Treatment FAQs

If you have had radiation for painful bone mets and are still suffering from pain, or you have reached a maximum dose or refuse to have radiation, Exablate may be a treatment option for you.

However, your doctor is the best person to ask this question as Exablate is not suitable for all patients.

In general, people who cannot undergo MRI imaging will not be able to have the focused ultrasound treatment. This includes patients with metallic implants, patients who are claustrophobic, patients who are allergic to contrast agents (a dye used to see blood vessels during MR imaging), or patents weighing more than 135Kg | 298 lbs.

You should let your doctor know if you are allergic to certain medications or contrast agents, and if you have metallic implants or medical patches, or if you weigh more than 135Kg | 298 lbs. In addition,  you should discuss with your doctor the following:

• Your personal health history, including any allergies you may have
• Any recent illnesses
• Any medical conditions you have, including if you are on dialysis or are pregnant
• Any skin scarring over the areas that would be treated
• Medicines, including both prescription, over-the-counter and herbal medicines or dietary supplements you are taking
• Any implants and/or medical patches and weight
• Recent activities, including air travel
• Your level of normal physical activity

Previous MR or CT scans

Overall, when used appropriately, Exablate is a safe procedure for pain palliation of bone metastases with minimal risk. Infrequent complications that have been reported following the Exablate treatment are listed below. You should consult with your doctor about the following risks:

• Dizziness
• Back or leg pain that persists for a few days
• Mild skin burns (rare)
• Allergic reaction to contrast media or medications
• Nausea and/or fever
• Transient discomfort or pain
• Neuropathy
• Blood in urine or kidney or bladder infection due to urinary catheter
• Bruising at site of IV
• Blood clot or DVT after the procedure, which, if not treated quickly, may cause long term complications such as muscle, heart, brain, or lung damage

There is a chance that the treatment may not be successful and you may require an alternative treatment therapy to improve your symptoms.  This procedure does not treat the underlying disease nor prevent progress of the disease.

Any questions concerning risks and complications of the procedure should be discussed with your physician.

Following the treatment which lasts 3-4 hours, you will rest for an additional 1-2 hours until the sedation wears off.  Exablate can be performed as an outpatient procedure or your physician may choose to keep you overnight. You will be released from the hospital with medical instructions.

Occasionally patients may experience some pain from lying on the treatment bed. Prior to your release from the hospital, you should be aware of who to contact in an emergency.

It is important that you discuss with your physician ahead of time who will handle your follow-up care. Arrange follow-up phone calls and/or office visits for after the procedure.

Most patients feel pain relief within a few days and many reduce their intake of pain killers. The published results of patients suffering from pain due to bone metastases show that 56% of patients undergoing Exablate reported substantial pain relief within three days of their treatment and nearly 70% experience significant pain relief at 10 days after the treatment, lasting for 3 months.[1] Almost half of the patients who experienced pain relief decreased their opioid and non-opioid analgesic intake following treatment.
[1] Hurwitz et al, Magnetic Resonance–Guided Focused Ultrasound for Patients With Painful Bone Metastases: Phase III Trial Results, JNCI J Natl Cancer Inst (2014); https://www.accessdata.fda.gov/cdrh_docs/pdf11/P110039c.pdf.