one week. During that time there's no need for patients to keep away from family and friends.

Dr. Porter claimed there have been no acute reactions after the injection. A few patients have experienced a transient "pain flare" about 48 hours following the injection. This pain lasts for just a few days and is easily controlled by painkillers.

It's estimated that metastatic lesions receive 10 times the radiation dose of normal bone tissue. However, the bone marrow which plays a major role in manufacturing various components of the blood is temporarily weakened by Strontium-89. This causes a 30 per cent depression in platelet count which recovers in about six months.

So why isn't Strontium-89 being used routinely for patients suffering the agony of metastatic bone cancer? The explanation it seems is that Strontium-89 is neither fish nor foul. Since it's a radioactive isotope it's not classified as a normal drug. Nor is it similar to classical radiation therapy. As a result, it's fallen between the cracks of bureaucracy and currently no mechanism has been established to cover this treatment.

Bureaucrats in the Ministry of Health should quickly find a way to expedite the use of Strontium-89. During visits to English hospitals I have seen patients on massive doses of heroin to control the pain of metastatic bone lesions. The worst cancer pain, it's agreed, is that which involves bones. On humanitarian grounds alone, Ministers of Health should place the availability of Strontium-89 at the top of their list of priorities.

But apart from humanitarian grounds there's also an economic reason for cutting through red tape to allow the use of this treatment. A single injection of Strontium costs $1,600.00. This figure may initially seem to be a large sum for one injection. But what's the alternative?

Few people realize the huge cost of painkillers such as morphine, heroin and dilaudid. Patients in severe pain from metastatic bone lesions who require massive amounts of these drugs cost taxpayers hundreds of dollars every day. Some patients require these narcotics for several months. The eventual cost is tens of thousands of dollars. $1,600.00 then becomes a paltry amount.

Can medical consumers help to push this matter to the top of the priority list? If you have a loved one suffering from metastatic bone cancer write, to your Provincial and Federal Health Ministers. Urge them to act on this humanitarian issue of Strontium-89. Lets remember as we enter 1991 that needless cancer pain will continue in this country until the public screams loud enough to stop it.

This is the 16th year I've had the pleasure of wishing readers a merry Christmas. And special thanks to those who have helped the W. Gifford-Jones Foundation purchase computerized pumps to ease the pain of terminal cancer patients.


W. Gifford-Jones M.D is the pen name of Dr. Ken Walker graduate of Harvard. Dr. Walker's website is: Docgiff.com

My book, �90 + How I Got There� can be obtained by sending $19.95 to:

Giff Holdings, 525 Balliol St, Unit # 6,Toronto, Ontario, M4S 1E1

Pre-2008 articles by Gifford Jones
Canada Free Press, CFP Editor Judi McLeod