Low-dose radiation therapy helps relieve osteoarthritic pain

Before Barbara Coates met radiation oncologist John Plastaras, it was impossible for her to walk without excruciating pain. Within 24 hours of her first treatment session with him, she was moving better than she had in years and crying tears of joy. The 58-year-old Montgomery County resident had severe osteoarthritis, a condition where the cartilage that cushions the ends of your bones wears down over time. Without enough cartilage, bones rub against each other, causing pain, stiffness, and swelling—for some patients, with every step.

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Coates was one of the first patients at Penn Medicine to receive low-dose radiation therapy to treat her osteoarthritis. While radiation therapy is most often used for cancer treatment, it’s gaining traction as a tool for other non-cancerous conditions, and Penn Medicine physicians are leading the charge for implementing low-dose radiation therapy in a patient-centric fashion while advancing research on these approaches.

“I’d been in crippling pain for at least five years,” Coates recalls. Her osteoarthritis was exacerbated by two other conditions called Ehlers-Danlos syndrome (EDS) and mast cell disease. EDS is an inherited condition that results in overly flexible joints and fragile skin, while mast cell disease causes sensitivity to drugs and allergens in the environment. The EDS meant that she needed to exercise daily—no matter how painful it was—to strengthen the muscles holding her joints together. The mast cell disease meant that she wasn’t a good candidate for injections or surgery, the typical treatments for osteoarthritis.

As a former Division-1 athlete and USA Field Hockey Junior National Team coach, who spent time managing a physical therapy clinic and working in academic medicine administration, Coates was well prepared to face the physical challenges of her ailments head on: “I have the attitude of an athlete: let’s keep going,’” she says. So, when her physical medicine and rehabilitation physician in Elkins Park told her that his brother, a radiation oncologist at Penn Medicine, was piloting a new treatment, Coates was all in to try it.

So far, Plastaras and his team have treated more than 150 patients with osteoarthritis and a dedicated clinic is opening at Penn Presbyterian Medical Center, where the health system is currently expanding its radiation therapy capabilities and building a fourth proton therapy location. The low-dose radiation treatment is designed for arthritis in joints that are not part of the spine, like the ankle, knee, or wrist. It’s limited to patients who are not yet candidates for joint replacement surgery, or who have had persistent pain or dysfunction despite trying other therapies.

“Since this treatment is relatively new to the U.S., we’re going to study it in a clinical research protocol, meaning we’ll track the treatments and outcomes, so we can report on what works and what doesn’t,” Plastaras says.

Read more at Penn Medicine News.