sorry to hear your dad also has to fight bone mets. They seem to cause more impact on the life than the primary cancer (the cholangiocarcinoma) ever did.
So far I had not heard about tomotherapy (and I thought I had found out about all options) but am trying to get more information about it. Our problem might be the size of the rib met. It is rather large, too large for cyberknife. Do you have any idea about what sizes of bone mets can be treated with the helical tomography?
We are also looking into the ablation techniques such as RFA etc. and other options such as cementoplasty. It might just be that a filling with bone cement is not feasible because it's got to be contained inside the remaining bone. But two ribs have been partially been destroyed, eaten away by the cancer.
He's had the maximum dose of conventional radiotherapy to the bone met. The initial response was very good, it shrunk and the pain went. But then it started to grow again and the pain came back stronger than before. He's been on Oxicodone before but had too many side effects. So that's why he is on Morphine at the moment, which seems to have less side effects in his case but makes him extremely tired. There are so many things he would like to do but often he's even too tired for a 500m walk.
It is so frustrating to see him in a state like this and then in UK with the NHS things move very slowly (the cancer is growing faster than they make any decisions). The oncologist is a nice person but very young and has imo not a lot of experience. Some treatments on my list (gave her a list with different options last time which she should look into and advise accordingly) she admitted that she'd never even heard about it, like stereotactical radiotherapy or HiFU... so we had to organise getting the medical files and CT scan images to consult with the cyberknife team in a private hospital ourselves. Standard treatments like Bisphosphonates weren't considered...
She'd happily just increase the Morphine and painkillers regularly which I think is a disgrace. I don't think we are yet at the point where this is the only solution. It's like sedating the patient instead of trying to treat. There won't be curative treatments but only palliative ones but at least more options should be explored.
The more I think of it, the more it upsets me... sorry for venting here... but like today: he insisted on cutting the grass (he won't let me do it) which is not really a demanding task, the grass being only 3cm long and the petrol lawnmower not being heavy but afterwards that was him knackered and in agony again having to top up with additional liquid Morpine...